The City of Memphis has infrastructure to give 60,000 vaccines a week in its public drive-thru centers. At its peak a few weeks ago, it hit 50% capacity.

It is now delivering at a rate of 20,000 doses, even with a $100,000 investment in $20 gift cards last weekend.

State survey finds which demographics fear vaccine most

The frustration is evident. Tuesday, April 20, when a reporter asked Chief Operating Officer Doug McGowen what the city planned to do to right the ship, his usual confident response was thin.

“Well, that’s a great question, and I welcome your ideas.”

With the reproduction rate now well above 1, social media rife with images of unmasked people congregating in close quarters and case numbers in Week 3 of a sustained rise, the city is reaching out to behavioral experts to try to change the trajectory.

A fourth COVID surge would affect the young, workforce

“We’ve been talking internally about behavioral economics, and what actions we can take that will drive people’s behavior,” McGowen said.

Including the messaging, perhaps.

Last week, the state Department of Health released survey results of work it did in late March and early April to tease out reservations demographic groups have toward the vaccine. 

In an executive summary, the state Health Department is advised to use words such as “research,” “medical research,” “medical experts,” scientific” and “safety” to appeal to the 53.7% who are willing but hesitant to be vaccinated with the proviso that there is little chance of changing the minds of people who are against the vaccine.

Shelby County has 170 military personnel at the Pipkin center site in what is now the third week of a six-week commitment to boost vaccination levels. With FEMA and the Department of Defense participation comes 21,000 extra doses of vaccine a week.

While there is no threat the doses will be cut, the city also is not in the business of warehousing large inventories of vaccine, McGowen said.

City leaders, he said, are in constant communication with FEMA and the Department of Defense.

“We talk about what is the next step here if we don’t see demand pick up. We haven’t made any decisions yet.”

The issue is not unique to Memphis or even the state of Tennessee. Of the more than FEMA/DoD vaccination missions across the U.S., only two are meeting their “very aggressive” vaccination goals, McGowen said.

“There is no intention yet, but we talk every day about what our next steps might be so that we are not wasting manpower unnecessarily,” he said.

Locally, the goal is to vaccinate 700,000 people to reach herd immunity. But without vaccines approved for children under 16, that means reaching larger numbers of adults, which McGowen says will be difficult.

Since public vaccination began in the last days of 2020, 480,000 doses have been delivered in Shelby County, including shots given by some 90 private partners, including pharmacies and physician offices.

The city has tried a number of things to boost participation at the public sites, including opening up no-appointment days at the Pipkin. The new mass site at Southwest Tennessee Community College’s Gill campus in Frayser will be open Tuesdays and Thursdays; appointments are not necessary. It opened Tuesday, April 20.

Southwest opening Frayser COVID-19 vaccine site

Certainly, one of the strategies is eliminating appointments at all the public sites. But that is a hard decision when administering vaccine that, for the most part, must be stored at extremely cold temperatures.

Appointments indicate demand, which immediately translates into how much vaccine to thaw for next day’s clinics, McGowen said. 

Beyond the well-documented hesitancy, McGowen is also aware that people may be putting off getting the vaccine because they expect the public sites will be open indefinitely.

“Well, quite frankly, public vaccination efforts can’t go on forever,” he said, noting that the early signs of that are well in place now with COVID-19 vaccine available in many pharmacies and private doctors offices.

If a third booster is required later to protect against COVID variants, McGowen said it would not be prudent to be still needing first doses when others are getting the boosters.

The city’s most visible effort to increase participation involved $20 gift cards at the Pipkin last Friday and Saturday, roughly a $100,000 investment in city funds to see if giveaways increase participation.

The plan was to give the cards to the first 2,500 on both days. Over the two days, the city vaccinated 3,000 people, not exactly the “aspirational goal” it anticipated, McGowen said, but a beta test of what it might take to move people who are on the fence.

In a crowd of 3,000, data shows that at least 10 would get seriously ill from COVID and likely die, he said.

“So on balance, the cost was not necessarily a consideration, and compared to the overall cost of response, it was worth the effort to determine if we could get an uptick,” he said. 

The city will use the leftover cards to create other vaccination packages to drive demand.

“This is a race. We want to add fuel to the runners so that they come in and get vaccinated,” McGowen said.

Where we are

The reproductive rate is now 1.14, proof that the epidemic is growing again in Shelby County.

The rate of transmission can be a better gauge than daily case numbers of how fast the disease is progressing in the community.

Coronavirus: New cases hit two-month high

Tuesday, April 20, is a good example. The Shelby County Health Department reported 65 new cases, down from the 150-plus it has been reporting in the daily cycles. But weekends are typically slow test times, said David Sweat, deputy director of the Health Department.

“And so, in spite of the fact that we only had 65 cases reported yesterday, we know that in fact the epidemic is growing,” Sweat said. “That is what we’re concerned about and that’s why we want to remind everyone of the importance of always wearing a mask when you’re in public.”

The reproductive rate has been below 1 two times in the epidemic, including last summer through late September, and then again beginning in January 2021 where it stayed through much of March before ticking upward.

At 1.14, every person who tests positive is theoretically spreading the disease to 1.14 people.

“Crucially, a year ago when we were at this podium talking about the epidemic, the tool that we did not have was the vaccine,” Sweat said.

“We had no way to immunize people against this virus and prevent them from getting infected. Today we have that tool, and it’s amazing that a year later from when this epidemic really got started that we have this tool. That’s a miracle of science.”