The Washington PostDemocracy Dies in Darkness

One county has twice as many covid-19 deaths. The other does much better with vaccinations.

U.S. Air Force Tech. Sgt. Kyle Trengo prepares to administer the Moderna coronavirus vaccine at the Talbot County Community Center in Easton, Md., on Friday. (Will Newton for The Washington Post)
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Less than 4 percent of residents in the Maryland county hit hardest by the coronavirus have received their first dose of vaccine — the lowest rate in the state.

Across the Chesapeake Bay, more than 13 percent of residents have gotten their first shots, in a county that has largely escaped the brunt of the pandemic.

Prince George’s County, a majority Black suburb of Washington, and Talbot County, a much smaller, majority White community on the Eastern Shore, are emblematic of the successes and failures of the nation’s vaccine rollout — and the disparate realities playing out within states.

One reason is an inequitable distribution process: Because the state gives even sparsely populated counties at least 300 weekly doses, Talbot has received 16 doses per 1,000 residents, according to state data, while Prince George’s got nine doses per 1,000 residents.

But officials also say smaller jurisdictions are more nimble than large ones, and Prince George’s has been especially hurt by vaccine reluctance in Black and Latino communities.

“We may all be in the same storm, but we are in different boats,” said Stephen B. Thomas, head of the Maryland Center for Health Equity at the University of Maryland.

In Prince George’s, hundreds who signed up to get vaccinated found themselves waiting for hours in the cold. Others have been wary — or willing but unable to get appointments, clamoring for a supply of doses that lawmakers say needs to be increased.

Meanwhile, in Talbot — a haven for retirees 30 minutes from Annapolis — nearly all 700 public school teachers have gotten their first shot, and everyone in independent living facilities who wanted to be vaccinated has been. Officials want to expand the operation to local fire stations, which normally host weekly bingos. They, too, need more doses.

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The state has taken steps to boost vaccination rates in Prince George’s, including opening a mass vaccination clinic at Six Flags America on Friday. But health experts and lawmakers say long-standing problems continue to plague vaccination efforts, including a cash-strapped health department, distrust among Black and Latino residents, and disparities in access to health care. They want a greater focus on equity in distribution of the precious elixir, noting that there have been nearly twice as many covid-19 deaths per capita in Prince George’s as in Talbot.

Maryland Gov. Larry Hogan (R) announced the state will launch mass vaccination center, as well as deploy pharmacists at select Safeway and Rite Aid stores. (Video: Gov. Larry Hogan)

“Go where the Black and Brown people are,” said Del. Joseline A. Peña-Melnyk (D-Prince George’s), who has lost her father, a cousin and two friends to the coronavirus. “The number of people that are dying and positive is much higher in those communities . . . you have to have a preference.”

Your questions about the coronavirus vaccine, answered

Demand and misinformation

Standing in his barber shop in a Hyattsville strip mall — in a Zip code with one of the highest numbers of coronavirus cases in the state — Mike Brown lists the vaccine rumors he has heard. It’s a sterilization effort. It’s a way to put microchips in people. It’s somehow related to the Tuskegee syphilis experiment.

Brown, 49, is part of a network of barbers working with Thomas, the U-Md. professor, to dispel the tide of misinformation. “I’m definitely pro-vaccine,” he told an old middle school friend who came in the other day. “We’ve got to take it to protect ourselves.”

County Executive Angela D. Alsobrooks (D) has talked publicly about the challenges posed by mistrust of the vaccine, noting that her mother and cousin were reluctant to be vaccinated.

But the county health department, depleted by months of fighting the virus, also faced a shortage of medical staff to administer shots early on, made worse by the departure of nurses hired with federal Cares Act funding that was slated to end.

Health Officer Ernest Carter said there are now enough vaccine administrators, thanks to a surge of volunteers through the state’s network, paramedics from the fire department and the Maryland National Guard.

County officials reversed an initial decision to let people from outside the county snap up appointments. And after seeing long lines outside the Wayne K. Curry Sports and Learning Center in Largo, officials changed the rules so people could wait in their cars.

Still, technical and logistical barriers remain.

Raechelle Bolding said she registered her 80-year-old father two weeks ago, but he still doesn’t have an appointment. He could not sign up online because he does not have a computer. He has hypertension and has survived a heart attack, but he insists on volunteering at his church — which his daughter worries puts him at increased risk.

“I just don’t get it,” she said.

Most nursing home workers refused the vaccine. Some facilities convinced them.

To address hesitancy at Villa Rosa Nursing and Rehabilitation in Mitchellville, administrator Barry Grofic offered workers a $75 vaccination bonus, along with weekly online updates and printed information from the Centers for Disease Control and Prevention.

