The Biden administration is moving into a new phase of its campaign to vaccinate as many Americans as possible for the coronavirus, one where the government may not always be the best messenger to persuade people to get their shot.
So it's working to bring together hundreds of local and national groups into something it calls the COVID-19 Community Corps, enlisting people to help their friends, family and neighbors make appointments and get access to vaccines.
On a recent evening, Surgeon General Vivek Murthy led a Zoom call for people who have signed up to help. "I just want to remind you again, which we will keep doing again and again and again, that this is not just a government-driven effort," he said.
"It's about creating a community where we can celebrate what people are doing," Murthy said. "Where we can share best practices, where we can inspire one another just as we learn."
The country is nearing the point where vaccine supply will outstrip demand. It was only this week that every state lifted restrictions on who could be vaccinated, and just under 50% of adults have yet to get their first shot.
The people who went out and got vaccinated right away were the equivalent of the people who wait overnight at the Apple store for the latest iPhone, said Dr. Ashish Jha, dean of Brown University's School of Public Health.
But those who have yet to get a vaccine include people who can't or won't jump through a lot of technical hoops to land an appointment. Others have questions or concerns about getting vaccinated. But Jha said it would be a mistake to label them as hesitant or resistors.
"That's hugely problematic because I don't think they are," Jha said. "I think actually there are lots of people who are perfectly happy to get a vaccine but aren't desperate for it, aren't convinced they need it badly and we still make it too hard for many people."
It can be harder to access vaccines in some rural areas, and an NPR analysis of county-level vaccination data from the Centers for Disease Control and Prevention shows signs of an emerging rural-urban divide in vaccination rates.
But the list of founding members of the administration's COVID-19 Community Corps is dominated by progressive organizations, raising the question of how the government plans to reach conservatives and people in rural areas where polling reveals greater vaccine hesitancy.
Administration officials are aware of the limits of their influence, said Terri Moore of the American Farm Bureau Federation.
"To their credit, when the White House reached out, they acknowledged that they are not going to be the strongest voice necessarily in some rural communities and they need those strong trusted voices," Moore said.
The Farm Bureau, with its 6 million members and 2,800 county affiliates, was eager to jump in and help. They've joined Murthy's Zoom calls and shared what works.
"In Idaho, one of our members, a potato farmer, hosted a clinic on their farm and got 350 people vaccinated in a couple of hours," Moore said. The Farm Bureau shares these stories with their members in hopes that it will inspire others to do the same.
Improving access in rural areas is also critical, said Alan Morgan, chief executive of the National Rural Health Association, whose group is part of the Community Corps and has sent suggested talking points to the Biden administration.
"Rural's not a small version of urban," said Morgan. "It's a unique community unto itself and it's not all middle-aged white guys either." Some rural areas have large Latino and Black populations.
"The messaging in a rural context is, 'Forget what the federal government's telling us,' " Morgan said. "As a community, what do we need to do to keep our family, friends and loved ones safe? What do we have to do as a community? And that's a huge communications shift than what is currently ongoing."
Connecting to someone you know
That's the approach Dr. Ada Stewart has been taking. She practices at a community health clinic in South Carolina and is also president of the American Association of Family Physicians. She says transportation is a major issue for her rural patients. They can't drive two hours to a mass vaccination site. There's also a matter of trust.
"I had patients that said, 'Uh ah. I'm gonna wait until Dr. Stewart can give me my vaccine. I don't trust anybody else,' " Stewart said.
Her clinics now have enough doses available that if a patient comes in for another reason, they can usually give them a COVID vaccine right then and there. Some of her patients do have questions or are on the fence about getting vaccinated, but she says telling them that she is vaccinated often helps.
And when it comes to success stories, there often aren't any federal government fingerprints at all. In Greenbrier County, W.Va., getting people vaccinated became a big community-wide volunteer effort.
"We have yet to lose a dose," said Julian Levine, who does community outreach at the West Virginia School of Osteopathic Medicine, which has been working closely with the Greenbrier County health officer.
Sometimes that's meant running the Saturday vaccine clinic extra late. And in one case, the county health officer and her staff took doses over to a local restaurant to make sure they didn't go to waste.
At the start of the pandemic, the school jumped in to help the county. Then when vaccines became available, they helped build a system for getting shots in arms, mobilizing volunteers and helping on the technology side. In the end, though, Levine credits the personal touch.
"Really, it's connecting to people that we know one-on-one," Levine said.
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