Rural dilemma: vaccinating hard-to-reach residents

Marion County signed up residents via telephone

By Julie Chang

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When Marion County officials got the call that they were going to receive hundreds of doses of a COVID-19 vaccine in January, they knew they had to find their own way to roll out the vaccinations — and different from that seen in other parts of the state. 

Many of the East Texas county’s 9,800 residents are elderly and live in areas without reliable internet access. So instead of relying on its residents to sign up for vaccinations online like many of its less rural counterparts had done, Marion County opened its phone lines. 

“Sandra Wright, our phenomenal clerk, took 600 phone calls over a course of a couple of days,” said Marion County Judge Leward LaFleur. “It took her 18 minutes to fill 50 vaccines. It took the online portal an hour to fill 50.”

Marion County’s vaccine distribution plan is among the different ways counties have delivered public health services to rural residents during the pandemic. Recognizing a different need for rural counties, state officials have deployed the Texas National Guard to vaccinate older residents in their homes in remote parts of the state. The effort was part of Gov. Greg Abbott’s plan to have a majority of residents over the age of 65 vaccinated by the end of March.

As of March, Marion County had received a total of 500 doses from the state. 

In February, LaFleur’s staff used the first round of vaccines — about 100 doses — in a pilot telephone sign-up program, which proved so successful that the county compiled a waitlist of 300 people from those calls. 

When state officials sent 400 more vaccine doses a few weeks later, all those slots were filled by people who called.

“We’re still getting calls every day asking if we have any available,” LaFleur said.

Unlike its less rural counterparts that received the vaccine as early as December, Marion County didn’t see its first dose until two months later. Several residents have had to travel dozens of miles to Longview, Texarkana or Shreveport, Louisiana, to get their shots. Although Marion County had received 500 vaccines from the state, as of February, about 1,500 residents had received their first dose. Many of them presumably had to travel outside of the county to do so.

“Residents want the vaccine but don’t want to travel to get it because they were told for the past year to not go anywhere,” LaFleur said.

LaFleur hopes the state will continue to focus on small counties like his that still need more deliveries. The county has had more than 330 COVID-19 cases since the start of the pandemic and more than 30 deaths. 

He said his residents want to be vaccinated. 

“We don't have the large resources that other counties have, so we're very, very blessed and happy that the state has come in and done what they have done,” LaFleur said. “But, you know, we need help.”