Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South
Abstract
:1. Introduction
2. COVID-19 Vaccinations in the South
3. COVID-19 Vaccinations in Tennessee
3.1. Urban Communities
3.2. Rural Communities
4. Factors Contributing to COVID-19 Vaccine Hesitancy in Rural Tennessee Counties
5. COVID-19 Vaccine Hesitancy in Urban Communities
6. Specific Strategies to Combat COVID Vaccine Hesitancy in Rural Tennessee Communities
7. Outlook for Rural Communities in Tennessee during the Course of the Pandemic, Changes, and Projected Consequences
8. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Bassetti, M.; Vena, A.D.; Giacobbe, R. The Novel Chinese Coronavirus (2019nCoV) Infections: Challenges for fighting the storm. Eur. J. Clin. Investig. 2020, 50, e13209. [Google Scholar] [CrossRef] [Green Version]
- Lai, C.C.; Shih, T.P.; Ko, W.C.; Tang, H.J.; Hsueh, P.R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int. J. Antimicrob. Agents 2020, 3, 105924. [Google Scholar] [CrossRef] [PubMed]
- Li, Q.; Guan, X.; Wu, P.; Wang, X.; Zhou, L.; Tong, Y. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med. 2020, 13, 1199–1207. [Google Scholar] [CrossRef] [PubMed]
- Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020, 395, 497–506. [Google Scholar] [CrossRef] [Green Version]
- Hartenian, E.; Nandakumar, D.; Lari, A.; Ly, M.; Tucker, J.M.; Glaunsinger, B.A. The molecular virology of coronaviruses. J. Biol. Chem. 2020, 37, 12910–12934. [Google Scholar] [CrossRef]
- Satija, N.; Lal, S.K. The molecular biology of SARS coronavirus. Ann. N. Y. Acad. Sci. 2007, 1, 26–38. [Google Scholar] [CrossRef] [PubMed]
- Brian, D.A.; Baric, R.S. Coronavirus genome structure and replication. Curr. Top. Microbiol. Immunol. 2005, 287, 1–30. [Google Scholar]
- Su, S.; Wong, G.; Shi, W.; Liu, J.; Lai, A.C.; Zhou, J.; Liu, W.; Bi, Y.; Gao, G.F. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016, 24, 490–502. [Google Scholar] [CrossRef] [Green Version]
- Cui, J.; Li, F.; Shi, Z.L. Origin and evolution of pathogenic coronaviruses. Nat. Rev. Microbiol. 2019, 3, 181–192. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Woo, P.C.Y.; Lau, S.K.P.; Lam, C.S.F.; Lau, C.C.Y.; Tsang, A.K.L.; Lau, J.H.N.; Bai, R.; Teng, J.L.L.; Tsang, C.C.C.; Wang, M.; et al. Discovery of seven novel Mammalian and avian coronaviruses in the genus deltacoronavirus supports bat coronaviruses as the gene source of alphacoronavirus and betacoronavirus and avian coronaviruses as the gene source of gammacoronavirus and deltacoronavirus. J. Virol. 2012, 86, 3995–4008. [Google Scholar]
- International Committee on Taxonomy of Viruses. Virus Taxonomy: 2017 Release. (EC 49, Singapore, 2017). Available online: https://talk.ictvonline.org/taxonomy/ (accessed on 6 October 2021).
- Du Toit, A. Outbreak of a novel coronavirus. Nat. Rev. Microbiol. 2020, 18, 123. [Google Scholar] [CrossRef]
- Rothan, H.A.; Byrareddy, S.N. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J. Autoimmun. 2020, 109, 102433. [Google Scholar] [CrossRef] [PubMed]
- Chan, J.F.W.; Kai-Wang, K.; Tse, H.; To, K.K.W.; Jin, D.Y.; Yuen, K.Y. Interspecies transmission and emergence of novel viruses: Lessons from bats and birds. Trends Microbiol. 2013, 10, 544–555. [Google Scholar] [CrossRef]
- Wiersinga, W.J.; Rhodes, A.; Cheng, A.C.; Peacock, S.J.; Prescott, H.C. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA 2020, 8, 782–793. [Google Scholar] [CrossRef]
- MacDonald, N.E. SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine 2015, 34, 4161–4164. [Google Scholar] [CrossRef]
- Coustasse, A.; Kimble, C.; Maxik, K. COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome. J. Ambul. Care Manag. 2021, 1, 71–75. [Google Scholar] [CrossRef] [PubMed]
- Turner, P.J.; Larson, H.; Dubé, È.; Fisher, A. Vaccine Hesitancy: Drivers and How the Allergy Community Can Help. J. Allergy Clin. Immunol. Pract. 2021, 10, 3568–3574. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Ten Threats to Global Health in 2019. 2019. Available online: https://www.who.int/emergencies/ten-threats-to-global-health-in-2019 (accessed on 25 February 2019).
