A close-up picture of a nurse giving a vaccine to a patient (Photo illustration by AdobeStock)
Garfield County counted the lowest coronavirus vaccination rate in Montana this week, with just 21 percent of the population fully vaccinated, according to data from the Montana Department of Public Health and Human Services.
Tied at second lowest, Powder River and McCone counties weren’t too far ahead at 23 percent.
On the other end of combatting COVID-19?
Missoula County hit a 59 percent vaccination rate, the highest in Montana at least on Thursday. Deer Lodge and Silver Bow Counties weren’t far behind, at 55 percent and 56 percent, respectively.
Herd immunity for COVID is estimated to be at least 70 percent, possibly 90 percent.
The split is wide, but public health officers at both ends of the spectrum said outreach is a challenge. Overall, Montana sits at a 46 percent vaccination rate.
“We are really happy to be where we’re at, but we still have a long way to go if we’re going to hit herd immunity,” said D’Shane Barnett, head of the Missoula City-County Health Department.
Darlynn Williams, at Powder River County Public Health, said people still hold conspiracy theories about the vaccine.
“So any mitigation that we do to try to slow the spread or increase the uptake of the vaccine is met with a lot of resistance,” Williams said.
People in agricultural areas contend with yet another factor, said Anne Miller, public information officer for Garfield County. Last year’s pandemic made for “one whopper of a year,” and she said many people are heading into 2021 with their tanks on empty.
Those whose livelihoods are linked to agriculture have an added challenge ahead. Miller said their priorities might be figuring out how to keep their animals fed in the face of drought.
“A lot of people are probably going to say, ‘I’ll deal with this vaccine business later. I’ve got to go out and deal with these cows,’” Miller said.
In Powder River, where 344 people are fully vaccinated, Williams said access to the shot isn’t a problem, and she believes most people aren’t on the fence when it comes to vaccinations.
“I just really feel like we’re fighting a losing battle. The people who are interested in getting the vaccine have already got it, I think,” Williams said.
Challenges include people who feel like the government wants to force them to take the vaccine, and county leaders who don’t support public health efforts — or those who do but don’t make their support publicly known, she said.
The county had just four active cases as of Thursday, but Williams is worried about a fall outbreak: “Our elderly and most vulnerable aren’t covered real well. They’re over 50 percent, but just barely. That leaves a lot of people who are still vulnerable to the virus.”
In McCone County, public health nurse and director Sue Ann Good has been laughed at for wearing a face mask. She said the vaccination rate is disheartening, but medical professionals can’t force people to get shots.
As of Thursday, 334 people were fully immunized in McCone County. Good said the county has held 24 vaccination clinics since Dec. 30.
“We’ve been working our butts off out here, and you can’t make people get a vaccine,” she said. “And that’s the bottom line.”
Miller said flexibility is key in Garfield County, where 228 people are fully immunized. For example, she said, if someone can’t get off work early but wants a vaccine, the clinic stays open longer.
It might take an hour or hour-and-a-half to drive to the clinic, depending on the weather, she said. Rain will muck up the roads, though it’s been dry of late.
“The roads are not muddy, so the transit times are faster,” she said.
Garfield County had no active cases as of Thursday, and Miller said that’s one plus side to the relative low density: “Isolation is a beautiful thing in both animal and human health.”
She said a lot of counties with lower vaccination rates are also agricultural communities, and this year, people are worried about the lack of rain and how the markets are looking.
So even though the county counters inaccurate information about the vaccine, she said it’s hard for people to make clear choices when they are overwhelmed with stress. And medical providers need to be understanding of the public.
“It can overwhelm your brain and system to the point you don’t want to deal with it anymore,” Miller said.
Alison Brennan, extension mental health specialist at Montana State University in Bozeman, said agricultural producers and families experience distinct forms of stress. To a large degree, she said it’s a pile up of stressors.
“And they are chronic, which makes a big difference,” said Brennan, assistant professor at MSU.
Those include high debt loads, she said; it’s difficult to work in agriculture without debt due to the sheer expenses associated with tending crops and caring for animals and maintaining machinery.
Producers worry about commodity prices, weather, natural disasters, physical injury, and they experience geographic and social isolation. Many of those issues are unpredictable and uncontrollable from an individual standpoint, she said.
When people are stressed, blood flow in their brain changes, and it’s more challenging to engage the frontal cortex, associated with making decisions, she said. Even day-to-day decision-making can feel oppressive.
Add a pandemic and decision about a new vaccine to a farmer’s list of considerations in a drought?
“That is just truly more challenging when you’re under stress,” Brennan said.
Missoula County is urban relative to Montana, but like health officials in counties with low vaccination rates, Barnett wants to see more people get shots, and he said education takes a lot of work.
At the same time, he said he’s happy with the number of people who are fully immunized, and he attributes the high vaccination rate to health department partnerships.
“The Missoula City-County Health Department is not doing this all on its own,” Barnett said.
He pointed to All Nations Health Center, where he previously worked, Southgate Mall, Missoula County Public Schools, the University of Montana, Partnership Health Center, and the hospitals as among the partners. With those organizations, he said, the health department was able to meet people where they were at and eliminate many barriers to access.
“By working together, we’re able to get out to more people more quickly,” he said.
He too said combating bad information is hard work, and education is the heaviest lift. It’s an ongoing pursuit, he said, and it’s intensive.
It means going out into the field and asking people what they are hearing, crafting a message in response to any misinformation or disinformation, and then figuring out where people will receive the message, he said. (The county is posting Instagram Reels and is on TikTok.)
“We have to find ways to reach people where they are and get them the information in a way that they can understand,” he said. “It takes time and effort, and it’s worth it.”
The next couple of seasons could bring more challenges. This week, the former chief of the Food and Drug Administration warned of a possible coronavirus spike in the fall and said surges are already taking place in some states.
Meanwhile, drought and fire are hitting Montana.
“There’s a lot of worry about what the coming months are going to bring,” Williams said.
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