With COVID-19 vaccines readily accessible and convenient across large swaths of South Carolina, the state’s public health authority and community leaders are shifting their strategy to reach residents who remain unvaccinated.
Nowhere is that more evident than in Cherokee County.
The mostly rural county between Spartanburg and Charlotte, N.C., has the lowest percentage of vaccinated residents in the state at just under 24 percent as of May 27, compared to 36 percent of residents statewide.
The state’s coastal counties lead the way with the most vaccinated residents ages 12 and older. In Charleston, 48 percent have completed vaccination, followed by Georgetown at 47 percent, McCormick at 47 percent, Horry at 43 percent and Beaufort at 41 percent. Greenville County leads the way in the Upstate with 39 percent having completed the vaccination regimen.
But as case counts, deaths and hospitalizations fall and vaccination levels slowly rise, health leaders are finding they must navigate a different path to improve the vaccination rate in some of the state’s smaller, more rural communities.
That starts with reaching the right populations.
In Cherokee, the state Department of Health and Environmental Control’s Upstate COVID-19 Regional Community Assessment Review and Equity (CARE) Panel, a volunteer group of regional health and community leaders, put together a task force to assess the county. Their goal is to better reach residents with accurate information.
“One thing that we’re doing in our rural counties like Cherokee is to really localize and humanize our messaging about the importance of getting your COVID-19 vaccines,” said Dr. Brannon Traxler, DHEC’s director of public health.
Traxler said the health agency is running a series of articles in the local newspaper, The Gaffney Ledger, by residents who have been vaccinated about why they chose to get the shots.
She said they have seen a combination of factors in low vaccination rates, particularly in rural communities. Those include hesitancy to get the vaccine, a lack of convenient access to vaccine, and not being armed with correct information about why vaccination is important even in rural areas where the spread has been less prevalent.
In 10 counties, the rate of completed vaccinations is less than 30 percent of the eligible population. Of those, four are considered rural counties, including Cherokee, Chesterfield, Lee and Marlboro. The others are Jasper, Lancester, Laurens, Saluda, Sumter and Union.
Not all rural counties are slower to get the vaccine. Seven of the state’s 16 rural counties are in the top half of vaccinated counties by percentage, including McCormick, where 47 percent of residents are vaccinated.
Overall, the number of people coming to Regenesis Gaffney Health Center in Cherokee County has been at a relatively slower than neighboring Spartanburg, said Dr. Matthew Delfino, Regenesis’ Chief Medical Officer.
Turning a corner on Cherokee’s vaccine rates will take time, said Kandi Fredere, DHEC’s Upstate public health director.
“I think it’s a marathon for us, not a sprint,” Fredere said. “I think there are some barriers we’re going to have to overcome. There’s some conversations that are going to have to occur.”
Spartanburg Regional Healthcare System, the largest healthcare provider in Cherokee, said in an emailed statement that the reasons for hesitancy in the community are much the same as those across the country — distrust of the vaccine, misinformation on social media, and not seeing a need to be vaccinated because of younger age or good health.
Stakeholders including DHEC, government, schools, members of the faith community, representatives from nonprofits, ReGenesis and Spartanburg Regional are putting together visible campaigns for community leaders to advocate for vaccines and are making door-to-door visits to share information.
A first round of postcards have also been mailed to homes across the state, an effort to get vaccine information into every home in South Carolina, Traxler said.
At the community level, stakeholders are learning as they go. In Cherokee, just more than 100 residents between the ages of 20 and 24 have completed their vaccinations. Traxler realized they had no direct messages to that population group.
She said not to expect to double vaccination rates in Cherokee any time soon.
“I think that’s just going to take us a good bit of time.”
Cherokee is 76 percent white and 21 percent Black. No one population group stood out as a particular concern. Rather, nearly all segments of the population in Cherokee were behind other counties, said Angelique Jarvis-Simmons, a member of the Upstate CARE panel.
But the slow rate of residents choosing to take the vaccine showed the work needed to target specific groups with information, she said.
For example, less than 18 percent of the Hispanic population in Cherokee County has completed vaccination, according to DHEC data. Cherokee is 4.6 percent Hispanic but a large number of migrant agricultural workers also arrive in April and work through September in Cherokee and other rural agricultural communities.
This year, about 6,300 migrant and seasonal farm workers and 6,270 H–2A visa holders will live and work in the state, mostly in 16 rural South Carolina counties, including Cherokee, according to the state Commission for Minority Affairs.
At first, members of the Upstate health panel assumed Hispanic residents in Cherokee would get vaccine information from local radio hits or news bites from Greenville radio or Greenville and Spartanburg television stations. But after talking with Hispanic residents, they realized most in the area actually listen to radio stations in the Charlotte area, Jarvis-Simmons said.
The group also realized it needed to make vaccine information readily available in Spanish in areas like Gaffney, Blacksburg and the smaller communities of Chesnee and Cowpens.
Work is underway to bring mobile vaccine units to area schools where Hispanic parents are used to going to drop off children, and to churches like Sacred Heart Catholic Church in Gaffney, which will hold a vaccine clinic during an upcoming festival, Jarvis-Simmons said.
“They really want to hear from someone who’s an expert. So if they hear from a doctor in their language, that would have a great impact,” Jarvis-Simmons told the CARE panel.
Efforts have been ongoing to bring the vaccine to agricultural workers in Cherokee, said Marlon Hunter, CEO of Regenesis Health Care, which has partnered with Spartanburg Regional’s Cherokee Medical Center on COVID testing and vaccine distribution.
A pop-up mobile clinic earlier in May vaccinated 20 farm workers in one night in Cherokee, Hunter said. More than 600 agricultural farm workers had been vaccinated through Regenesis mobile clinics throughout the Upstate, he told the CARE panel.
Delfino said he was surprised by the good intake of the vaccine among agricultural workers.
“They’re motivated to keep working,” Delfino said. “If they get sick, it directly affects their income. There’s a pretty specific connection there.”
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