- Self, W.H.; Tenforde, M.W.; Rhoads, J.P.; Gaglani, M.; Ginde, A.A.; Douin, D.J.; Olson, S.M.; Talbot, H.K.; Casey, J.D.; Mohr, N.M.; et al. Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions—United States, March–August 2021. MMWR Morb. Mortal Wkly. Rep. 2021, 38, 1337–1343. [Google Scholar]
- Oliver, S.E.; Gargano, J.W.; Marin, M.; Wallace, M.; Curran, K.G.; Chamberland, M.; McClung, N.; Campos-Outcalt, D.; Morgan, R.L.; Mbaeyi, S. The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Moderna COVID-19 Vaccine-United States, December 2020. MMWR. Morb. Mortal. Wkly. Rep. 2021, 5152, 1653–1656. [Google Scholar] [CrossRef] [PubMed]
- Livingston, E.H.; Malani, P.N.; Creech, C.B. The Johnson & Johnson Vaccine for COVID-19. JAMA 2021, 325, 1575. [Google Scholar] [CrossRef] [PubMed]
- Gatwood, J.; McKnight, M.; Fiscus, M.; Hohmeier, K.C.; Chisholm-Burns, M. Factors influencing likelihood of COVID-19 vaccination: A survey of Tennessee adults. Am. J. Health Syst. Pharm. 2021, 10, 879–889. [Google Scholar] [CrossRef] [PubMed]
- Aschwanden, C. The false promise of herd immunity for COVID-19. Nature 2020, 7832, 26–28. [Google Scholar] [CrossRef] [PubMed]
- Adunlin, G.; Murphy, P.Z.; Manis, M. COVID-19: How Can Rural Community Pharmacies Respond to the Outbreak? J. Rural Health 2021, 1, 153–155. [Google Scholar] [CrossRef] [Green Version]
- Altmann, D.M.; Boyton, R.J.; Beale, R. Immunity to SARS-CoV-2 variants of concern. Science 2021, 6534, 1103–1104. [Google Scholar] [CrossRef] [PubMed]
- Otto, S.P.; Day, T.; Arino, J.; Colijn, C.; Dushoff, J.; Li, M.; Mechai, S.; Domselaar, G.V.; Wu, J.; Earn, D.J.D.; et al. The origins and potential future of SARS-CoV-2 variants of concern in the evolving COVID-19 pandemic. Curr. Biol. 2021, 14, 918–929. [Google Scholar] [CrossRef]
- Walensky, R.P.; Walke, H.T.; Fauci, A.S. SARS-CoV-2 Variants of Concern in the United States-Challenges and Opportunities. JAMA 2021, 11, 1037–1038. [Google Scholar] [CrossRef] [PubMed]
- Singh, J.; Rahman, S.A.; Ehtesham, N.Z.; Hira, S.; Hasnain, S.E. SARS-CoV-2 variants of concern are emerging in India. Nat. Med. 2021, 7, 1131–1133. [Google Scholar] [CrossRef] [PubMed]
- Prusaczyk, B. Strategies for Disseminating and Implementing COVID-19 Vaccines in Rural Areas. Open Forum Infect. Dis. 2021, 6, 152. [Google Scholar] [CrossRef]
- Jin, J.; Agarwala, N.; Kundu, P.; Harvey, B.; Zhang, Y.; Wallace, E.; Chatterjee, N. Individual and community-level risk for COVID-19 mortality in the United States. Nat. Med. 2021, 2, 264–269. [Google Scholar] [CrossRef] [PubMed]
- Price-Haywood, E.G.; Burton, J.; Fort, D.; Seoane, L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N. Engl. J. Med. 2020, 26, 2534–2543. [Google Scholar] [CrossRef] [PubMed]
- CDC: COVID-19 Vaccinations in the United States. Available online: https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-total-admin-rate-total (accessed on 16 August 2021).
