Public health college dean: Information, not nagging, key to increasing uptake

JOHNSON CITY, Tenn. (WJHL) – It’s a big milestone — 200,000 Northeast Tennesseans have now gotten at least one COVID-19 vaccine dose.

But behind the raw number, trends show the region continuing to fall further behind national vaccination rates.

The past four weeks saw an additional 4.8 percent of Americans get their first shot. The increase in Northeast Tennessee, 2.5 percent, was barely half that total. Statewide the percentage was only slightly better at 2.8 percent.

And another milestone also stands out. Thursday, the percentage of fully vaccinated Tennesseans moved ahead of the percentage of Northeast Tennesseans fully vaccinated for the first time.

‘Nagging people doesn’t work … I think what you have to do is understand why a given individual is hesitant and give them as much information as they need’

ETSU college of public health dean dr. randy wykoff

That’s despite the fact that according to the Centers for Disease Control (CDC), Tennessee ranks 45th among the states in that category.

Tennessee Department of Health (TDH) data show 35.8 percent of Tennesseans are now fully vaccinated, compared to 35.7 percent of Northeast Tennesseans and 44.7 percent of Americans.

Two months ago, Northeast Tennessee’s fully vaccinated rate was 2.6 percent higher than the state’s percentage — 25.6 percent to 23.0 percent.

Those trends concern Dr. Randy Wykoff, East Tennessee State University’s College of Public Health dean, and many of his colleagues. Wykoff said the region is far from herd immunity, with fewer than 40 percent at least partially vaccinated.

Over the past four weeks Northeast Tennesseans have gotten vaccinated for COVID-19 at a rate barely half the national average and slightly slower than the rate for Tennessee, which ranks 45th nationally for percentage of its population vaccinated.

That compares to 53 percent of the U.S. population.

The numbers are similar in Southwest Virginia, where 40.4 percent of the population has gotten at least one vaccine dose.

“The nation could have herd immunity, but there could be areas – ours or somewhere else – where we don’t,” Wykoff told News Channel 11 Friday.

He said public health officials nationally remain concerned about the country’s slow pace toward herd immunity, which comes when enough people are vaccinated to prevent natural spread of the virus. That’s estimated at between 70 and 80 percent.

“People are concerned with two things,” Wykoff said.

“One, we’re not moving quickly enough to get to herd immunity, and secondly … there are going to be regions of the country that are not immune, and if a variant comes in that is more infectious, easier to spread, bypasses our immunity, we’re going to see a spike in deaths, we’re going to lose more people, we’re going to have hospitalizations and costs and everything else.” 

While that 200,000 number sounds impressive, and it is, if the region were within even a few percentage points of the national average — say 50 percent — another 50,000 people would be vaccinated already.

At the rate new vaccinations have occurred recently (fewer than 3,000 per week), the region won’t reach that 50 percent mark until sometime around Halloween.

Access not the main issue

Access issues remain for some people in the region, Wykoff said, but the primary cause for slow progress is people who can get that first shot fairly easily if they want it. 

“It’s people who have not yet made the decision that they want to be vaccinated,” he said. 

Other than a tick upward the first week 12 to 15-year-old were eligible, Northeast Tennessee’s weekly new vaccination totals have hovered around 3,000 for weeks.

“There are some areas, in rural counties especially, where there may be some issues.” 

Those mirror health access challenges not related to vaccination, Wykoff said. 

“People in rural areas have transportation issues, cost issues, getting leave from work kind of issues. But generally there are enough vaccines available for people who want to take them.” 

Wykoff said the main groups in the vaccinating community, including ETSU, Ballad Health, public health departments and the “Take a Shot on Life” campaign, have learned people who aren’t yet vaccinated have numerous reasons.

“We have some folks who are adamantly opposed who say they’ll never get a vaccine, but there are a lot of people sitting on the fence and I think it’s those folks sitting on the fence who need to be reminded of how serious this pandemic is, could be, and also the fact that we don’t really know what the long term consequences of COVID are for everybody.” 

Some people have decided they’re willing to risk the highly likely impact of COVID infection given their age and health – light to no symptoms. 

“What we don’t know is what’s going to happen to you if you’ve had COVID and what’s going to happen in six months, 12 months, five years. Probably nothing, but we don’t know that for sure.” 

‘Nagging’ not the best way to move the needle

Wykoff said vaccination teams have learned one thing: People aren’t generally going to be guilted into rolling up their sleeves.

“Nagging people doesn’t work,” he said. “Just saying, ‘get the vaccine’ doesn’t work. You have to understand that people are not getting the vaccine for different reasons.” 

Those range from a belief the pandemic isn’t serious or perceived risks from the vaccine itself to not realizing the vaccine is free and easily available. 

“I think what you have to do is understand why a given individual is hesitant and give them as much information as they need,” Wykoff said.

He’s concerned that as deaths, hospitalizations and cases decrease, fewer people who have been on the fence will step up to get a shot. 

“If we were to see a resurgence of deaths and hospitalizations hopefully they would be willing to get the vaccine then. What I’m hoping is that we don’t have to wait to see more deaths before more people get vaccinated.”