Jenna Bonnell was among a steady stream of people getting a COVID-19 vaccination at a Benzie County pop-up clinic in late May.
“I’ve been kind of debating about it since they came out, but I figured it was just my time to do my civic duty,” said Bonnell, who is 27. “Everyone around me is vaccinated, so maybe it’s just the peer pressure.”
Later than afternoon, Madelyn Venhuizen was the sole person getting her shot at the Missaukee County office of the District 10 Health Department.
“A lot of people I know here don’t want to get it,” said Venhuizen,19.
Michigan’s northwest Lower Peninsula is home to counties with some of the state’s highest COVID_19 vaccination rates, including Benzie. But it’s also home to counties such as Missaukee where the rates are well below average.
About 64% of Benzie County residents age 12 and older have gotten at least one dose of vaccine compared to 49% in Missaukee. The state average is 56%.
There’s a distinct and intriguing pattern in the northern Lower Peninsula.
From Ludington to Mackinaw City, the counties along the Lake Michigan shoreline are all above the state average and two of the eight — Leelanau and Grand Traverse — rank first and second in percentage of vaccinated residents.
Meanwhile, the interior northern Lower Peninsula has some of the counties with the lowest vaccination rates — including Osceola, Mecosta, Newaygo, Ogemaw and Oscoda.
So what’s that about? Why are vaccination rates so much lower in some counties compared to others?
A variety of factors appear to be at work, including differences in sociodemographics, political leanings and local economies as well as the willingness of influential voices outside of the health department to promote the vaccine program.
Identifying those issues and how to address them is a vital issue for public-health officials. As vaccination rates plateau across the state, the gap between the high- and low-vaccination counties could make a difference if and when Michigan experiences its next coronavirus surge, with low-vaccination counties much more vulnerable to outbreaks.
“I don’t know what’s going to happen,” said Dr. Jennifer Morse, medical director for 19 counties in northern Michigan. “I’m really fearful” about continuing outbreaks in under-vaccinated counties.
In fact, it’s a pattern already evident in Michigan’s COVID case numbers: So far in June, the five counties with the highest number of cases per capita — Branch, Kalkaska, St. Joseph, Baraga and Luce — all have vaccination rates well below the state average.
Kevin Hughes heads District Health Department 10, which covers 10 northern Michigan counties where the vaccination rates range from 61% in Mason, home of Ludington, to 41% in Mecosta, home of Big Rapids.
He says the county-level vaccination rates tend to reflect the proportion of the population divided between three groups: Those “highly motivated” to get the vaccine; the “fence-sitters” and “those folks who really have no intention of ever getting vaccinated.”
“We see those differences across our jurisdiction,” agreed Lisa Peacock who heads the Benzie-Leelanau District Health Department as well as the Health Department of Northwest Michigan, which includes Emmet, Charlevoix, Antrim and Otsego. “There’s more willingness in some areas than others” to get vaccinated.
“There are individual who just really don’t feel COVID is a real issue,” Morse said. “They think it’s a bit of conspiracy or fake news behind a lot of this. That a lot of the data is falsified or exaggerated. So when you say, ‘OK, now you can get vaccinated,’ they say, “I don’t need to because this isn’t a real problem.’ ”
The story in high-vaccination counties
The string of high-vaccination counties along the northern Lake Michigan coast tend to have local economies centered around tourism.
While the 2020 tourism season proved to be much better than expected, the pandemic also made for a disruptive, anxiety-producing summer, one in which businesses had to scramble to comply with new restrictions and COVID outbreaks among among staff and/or customers that resulted in highly inconvenient albeit temporary closures.
Those in the hospitality industry have embraced vaccinations as a path to a much better summer. Tourists are expected to come flooding back to northern Michigan in record numbers, and vaccinations means they’ll be much less likely to infect the local population. Vaccinations also takes away the specter of staffing issues caused by worker illness, a plus for both employers and individual employees who don’t want to risk losing pay or being overworked because co-workers are out sick.
