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What We Can Learn From West Virginia's Vaccine Distribution Efforts


Coronavirus vaccinations are picking up momentum across the U.S. But for many, it's still difficult to get access to those appointments and shots, and we've been telling you all about those issues. But one early success story has been West Virginia, a state that's historically been known to struggle with high rates of poverty, food insecurity and poor health conditions. And yet, the state has emerged as one of the early leaders in vaccinations.

By late December, it had offered vaccines to all nursing home residents, ahead of the other 49 states. And by January, West Virginia had administered almost 90% of its doses, whereas many states lagged behind. Some having used only 30%, with the national average being 50% at the time. That success has been maintained as the rest of the country catches up.

So how did West Virginia do this? We are joined now from Charleston, W.Va., by Drew Massey. He's in charge of vaccinations at Fruth Pharmacy, a small, family-owned general store and pharmacy chain based in Point Pleasant, W.Va. Drew, thanks so much for joining us.

DREW MASSEY: Thank you for having me on the program.

MCCAMMON: At the start of the pandemic, did you think that West Virginia would be doing so well in this effort? I mean, it's a daunting task.

MASSEY: We had been planning for the vaccine for a while. So it was a work in progress from early on, well before the vaccine ever came out. I applaud Governor Justice for acting to protect the most vulnerable population that we have because West Virginia is a fairly older state.

MCCAMMON: And as you know, I mean, West Virginia has its share of challenges. It's a largely rural state, one of the highest poverty rates in the country. We've heard a lot in recent years about the opioid epidemic, how hard that's hit West Virginia. How have you managed, you know, logistically to get so many vaccinations to people despite all of those challenges?

MASSEY: I like to attribute the success in West Virginia to trust and honesty. I'm a pharmacist, and we engaged pharmacies early on. So pharmacies, especially our independent pharmacies, made a big dent, along with other health care providers, in getting these shots out and into arms. And pharmacists are one of the most trusted professions, and we tend to forge relationships with our patients. So they actually do trust our opinion when people come into the store.

MCCAMMON: You talk about having relationships with customers. At the same time, you know, a small local pharmacy - it's sort of counterintuitive. You would think that a pharmacy like yours might not have the same kinds of resources - right? - that a big chain would have for something like mass vaccine distribution. Why was this so successful, do you think?

MASSEY: OK. So that one there, I will say, is from the top down. You start with the governor, the National Guard, the health care providers, all of the small, little federal health care communities, all the way down to the volunteers. Everybody in West Virginia banded and worked together, and it was boots on the ground from day one. And we have smaller communities, and we were able to get the vaccines in arms due to our health care workers, our pharmacists and our volunteers. And we get telephone calls on a regular basis. And we go out to anywhere from a small clinic - I've gone to people's houses - all the way out to mass clinics where you're doing several thousand shots in a sitting.

MCCAMMON: As you move about the community, how much vaccine hesitancy have you encountered?

MASSEY: Most of the clinics and things, you're not going to encounter a lot of vaccine hesitancy because if they're coming to the clinic, they've already made the decision that they're going to get the shot. But as you go out into the community and you talk to people, there is some vaccine hesitancy. It's any - you get questions, anything from, where are we at with the science? This is new science, and it's unexplored territory for people - down to the ones that I try to avoid, when people are asking about things that are just not factual, and you need to make sure that they're comfortable.

Tell them the facts. Tell them the facts about the vaccine. Tell them that we did this in a very large trial, and a lot of really, really good scientists worked on this. And they always go back to the one thing, and I tell them, I would not have gotten the vaccine if I didn't believe in it.

MCCAMMON: Aside from hesitancy, another hurdle in many states has been the registration process, just coordinating all those sign-ups. What's that been like in West Virginia? How's that worked?

MASSEY: Day one, it was slightly painful because the system was just going into play. I will say that the systems have done an amazing job of taking feedback and making it more streamlined and adding on features. When people are trying to register for vaccinations, a lot of people get confused as to where do they register at. Do I need to go to a pharmacy website? Do I need to go, like, to the state website, or do I need to contact the health department? Or who do I talk to? Where do I go?

So I have seen everything from the state registration, the federal registration. I have seen stores doing their own waitlists. I have had walk-ins that are just first come, first serve. There's not one-size-fits-all for this. Like, in West Virginia, we're going to a central site, to where people can locate vaccine, and then, from there, it can go to either the provider portal, or it can go to the actual portal for that pharmacy - for pharmacies. So I'm hopeful that that will help to make things go a little bit smoother.

MCCAMMON: Of course, every state, every community is different. But are there lessons that you think other states can take away from what West Virginia has done here?

MASSEY: Yeah, I agree. Especially when you start to deal with states that have more urban areas and population centers, you have to have some different tactics. But the root of the message is that people need to trust in the shot, and they need to trust that the people are being honest with them when they go to take the vaccinations. You need to provide good information. And honestly, they want to make the decisions themselves. And if they come to that decision, it's a whole lot easier to get them to take the vaccine.

MCCAMMON: That is Drew Massey, director of pharmacy operations at Fruth Pharmacy in West Virginia. Thank you for your time.

MASSEY: Oh, absolutely. Thank you for having me on the program. Transcript provided by NPR, Copyright NPR.

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