Once a COVID-19 vaccine is approved, Alabama health officials foresee many deployment barriers to rural and impoverished areas, reports The Washington Post.
"Administering a vaccine in rural Alabama is not about pulling up to a Walmart parking lot," said John McGuinness, MD, a member of the committee advising Alabama on vaccine distribution. "This amounts to a military campaign, moving from town to town and gathering demographics, relying on local leaders and being comprehensive in that way."
Medical distrust pervades the state's Black community since the syphilis patients in Tuskegee, Ala., were deceived and withheld treatment from 1932 to 1972.
"That still haunts us today," said Benard Simelton, president of the Alabama State Conference of the NAACP.
Also threatening inoculation efforts is the "unprecedented head wind of disinformation," said Jim Carnes, policy director for Alabama Arise, an advocacy group for low-income residents. "How are you going to get people to take a vaccine to fight a virus they don't believe in?"
Vaccines requiring ultracold storage are "not practical" in rural areas without big hospitals, said Shane Lee, MD, a physician in Perry County, Ala. Drive-up sites are also not realistic because more than 16 percent of households in Perry County don't have a vehicle, he said.
"There are so many logistical issues that they, in total, are mind-blowing," said Scott Harris, MD, Alabama's state health officer.
Such access and racial disparity issues are mirrored across the U.S., said David Kimberlin, MD, a pediatric infectious disease specialist at the University of Alabama at Birmingham.
"Our challenges are not unique to us," said Dr. Kimberlin, the American Academy of Pediatrics' liaison to the CDC's Advisory Committee on Immunization Practices. "We are a relatively rural state, and we are in a part of the country where, generally speaking, people don't like to be told what to do."
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