Sherri Campbell Fenton, whose family owns the Black Star Farms wineries in Leelanau and Grand Traverse as well as an inn on their Leelanau site, said she’s “very excited” that both counties have such high vaccination rates.
Why Leelanau County ranks No. 1 in Michigan vaccination rates
Tourism is “absolutely is an economic driver” for the region, Fenton said. “If we’re not healthy and safe, we can’t keep our businesses open, period.”
Traverse City is the heart of Michigan’s tourism industry in the northern Lower Peninsula, and its civic leaders have been unabashed about urging people to get vaccinated.
That includes recent events such as a vaccination clinic at a popular downtown bar aimed at restaurant and other workers in the hospitality industry. In addition to free vaccines, the event featured $1 beers and live music.
“It’s just a fun way to get people that were maybe on the fence out to get vaccinated,” said Katy McCain, director of community development for the Traverse City Downtown Development Authority.
Crystal Mountain Resort in Benzie County is among the region’s employers who have held vaccination clinics for their own workers, and have opened those clinics to the general public.
Casey Petz, superintendent of Suttons Bay Public Schools in Leelanau County, noted the resort is one of the most well-known and trusted institutions in the region.
“By hosting a clinic, they’re not necessarily advocating for one decision or another, but the fact they’re willing to host lends some credibility to the process,” he said.
“It’s the same thing” for his school district, which has been hosting regular vaccination clinics since January, he said. “The district is lending their credibility to this, and it’s giving people that permission to make a decision they feel is good for their family.”
It also helps the coastal counties have a significant population of affluent, well-educated senior citizens who have retired in places like Traverse City, Charlevoix, Petoskey and Glen Arbor. It’s a group overwhelmingly positive about the vaccines, and who have used social media to convey their enthusiasm.
Hughes, the District Health Department 10 chief, said it “absolutely” makes a difference others outside the health department are amplifying the benefits of vaccination.
“When it’s just the healthcare folks, I think it’s the perception that, well, yeah, they’re just saying that because it’s their job,” he said. “When it’s the businesses, the social media posts, the schools, the faith-based communities, that helps drive the decision on whether to get vaccinated.”
It can work together to create a bandwagon effect that persuades the fence-sitters.
“A lot depends on where you get your information” about vaccines, said Nancy Call, a volunteer worker at a vaccination clinic at Crystal Mountain Resort. “There’s good information and bad information, and everyone is making decisions based on the information they’re getting.”
The story in low-vaccinated counties
The band-wagon effect works in reverse in under-vaccinated counties.
While almost all of the northern Lower Peninsula is Republican, the interior counties tend to be more conservative. Their economies are less dependent on tourism. There are fewer of the well-educated, affluent residents driving up vaccination rates in places like Traverse City and Charlevoix. Civic leaders are less likely to advocate for vaccination. The social media chatter is much more likely to be about resistance to vaccine.
Alma Wyckoff is 88 years old, an age that puts her at high risk for severe illness if she were infected with COVID-19.
Doesn’t matter to Wyckoff, who lives in McBain in Missaukee County. She hasn’t been vaccinated and has no plans to do so.
“Absolutely not,” Wyckoff said.
“I don’t consider myself a high-risk person” in regards to coronavirus, she said. “I make sure my immune system is in good shape. I’m not overweight, and most of the people (who have had severe COVID) had other issues. I’m very healthy. I still ride my motorcycle and I do my walking every day.”
She said that most of the people she knows are resentful about pressure to vaccinate, as well as the overall handling of the pandemic.
“Vaccines are this thing being forced on you, and a bunch of political crap,” she said. “It’s nothing but socialism. In southern Michigan, half the people are welfare and they get their shots, they’re all Democrats. This end of the state is not that way. It’s a totally different thought about life up here.”
The pandemic “is serious. I’m not saying it’s not,” Wyckoff said. “But it never should have been handled the way it was, creating such a mess in our country.”