About half the staff got a shot at the first clinic on Dec. 30. By the second, that number was up to 76 percent. Grofic expects 93 percent will have gotten at least one shot by the next clinic, on Wednesday.

“We started early because we knew it might be an uphill situation,” he said.

Angelo Consoli, president of the county’s Fraternal Order of Police lodge, said about 40 percent of Prince George’s officers got the vaccine when it was first offered in January. Consoli said there was a lot of nervousness that could have been dispelled if they had had more advance notice from the county and more educational information.

At Doctors Community Medical Center in Lanham, wary employees cited decades of racism in medicine, hospital President Deneen Richmond said, and the experience of Susan Moore, a Black doctor from Indiana who alleged racist treatment before dying of covid-19.

Richmond is giving out literature, hosting town halls and inviting community leaders to get vaccinated at Doctors, then share their experience on social media.

She emphasized that while the attention being paid to hesitancy is important, officials must continue to focus on boosting the number of doses sent to the county.

“There are a lot of people, including Black and Brown people, who want to get vaccinated,” she said.

Between 80,000 and 90,000 people are preregistered at Doctors.

'All hands on deck'

The head of human resources for the Talbot County Health Department was checking people into its weekly mass vaccination clinic on Friday, next to a man who normally troubleshoots the department’s computers. At the door was the woman who ordinarily handles Medicaid enrollment.

“It really is all hands on deck,” said acting health director Maria Maguire, walking through a community center that normally hosts curling competitions. Within nine hours, 720 people were scheduled for their first or second shots, including health-care workers, teachers and seniors.

Alan Kirk, 94, proudly sat with his “I got the vaccine” sticker on his light blue sweater, as he waited the required 15 minutes before leaving the center. “They are so efficient,” he said.

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Maguire said she is not exactly sure how her staff of 102 permanent employees has gotten 97 percent of its vaccines into the arms of its residents, outperforming bigger and wealthier counties.

“We’re so used to just kind of turning on a dime to make something happen, with no resources,” she said.

Take the decision to convert the curling rink into a vaccination site.

Health officials considered using a drive-through location that worked so well for testing. Then they thought about their nurses, paramedics and National Guard troops trying to draw a liquid from vials in frigid weather and give shots to a mostly elderly clientele.

The county also prioritized by age among senior citizens, starting with those 80 and older, while going directly to people who are homebound. Officials decided it was more efficient to use the county clinic to vaccinate workers from private medical practices, instead of sending teams to those doctors’ offices.

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But Talbot also has a waiting list of thousands of eligible residents. After its weekly allocation recently dropped from 600 doses to 300, Maguire said it may take from 11 to 15 weeks for those people to get vaccinated.

“There’s a lot of confusion right now,” said Del. Johnny Mautz (R-Talbot). “The process is really a challenge.”

Russ Dwyer, 75, a waterman who has never received the flu vaccine, has put his name on lists at hospitals, drugstores and the county health department. He even tried his doctor’s office with no success. Two weeks ago, a close friend died of covid-19. The man was 77 and otherwise healthy. “It’s scary,” Dwyer said.

Before its allotment was cut, Maguire said, Talbot and some other small counties had asked the state whether they could move through the phases of eligibility at their own pace. Now Talbot, like Prince George’s and other large jurisdictions, is having trouble keeping pace with the stages sanctioned by Annapolis.

Complicating the picture further, retailers who get their own supply of vaccine from the state appear to be following different guidelines in some instances; Maguire said she has preliminary data showing that the local Walmart gave 27 percent of its doses to people who didn’t meet the criteria.

“It’s kind of frustrating from our end when we’re trying to stick to this ethically devised prioritization scheme, which is essentially rationing, you know?” she said. “And then there is another player who for whatever reason is not sticking to it. It’s been a weird experience.”

Equity is not equality

State lawmakers are watching closely, with Democrats calling on Gov. Larry Hogan (R) to send doses to communities that have seen the most cases and deaths.

“Equity isn’t just about making sure that you’re dividing equally by population,” Sen. Mary L. Washington (D-Baltimore City) told acting health secretary Dennis Schrader at a hearing. “Equity from a public health perspective . . . and any number of perspectives is making sure that you are giving what is needed.”

Schrader said a vaccine equity task force will look at the issue and said the state is trying to get more doses to hard-hit areas through outside providers. Hogan touted one such program last month at a Giant pharmacy in District Heights. “This terrible disease has really affected the communities of color more than anyone,” he said.

But about half of the people getting vaccinated that day were White, said District Heights Mayor Johnathan Medlock. Medlock was not surprised. He knows fear of the vaccine runs deep in his community, and many residents lack computers and Internet savvy.

He left the event feeling grateful for the older Black residents who had come to get their shots — and hopeful they would encourage others to do the same.