Even as Kansas remains far from reaching the coveted public health standard of herd immunity against COVID-19 — essentially starving off the virus because it runs out of vulnerable bodies — more than 60 counties just turned down their weekly allotment of vaccine doses.
Not long ago, local health officials struggled to get enough doses for people clamoring for protection in a pandemic. Now they’re straining to get people willing to take their shots — and sorting out how to make the most of doses given out to smaller groups.
Consider Barton County in central Kansas. It’s named for Clara Barton, the founder of the American Red Cross. So far, it’s given at least one dose of the vaccine to about 30% of its adults compared to 36.4% across the state.
A decline in demand
“Herd immunity is great and 80% sounds wonderful,” said Karen Winkelman, a nurse and the Barton County health director. “But I don’t think we would ever reach that.”
She’d be happy if half the adults in Barton County got vaccinated. Herd immunity typically requires that more than three-fourths of a population get protected against a virus.
If counties like Barton plateau in that 30 to 50% range, experts typically worry that the community remains vulnerable to sickness, to overwhelmed hospitals and to avoidable deaths.
“That’s a problem,” said Dennis Kriesel, the executive director of the Kansas Association of Local Health Departments. “Everyone would agree 30% is not going to do it.”
Settling for lower immunization rates, he said, invites more waves in the deadly pandemic.
“It would mean that we would still have a great likelihood that COVID is going to stay present in the community,” Kriesel said.
The 50% of a county that’s vaccinated will experience more freedom to socialize without masks or to eat at indoor restaurants.
“But on the flip side, with so many people that are unvaccinated, if (COVID-19) stays and takes root and continues to spread, that’s what develops the variants, because these things are mutating,” Kriesel said. “They’re always mutating.”
Barton County isn’t alone. This week, 62 counties declined their weekly allocations of vaccines from the state.
On weekly calls with the Kansas Department of Health and Environment, Winkelman said, “there has been talk of that very thing. ... ‘Do you feel like you’ve saturated your community?’ ‘Maybe.’”
Cheyenne, Decatur, Lane, Phillips, Sheridan, and Woodson Counties have skipped their allocations for the past four weeks. Their immunization rates range from roughly 26% to 32%.
Demand for vaccinations is stagnating. A spokesperson for Gov. Laura Kelly said that Kansans may feel less threatened by the pandemic after a steady drop in infections, hospitalizations and deaths.
“There seems to be a lack of urgency with some individuals waiting to get a vaccine when it is most convenient,” the governor’s office said in an email.
Counties can also receive vaccines through federal programs like the Retail Pharmacy Program and the Federal Dialysis Program, and from federal agencies like the Department of Defense or the Department of Veterans Affairs.
Kriesel said counties could be skipping their allocations for other reasons: vaccine hesitancy and a part of the population that’s indifferent to the vaccine.
“It’s not a question of safety. … It’s a, ‘Yeah, but if I get COVID, I might have a sniffle,’ sort of thing,” he said. “So, I don’t know if I count those as vaccine-hesitant. People are more just disinterested.”
Changing Strategy
Kriesel said there are plans underway to target younger high school-aged populations, which make up a large number of new cases in the state.
“I’m hoping that will get us a decent way further along on that path,” he said. “If that gets us the 30 to 50(%), that's great, but is still not enough.”
Meanwhile, the state is creating a public health campaign to target people who are indifferent or reluctant to get vaccinated.
The minimum Moderna shipment comes with 10 vials. Once a vial is punctured it must be used within 12 hours. The minimum Pfizer shipment is 195 vials. They last just six hours after the seal is broken.
“Even if you’re doing a good job — and I’m sure Kansas is — of spreading the vials across providers, the providers themselves are hesitant unless they have actually the right number of people lined up for that day to puncture that vial,” said Claire Hannan, the executive director of the Association of Immunization Managers.“The packaging is meant for high volume and we just don’t have that high volume in rural areas,” she said.
Hannan said rural areas may need to shift from mass vaccination sites to private providers who are trusted in the community, and retail pharmacies that may have closer relationships with local patients.
That’s the direction Barton County has moved toward. The county accepted 500 doses this week. Now it’s offering walk-ins at the health department for the first time since January, and it’s sharing some of the county’s allotment with the three area hospitals.
But Winkelman, the nurse and county health director, said she won’t twist people’s arms to get vaccinated.
“I would like to see the number higher,” she said, “but I can also respect people’s decisions.”
Abigail Censky reports on politics for the Kansas News Service. You can follow her on Twitter @AbigailCensky or email her at abigailcensky (at) kcur (dot) org. The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
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