Former President Donald Trump is still widely revered in this rural swath of Virginia’s Shenandoah valley, with lawn signs and campaign flags adorning the landscape. Vaccines to combat the coronavirus, on the other hand, aren’t as common.

Laura Biggs, 56, who has already recovered from the infection, is reluctant to get the vaccine. Assurances from the CDC and the Food and Drug Administration have done nothing to alleviate her concerns that the vaccine might cause death.

“As far as I’m concerned, I don’t need the vaccine at this time,” she said. “And I’m not getting the vaccine until it’s been thoroughly tested.”

That sentiment exemplifies the difficulty that public health officials will face as the United States ramps up its attempts to achieve universal vaccines that could bring an end to a catastrophic pandemic that has claimed the lives of more than 530,000 people. The campaign may falter if it becomes another litmus test in America’s raging culture wars, just as mask-wearing mandates were at the outbreak of the virus.

While vaccine apprehension is on the decline in general, Republican opposition remains steadfast. According to a new poll from The Associated Press-NORC Center for Public Affairs Research, 42% of Republicans believe they would almost certainly not get the shot, compared to 17% of Democrats — a 25-point gap.

Although demand for vaccinations continues to far outstrip supply in most parts of the world, there are already signs of registration slowing in some areas. And, according to Ashish Jha, dean of Brown University’s School of Public Health, the effect will worsen when supply starts to exceed demand in late April or early May.

“This is going to be a massive problem,” he predicted. “So if we stay at 60 or 65 percent vaccinated, we’ll continue to see major outbreaks and real problems in our world, and getting back to what we think is natural will be much, much harder unless we can get that number higher.”

Ron Holloway is a prime example of the difficulties that health officials face. The virus is more likely to infect the 75-year-old Forsyth, Missouri, resident and his 74-year-old companion. He was adamant, however, that they “don’t do vaccines.”

He described the virus as “blown way out of proportion and a bunch of nonsense.” “We haven’t lost a single percent of our population yet. It’s completely absurd.”

Biggs is a Republican from Virginia who voted for Trump. In all aspects of the pandemic, she said, partisan divisions were evident among her friends and family, including vaccine acceptance.

“Left-wing family members haven’t left the house in a year,” she said, while she and her husband “went everywhere.” In 2020, we traveled more than we have in every other year of our lives…. I simply assume there was panic around it. And people, in a way, placed themselves in boxes.”

The resistance is much stronger for Holloway, who works in real estate. In general, he is critical of vaccines, as well as the government and pharmaceutical firms. He claims the virus was exaggerated in order to deny Trump a second term, which he sponsored.

“I simply do not believe that vaccines are appropriate. Holloway said, “I don’t believe it is the way God intended for us to be.” “The bulk of my colleagues and associates, including the people with whom we attend church, do not wear masks or receive shots. I’m not sure why people are so scared of it. It’s not even close to being as bad as the flu.” In reality, COVID 19 is much more lethal.

Republicans have been wary of the pandemic from the start. According to AP-NORC polling, they are less concerned about illness than Democrats and are more opposed to bans and mask-wearing. Many people asked why they should be early adopters of vaccines with possible side effects because they weren’t concerned about the virus and had already moved on in interviews over the last few days.

However, Republican pollster Frank Luntz is concerned about vaccine resistance. On Saturday, he convened a focus group with 20 vaccine-skeptical Trump voters and try to find out what kinds of messages could convince them to take the shots. Republican congressional leaders, including House Minority Leader Kevin McCarthy, former New Jersey Governor Chris Christie, and former CDC Chief Thomas Frieden, attended the meeting.

“The overriding message from this session is that it will be extremely difficult,” he said. “Those who voted for Trump and refuse to take the vaccine are adamant in their refusal. They don’t believe in science. They don’t trust the media and feel that all is partisan.”

“You have to start with the truth and then add on the emotion” to persuade them to change their minds.

“You have to understand and empathize with their fears and reservations,” he said.

Some also criticized Trump, who spent most of the pandemic downplaying the virus’s risks, even after he was admitted to the hospital and needed supplementary oxygen and experimental treatments. Trump did get the vaccine before leaving office, but he did so privately and in secret, refusing to reveal the information until this month.

And, despite urging Americans to get vaccines in a recent address, he has done little to support the initiative and is noticeably absent from an ad campaign featuring former Presidents Barack Obama, George W. Bush, Bill Clinton, and Jimmy Carter, as well as their wives.

Dr. Anthony Fauci, the government’s top infectious disease expert, said on Sunday that Trump’s “incredible impact” among Republicans would “make all the difference in the world” in overcoming apprehension.

However, Luntz claims it is too late. An advertisement featuring former presidents made participants in his focus group less likely to want to get vaccinated. Participants have reported that they had more confidence in their physicians than they did in the former president.

“My recommendation to politicians is to step back and hand over power to the medical professional,” he said.

Meanwhile, officials from the Biden administration and others claim that various outreach attempts are underway to reach out to Republicans, especially evangelical Christians. Local physicians, ministers, and priests have been encouraged by President Joe Biden to talk about vaccinations in their neighborhoods.

The Association of State and Territorial Health Officials’ chief medical officer, Marcus Plescia, said, “We need to think about how to meet the people who are maybe more reluctant.”

Others, on the other hand, are ready to shoot as soon as their turn comes up.

Lenton Lucas, 51, of Arlington, Virginia, works for his brother’s Front Royal restaurants and has spent most of the pandemic serving meals to those too afraid to leave their homes. Lukas, a Black Republican who voted for Trump, said that in his neighborhood, vaccine access is much more of a problem than vaccine hesitancy, with residents desperate to get vaccines amid a long history of prejudice and mistrust.

And, though he says he’d like to learn all about the vaccines because “all has pros and cons,” he’s ready to have his so he can spend more time with his family and his grandma, who is 70 years old.

“I have to do what I have to do in order for her to be comfortable,” he said. “It must be completed.” This article was co-written by Associated Press authors Emily Swanson and Zeke Miller in Washington, Michelle R. Smith in Providence, Rhode Island, and Anila Yoganathan in Atlanta.