Vermont has the highest rate of complete COVID-19 vaccinations in the country, according to USAFacts. As of early November, about 80% of Vermonters had received at least one shot of the vaccine. US News reports that Vermont’s success in its vaccine rollout is due to a range of factors and strategies – some of which are especially suited for a small state like Vermont, experts say.
State health officials have a centralized data source, keeping track of vaccinations and providing one-stop, consistent guidance for residents. They use trusted messengers – whether they are local first responders, immigrant aid groups or respected local pharmacists. And they don’t try to cajole people into traveling to some mass vaccination site. They bring the vaccine to the people.
Vermont did mass vaccinations but also showed up at smaller events – the local general store, gas stations, local car races and “mud bogging” events, where people drive off-road vehicles, says Jenney Samuelson, deputy secretary of the Vermont Agency of Human Services. “I don’t know how many people said, ‘I wasn’t thinking of getting the vaccine today, but it’s right here,’ ” Samuelson says.
Vermont starts out with some demographic and cultural advantages. The state is older than the national average – 20% of residents are 65 or older, compared to 16.5% nationally, according to the census. And seniors have a higher vaccination rate: Nationally, more than 94% of those 65-74 have gotten at least one shot, and 90% of those 75 and older have been at least partially inoculated. Those numbers drop steadily among younger age groups.
Vermont, while famously independent, also has a strong sense of community, Samuelson and others say, spurring people to get vaccinated as a matter of public health. “There is a collaborative spirit,” says Dr. Jan Carney, professor of medicine and associate dean for public health and health policy at the University of Vermont.
But that still meant state health officials had a big challenge in getting people vaccinated. Vermont is a small state, but also largely rural – around 60% of its residents live in rural areas.
To start, state officials created a central site for people to sign up for a vaccine and to get information, avoiding the patchwork of sign-ups from different pharmacies and other providers, Carney explains. Unlike other states, Vermont has a state health agency with local offices; it does not have county health departments. That made it easier to establish a single source for vaccination information and guidance.
Officials also didn’t rely just on the internet to get the message across, which could exclude people who don’t have broadband access or aren’t comfortable with digital technology. They also used old-school posters, local newspaper ads and school newsletters, Hazelton says.
While using mass vaccination sites such as schools and arenas for those who could make the trip, officials set about getting to those not-so-easily reached. That meant creating pop-up clinics in unconventional places, such as fishing accesses (where Vermonters park their boats to fish) and the euphemistically-named “transfer stations” – aka the dump.
First responders would also go right to people’s homes, an essential service for those who physically cannot leave the house or travel. Further, such visits are familiar to people, since they are used to having such volunteers come to their homes for emergencies. “It’s amazing. The tears” from people when they see someone has come in person to deliver a vaccine, says Mark Podgwaite, executive director of the Waterbury Ambulance Service. “They can’t believe we are coming to their home.”
In classic Vermonter form, Podgwaite says, a woman asked if there was anything she needed to do to prepare for the vaccine visit. He told her to have coffee and cake waiting. “I was kidding!” he says – but the refreshments were indeed ready for him when he arrived.
That episode, officials say, reflects another critical element of the Vermont vaccination strategy – use messengers local people know and trust to ease worries among vaccine skeptics. “Firefighters and ambulance drivers are local heroes, and are local leaders,” Samuelson says. The strategy is to be “culturally competent. Not only were (the vaccination sites) closer to home, but we made sure the vaccinators were culturally competent and appropriate for the setting.”
That includes a targeted outreach to what some nonprofit workers call the “new American community” – immigrants and refugees who may have a language barrier or be unschooled in how to receive health care, including the COVID-19 vaccine.
The Association of Africans Living in Vermont got involved in the vaccine effort by educating new Americans, following up to help them make appointments and to tell them what to expect, and providing translators for a wide swath of foreign language speakers. The group has informational videos on YouTube channels in 10 languages (French, Spanish, Arabic, Burmese, Kirundi, Maay Maay, Nepali, Swahili, Somali and Vietnamese) that explain everything from the delta variant to when and how to get a booster shot.
The Burlington-based group also had a vaccination site in Winooski, Vermont, a small but densely populated town near Burlington, where there are more newcomers to the country, says Thato Ratsebe, the association’s associate director and programs manager. “I think that’s what drives our success rate – the ability to give facts about the vaccine” in languages and through channels that are familiar to people, she says. Initially, “there were myths about the vaccine” – such as incorrect rumors that it had an impact on fertility – but the association was able to counter those through its outreach campaign, Ratsebe says.
The Washington Post reports that Vermont has recently seen a spike in infections, but that’s happening in a number of states because of the delta variant, Carney says. “It pops up a little differently in different states,” she says. And Vermont still had the lowest per capita death rate nationwide for the duration of the pandemic as of November 10, with about 62 deaths per 100,000 people, compared to the national average of about 228 deaths per 100,000.
And for the vaccine holdouts, “we try to spread the message of being compassionate to folks who have chosen not to get vaccinated, and to provide information rather than condemnation,” Samuelson says. With its high inoculation rate, Vermont doesn’t have far to go.
—
Photo Credit: Katherine Welles / Shutterstock.com