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Why Are Southern States Lagging In Vaccinations?


Eight of the 10 U.S. states with the lowest levels of vaccinations are in the South. In much of the northeast, more than half of residents are fully vaccinated for COVID. Most southern states are stuck at less than a third of residents. Blake Farmer of member station WPLN in Nashville has this story on efforts to inspire more interest in immunity.

BLAKE FARMER, BYLINE: The unvaccinated still far outnumber those who've taken the shot, especially in more rural parts of the South. Skeptics are pretty easy to find on the town square of Lebanon, Tenn., an hour east of Nashville.

PATRICIA WRYE: I'd like to wait and see how this first wave of inoculations go, and I might consider it later.

FARMER: Patricia Wrye is 45 and says she's not an anti-vaccine person. She takes the flu shot usually, but not one for COVID, even though there's near universal agreement among doctors that it's safe and effective.

WRYE: The experts have yo-yoed on their opinions so many times. I don't trust that at this point.

FARMER: So instead of health officials making the case, states are tapping into some southern star power, with PSAs from the likes of longtime Alabama coach Nick Saban.


NICK SABAN: College football fans and players both want full stadiums this fall. Let's make sure we can safely make this happen by getting vaccinated.

FARMER: Tennessee is trying out more tailored messages after working with focus groups of vaccine naysayers. They found that rural white residents trust their doctor's opinion above all, so there's an ad for them, featuring a young man buying a box of nails at a small town hardware store.


UNIDENTIFIED ACTOR #1: (As character) There are a lot of opinions being shared. But I had the chance to talk with my doctor about my concerns.

FARMER: Black residents, however, favor the Centers for Disease Control and Prevention, so there's an alternate version showing up in their social media feeds.


UNIDENTIFIED ACTOR #2: (As character) I checked what the CDC says and spoke with my doctor about the potential side effects. It definitely made me much less anxious.

FARMER: Too soon to know if the 30-second spots are doing any good. Financial incentives are showing promising signs in a few states, though they've been slow to catch on in the South. Ohio is now giving away $1 million a week. The announcement of the lottery is being credited with reviving the pace of vaccinations, especially in young people. New York and Maryland are now following suit, but they're already above average nationally. In Tennessee, 24-year-old Paola Delvalle says she'd have to think twice if money were on the line.

PAOLA DELVALLE: You give them $100 to put a shot in them, I don't think they'll ask questions. They'll just think of what they'll do with that $100. I would think that.

FARMER: Delvalle is expecting her first child, so she's decided to wait on her vaccine. Either way, Tennessee is not contemplating financial incentives. Neighboring North Carolina, which already has some of the region's highest vaccination rates, is starting a program offering $25 cash cards in a handful of counties that need a boost. Dr. Mandy Cohen, who leads the state's Department of Health and Human Services, says they're also available to anyone who just drives someone to get a shot.

MANDY COHEN: This is a team sport, right? So we wanted to recognize that we need everyone to help.

FARMER: The problem is that the urgency is gone. Even in the least vaccinated southern states, infection rates and hospitalizations are still going down. Epidemiologist Leslie Waller leads community vaccine events in Nashville and says the complacency is concerning because it's not just vaccinations that are dropping. There's been a sharp decrease in people getting tested for COVID. So epidemiologists like Waller fear they don't know how many cases could be lurking.

LESLIE WALLER: We are not necessarily out of the woods. You know, we're not talking about just the short term here.

FARMER: Waller notes that heading into last summer, COVID was rather calm across the South, too. And then it wasn't.

For NPR News, I'm Blake Farmer in Nashville.


Blake Farmer