- McLaughlin, J.M.; Khan, F.; Pugh, S.; Angulo, F.J.; Schmidt, H.J.; Isturiz, R.E.; Jodar, L.; Swerdlow, D.L. County-Level Predictors of COVID-19 Cases and Deaths in the United States: What Happened, and Where Do We Go from Here? Clin. Infect. Dis. 2020, 19, 1729. [Google Scholar] [CrossRef]
- CDC, Delta Variant: What We Know about the Science. Available online: https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-variant.html (accessed on 27 August 2021).
- Privor-Dumm, L.; King, T. Community-based Strategies to Engage Pastors Can Help Address Vaccine Hesitancy and Health Disparities in Black Communities. J. Health Commun. 2020, 10, 827–830. [Google Scholar] [CrossRef] [PubMed]
- Traynor, K. COVID-19 mass vaccination involves unusual venues. Am. J. Health Syst. Pharm. 2021, 13, 1162–1164. [Google Scholar] [CrossRef] [PubMed]
- States Ranked by Percentage of Population Fully Vaccinated: Aug. Available online: https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-population-vaccinated-march-15.html (accessed on 16 August 2021).
- Tennessee Contends with Low Vaccination Rates and Republican Demagoguery. Available online: https://www.nashvillescene.com/news/citylimits/tennessee-contends-with-low-vaccination-rates-and-republican-demagoguery/article_397dd7b0-e354-11eb-9012-e3251d722cb6.html (accessed on 13 July 2021).
- Tennessee Statewide Number of COVID-19 Hospitalized Pediatric Patients. Available online: https://www.tn.gov/content/tn/health/cedep/ncov/data/hospitalization-data/current-covid-hospitalizations.html/ (accessed on 15 August 2021).
- U.S. Covid Hot Spots See Spike in Black, Hispanic Vaccinations: COVID-19 Tracker. Available online: https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/us-vaccine-demographics.html (accessed on 13 August 2021).
- Murthy, B.P.; Sterrett, N.; Weller, D.; Zell, E.; Reynolds, L.; Toblin, R.L.; Murthy, N.; Kriss, J.; Rose, C.; Cadwell, B.; et al. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties-United States, 14 December 2020–10 April 2021. MMWR Morb. Mortal. Wkly. Rep. 2021, 70, 759–764. [Google Scholar] [CrossRef] [PubMed]
- Tsai, T.; Jacobson, B.; Jha, A.; Health Affairs. American Hospital Capacity and Projected Need for COVID-19 Patient Care. Available online: https://ambulance.org/2020/03/17/hospital-capacity-and-projected-need-for-covid-19-patient-care/ (accessed on 17 March 2020).
- Tennessee Vaccination Rates by County. Available online: https://www.tn.gov/health/cedep/ncov/covid-19-vaccine-information.html#vaccine (accessed on 8 August 2021).
- Hamel, L.; Kirzinger, A.; Muñana, C.; Mollyann, B. KFF COVID-19 Vaccine Monitor: December. 2020. Available online: https://www.kff.org/coronavirus-covid-19/report/kff-covid-19-vaccine-monitor-december-2020/ (accessed on 15 December 2020).
- Hildreth, J.E.K.; Alcendor, D.J. Targeting COVID-19 Vaccine Hesitancy in Minority Populations in the US: Implications for Herd Immunity. Vaccines 2021, 9, 489. [Google Scholar] [CrossRef] [PubMed]
- Peters, D.J. Community Susceptibility and Resiliency to COVID-19 Across the Rural-Urban Continuum in the United States. J. Rural Health 2020, 3, 446–456. [Google Scholar] [CrossRef] [PubMed]
- Rural Tennessee’s Vaccine Hesitators by Astead W. Herndon. White Republican Evangelical Christians Remain Disproportionately Mistrustful About Coronavirus Inoculations. Here’s What That Looks Like in One Community. Available online: https://www.nytimes.com/2021/05/10/podcasts/the-daily/covid-vaccine-hesitancy-white-republicans.html (accessed on 10 May 2021).
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Alcendor, D.J. Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South. Vaccines 2021, 9, 1279. https://doi.org/10.3390/vaccines9111279
Alcendor DJ. Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South. Vaccines. 2021; 9(11):1279. https://doi.org/10.3390/vaccines9111279
Chicago/Turabian StyleAlcendor, Donald J. 2021. "Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South" Vaccines 9, no. 11: 1279. https://doi.org/10.3390/vaccines9111279
APA StyleAlcendor, D. J. (2021). Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South. Vaccines, 9(11), 1279. https://doi.org/10.3390/vaccines9111279