Valerie Farr, a Missaukee County resident in her 60s, also said she’s unlikely to get vaccinated.
She doesn’t like the fact that the vaccines have only emergency authorization so far from the federal Food and Drug Administration. She says she is “staunchly pro-life” and heard that Johnson & Johnson contains aborted fetal DNA as an ingredient. (That claim has been debunked.)
Farr said her religious beliefs also contribute to her reluctance to get vaccinate. “I believe that God is in control and will take care of us,” she said. “When it’s my time to go, it’s better off to be with the Lord.
“I feel that the choice is up to each individual,” Farr added about vaccination. “If a person feels that it’s for them, and they went to do it, that’s fine with me. I don’t hold it against them or think any less of them. That’s their choice. I just hope that I’m respected when not getting one is my choice, and the respect would go both ways.”
Missaukee County was rocked this spring by the deaths of Dave and Paul Ebels, two brothers who owned Ebels Hardware, one of the Missaukee County’s best-known businesses. The brothers were both hospitalized in mid-March with COVID; Dave Ebels died shortly afterwards at age 57 and Paul Ebels died in April at age 53.
A Michigan county thought it largely dodged the pandemic. Then Dave and Paul Ebels died
After Dave Ebels’ death, one of their surviving brothers helped organize two vaccination clinics and publicly urged for people to get their shots. As one of the most prominent families in the county as well as one of its biggest employers — the Ebels family also runs the Ebels General Store and Meat Market, which draws people from across northern Michigan — that advocacy likely changed some minds but not a lot, local residents say.
And it’s telling, they say, that many of those vaccinated at those clinics were walk-ins vs. people who made an appointment.
“I think 30 people signed up or register for our clinic, which doesn’t sound like a lot. But lo and behold, when we got there and actually did the clinic we had another 31 people walk in,” Hughes said. “Maybe they didn’t want to sign up because they didn’t want anybody to know they were going to do it, or may they just don’t like making appointments.”
Outside of the Ebels, there aren’t many people publicly championing for COVID-19 vaccines in Missaukee County.
The county’s political leaders have largely steered away from the topic, seeing it is a matter between individuals and their doctors, said Star Hughston, a Missaukee County commissioner.
“The commissioners that I’m on a board with would say it’s none of our business,” Hughston said. “If people get it, they get it. If they don’t, they don’t.”
Trying to up vaccination rates
As vaccinations have slowed to a trickle, health officials are realizing that those motivated to get vaccination already have gotten their shots and some people are just staunchly opposed.
So health officials are concentrating on the fence-sitters. A May survey by Health Department District 10 suggests that’s about a third those who haven’t gotten vaccinated yet.
For that group, the survey indicates that convenient access to getting vaccinated is one issue; another is providing easy access to getting their questions answered.
To that end, many health departments are running pop-up clinics, which is essentially sending health department workers out to sites ranging from community festivals to local grocery stores to casinos so that workers can answer questions and administer a vaccine on the spot.
While those are much less efficient than the mass clinics held in March, April and May, they also bring in folks who might otherwise not get vaccinated.
“We know there are people who may not go out of their way to make appointment. But if we can get them at a grocery store, they might come up” and get a shot, said Rachel Pomeroy, spokeswoman for the Benzie-Leelanau District Health Department. “We have to meet people where they’re at, make it convenient.”
Hughes, the District Health Department 10 director, said his agency is looking for any opportunities to vaccinate another 10 or 15 people.
“That’s what we need to do and it’s part of our pivoting,” he said.
In upcoming days and weeks, his agency will be administering vaccines at the farmer’s markets in Kalkaska, Big Rapids, Grant and New Era, as well as Luther Logging Days in Lake County, the Manistee Forest Festival, Fates grocery store in Remus, Woody’s Bar & Grill in Bitely and the Manton Truck Show. Vaccination clinics at Baldwin, Kaleva Norman Dickson and Pentwater schools also are on the schedule.
