Tennessee, which rivals Mississippi and Alabama for the lowest vaccination rates in the nation, turned away more than 80% of its coronavirus vaccine allotment last week, a billboard-sized sign of hesitancy in the Volunteer State.

“The hesitancy we are experiencing here is not unique to Tennessee, and it’s not unique to rural areas,” Health Commissioner Dr. Lisa Piercey said in a news briefing Tuesday, April 27.

“It is a bit worse in Tennessee. It is a bit worse in our rural areas, but it is something that the entire nation is experiencing.”

Next four weeks ‘critical’ as federal vaccine help likely to move on in May

In early April, the City of Memphis was giving 60,000 shots a week. Monday, April 26, it gave a total of 1,100 shots across all of its public drive-thru venues, a marked decrease in rate from the 20,000 it gave last week.

In the meantime, Tennessee is not losing access to the unused doses.

“The federal allocation is still reserved for us. We still have access to it,” Piercey said.

If there were a surge in demand, or if the Pfizer vaccine receives approval for children ages 12 and up, as experts believe will happen, Tennessee will have supply for demand.

“Right now, we are able to fulfill any of the orders our providers have made because the ordering, quite frankly, is lower than the maximum supply,” Piercey said.

Decreasing demand is a tragedy, says Dr. Rebecca Wurtz, associate professor at the University of Minnesota School of Public Health.

“Younger adults somehow believe that they are not at risk for serious consequences of COVID, but almost 25,000 people younger than 49 have died from COVID. Studies are beginning to show that as many as half of the children and 30% of adults who get COVID have long-lasting, even debilitating symptoms,” Wurtz said.

“People are under the impression that the vaccine is worse than the disease, when the disease is thousands — tens of thousands of times more dangerous — than the vaccine. And every person who isn’t vaccinated is potentially a vector, bringing COVID to immunocompromised people who don’t get protection from the vaccine, to children who are, as yet unable to get the vaccine, and to the small proportion of people (<5%) for whom the vaccine doesn’t work.”

State surveys found demographic groups have different reasons for being reluctant. Rural white conservatives voiced the strongest sentiments, including doubting the need for the vaccine.

Another issue, particularly among Hispanic residents, is the belief that the vaccine causes death.

“We want to reassure folks that there are exceedingly, exceedingly higher chances that you will contract COVID and die from it than the vaccine itself,” Piercey said.

“Now, albeit the risk of death from COVID is still relatively low, particularly in younger populations, but it’s not zero by any stretch of the imagination, but it is exceedingly more likely than death from the vaccine.”

Low vaccine turnout raises questions about how long military needed at Pipkin

Wurtz suspects the J&J vaccine pause April 13 scared even more people.

“Some may not understand that its safety concerns don’t apply to the mRNA vaccines. I think the most likely people to want to get vaccinated (older people, people with underlying conditions, maybe women, maybe liberal people) went right out and got vaccinated as soon as they could, and now we are dealing with people with more ambivalence,” she said.

The J&J vaccine was resumed last weekend, including in Tennessee.

Sidney Hickey is among the 75% of Tennesseans age 70 and above who have been vaccinated. She now watches the landscape and nightly news in disbelief.

“My concerns are like those of many others — the threat of the variants increasing our cases among those who are not vaccinated and the inability for everyone to return to a more normal life due to the threat of the virus among those unvaccinated,” she said.

Hickey worries that pockets of outbreaks will prolong the instability of the economy, particularly in the service industry.

Gov. Bill Lee on Tuesday said the serious public health threat is no longer an issue that requires masking mandates. Although Tennessee never had a mask mandate, many counties did.

Lee asked that the six metro counties that have independent health departments, which includes Shelby County, to lift their mask mandates by May 30.

Local health authorities here said they had not had time to review Lee’s order nor the CDC guidelines, which were also issued Tuesday. Those guidelines lifted some restrictions on masking for outdoor activities, including for those not vaccinated.

Piercey said she would have no authority to take action against counties that retain their mask mandates.

“That would be at the discretion of the governor,” she said, noting that eliminating the mandate in no way means people couldn’t use masks.

“Just because the requirement goes away doesn’t mean the masks are going to go away forever and ever,” Piercey said. “People can still wear masks if they feel uncomfortable or if a private entity wants to have an organizational policy, they can still do that.”

On Saturday, May 1, the state will begin a digital media campaign directed to the hesitant, based on the responses of 1,000 vaccine-hesitant residents surveyed in March and April. A series of public service announcements will follow, beginning in mid-May, in traditional media.

That campaign is scheduled to run weeks or longer.

It may take that long for the hesitant “to sort of come around,” Piercey said.

“That’s OK. We want to support them and give them the information along the way.”

In a state where less than a quarter of adults are fully vaccinated, Piercey was asked about the wisdom of easing restrictions.

“It’s always been my stance that Tennesseans are intelligent people, and they know what they want, and they know what’s right for them,” she said.

“And so, it’s not a secret to anybody in this state of what to do to protect oneself: Wear a mask when you’re in a crowded indoor situation, get vaccinated, keep your distance, wash your hands. It’s the same stuff we’ve been saying for 15 months.”