LEILA FADEL, HOST:
Public health officials expected some people to be reluctant to get the COVID-19 vaccine. They just didn't think the most stubborn group would be white rural conservatives - hence the rush to put together vaccination campaigns with NASCAR and country music. As Blake Farmer of member station WPLN reports, convincing rural conservatives has become the next challenge in a race to reach herd immunity.
BLAKE FARMER, BYLINE: There are more than enough shots to go around in communities like Hartsville, Tenn., a quiet town tucked in the wooded hills northeast of Nashville. On a recent weekend, the county health department had trouble filling up even half the spots for a COVID vaccination event at the high school.
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FARMER: Down the street at the Piggly Wiggly grocery store, Cris Weske isn't even tempted.
CRIS WESKE: Somebody that - like me that's healthy, with a survival rate of 99% - I don't need it. I don't want to put the toxin - I'm kind of anti-vax (ph), period.
FARMER: Weske is wearing a we the people T-shirt and says the Constitution protects his choice to opt out. National polling by NPR and Marist finds that rural white Republicans, especially supporters of Donald Trump, are among the least likely to get a vaccine.
Cindi Kelton is loading dog food and milk into her van. She's 67 with COPD and emphysema, lung diseases that put her at high risk of complications with COVID. But she's more scared of the vaccine than the virus.
CINDI KELTON: I mean, we voted for Trump. But, I mean, that's got - Trump's got nothing to do with us deciding not to take the vaccine because we were planning on taking it until our doctor passed away.
FARMER: That's right - Kelton says her doctor died of COVID in late January, though it's unclear whether he was vaccinated. Either way, Kelton says it gave her pause. To this point, there has been scant attention paid to batting down rumors or answering vaccine questions in many rural communities. Public health officials have been far more focused on underserved groups concentrated in urban areas.
But it's rural communities where a few leaders are actively sowing doubts. They include state legislators and even a few pastors. Greg Locke is an outspoken preacher in Wilson County, Tenn., who peppers his sermons with mocking questions.
FARMER: People say, well, what are you going to do when they make the vaccine mandatory? And we'll tell them to take a hike like I've been telling them to take a hike. That's what I will do.
FARMER: Southern states where vaccination rates are lowest have seen ministers as key allies, but it's almost entirely Black churches agreeing to hold town halls or vaccine events. Pastor Omaran Lee has been working with churches and says the concerns in Black congregations aren't that different from what he hears from rural white communities.
OMARAN LEE: We don't trust the government, and we don't trust Joe Biden is what he said, right? Well, six months ago, it was, we don't trust the government, and we don't trust Donald Trump, right? Any time you have a marginalized person, you have people who are left out, they're going to be skeptical.
FARMER: And skepticism about the vaccine, Lee says, can be overcome if there's an intentional effort to reach people where they are - which brings us back to Hartsville, where communication is still a challenge.
BRENDA KELLEY: I don't even have a computer. I'm old-school.
FARMER: Brenda Kelley is a 74-year-old widow and says she didn't even know she was eligible to get the vaccine yet, much less that there are tons of shots available. They're mostly advertised on social media. Plus, she has her own questions about whether her diabetes, while elevating her COVID risk, might cause problems with the vaccine.
KELLEY: Kind of scared to get it, in a way, and in a way, I want it, you know? And my children - neither one of them want it. I don't know.
FARMER: It's not a never thing, she says - just a wait and see.
For NPR News, I'm Blake Farmer in Hartsville, Tenn.
FADEL: This story comes from NPR's partnership with National Public Radio and Kaiser Health News. Transcript provided by NPR, Copyright NPR.