Still, it’s slow going. Last week, District 10 administered 995 first doses among their 10 counties. It was the lowest weekly number since December when the vaccine program started.
The worry about undervaccinated counties
Because of vaccinations, COVID-19 caseloads in Michigan have been plummeting in recent weeks. Community transmission rates are near record low since the start of the pandemic. That greatly reduces the risk for everyone, including those who are unvaccinated.
But the virus hasn’t disappeared. When fall comes, schools resume and people start spending more time indoors, it’s certainly possible for the state to experience another surge, health experts say.
The numbers in the next surge are likely to be much lower, simply because so many people have immunity now either through vaccination or by having had the virus.
But those lacking immunity are still vulnerable — and maybe even more than ever, considering the rise of variants that appear to be more contagious and more lethal.
This past spring, Michigan was the country’s poster child for what could happen when a variant takes hold in a population. Even with most senior citizens vaccinated when that surge occurred, Michigan has had about 4,000 COVID-19 deaths and about 30,000 COVID-19 hospital admissions since March. That includes 149 deaths and more than 4,200 hospitalized among people under age 40.
“We don’t think COVID will ever go away,” said Alan Vierlang, president of Sparrow Hospital in Lansing. “We just think the numbers are going to shift,” towards the unvaccinated.
Any community or sub-community with enough people who lack immunity are vulnerable to outbreaks in the future, said Ryan Malosh, a University of Michigan epidemiologist.
“You need to go even below the county level into smaller geographic regions,” he said. “So certainly in places where there’s low vaccine uptake at the county level, you would expect more outbreaks. But even in a high-vaccinated county like Washtenaw, wherever there is a pocket of low vaccination, you could see small-scale outbreaks.”
That’s amplified by the fact that vaccinated and unvaccinated people are not evenly distributed — individuals in each group tend to be surrounded by people with the same vaccination status, experts say. That provides even more protection for people in high-vaccination areas; they’re much more likely to be part of a community that’s essentially achieved herd immunity. But that also means a person who is unvaccinated in, say, Missaukee County, is more vulnerable than the unvaccinated adult in Leelanau.
Malosh said that future outbreaks are likely to be much more manageable. “It won’t likely result in this widespread mitigation efforts, but more targeted efforts where we’re finally able to do the contract tracing and the isolation and keep people protected that way,” he said.
But for those who do get infected, it means they run the risk of getting hospitalized or even dying from what is now essentially a preventable disease. ‘
More than a year into the pandemic, there are still not enough effective treatments for severe COVID-19, said Dr. Frank Rosenblat, an Oakland County infectious disease specialist with McLaren Health.
“Once someone gets it, the drugs that we have available are really not all that great,” he said. “That’s why vaccination is important.”
Morse, the District 10 medical director, is frustrated by the numbers who refuse to be immunized.
She points to a poll by the Kaiser Family Foundation that found 29% of adults in rural communities said they will not get the vaccines.
“There’s a lot of, ‘Not my kid or not me. Everybody else can do it and then I’ll be protected,’ ” she said. “But unfortunately, if you have 29% of people saying ‘I’m not going to do it; let someone else do their herd immunity for me,’ that’s going to be a problem.”
And it’s not just a problem for the unvaccinated, she said, but also those children too young to be vaccinated; people who can’t get vaccinated because of medical reasons, or who do get vaccinated but fail to develop a robust immune response because of a compromised immune system.
“We need to protect them, so we need to just pull together as a community and starting taking care of each other,” Morse said.
More on MLive:
Doctors ‘push the limit’ with organ transplants as COVID-19 extends wait lists
24% of Michiganders have acquired natural immunity to COVID. Why doctors say vaccination is better.
Albion College offering free tuition for COVID-19 vaccination at select clinics
Is it ok to ask? How and when to inquire about someone’s vaccination status.
Credit: Source link