Winning over the 'vaccine hesitant,' one shot (of tequila) at a time

LAUREL, Ind. – Jennifer Profitt stands in front of a row of empty chairs in the old high school cafeteria, looking down at six syringes laid out side by side on a plastic folding table.

Each syringe contains a single dose of COVID-19 vaccine that will go to waste unless it’s used in just over an hour.

Profitt checks her phone and notes the time. She has until 8 p.m.

She and her team from the Franklin County Health Department are at the cafeteria on this rainy evening in early June to set up Laurel’s first temporary vaccination clinic. They brought a cooler filled with enough single-shot Johnson & Johnson vaccine to inoculate almost 100 people.

After two hours, they’ve given seven shots.

The place is quiet except for the chatter of a half-dozen health department workers and a volunteer who came to hand out hot dogs and bottled water to the newly vaccinated. No one stands in line at the check-in station. No one sits in the chairs waiting for a shot.

“We might get a late rush,” Profitt says, hopefully.

They all know the vaccine is a hard sell in Laurel. Four out of five people in Franklin County are unvaccinated – the lowest vaccination rate in Greater Cincinnati and the fourth-lowest among Indiana's 92 counties. Poor, rural towns like Laurel, where the median income is about half that of the rest of the nation, are a big reason why.

Fear, distrust and politics still dominate conversations about the vaccine among Laurel's 500 residents, complicating the job of public health officials, like Profitt, who worry the growing gap in America between communities with high and low vaccination rates will keep the pandemic going for years.

But as she paces the cafeteria’s white linoleum floor, waiting for a crowd that seems unlikely to show, Profitt feels she needs to keep trying. Not just because she’s the health department’s board president, but because she grew up in Franklin County and still lives here.

These are her friends and neighbors. She believes the vaccine can save their lives.

Profitt checks the time again. It’s 7 p.m. now, and the clock is ticking on those six doses of vaccine. She has exactly one hour.

She turns to Kim Neace, a nurse practitioner sitting at the table. Profitt tells her they need to try something different. If the good people of Laurel aren’t going to come to the clinic, she reasons, the clinic will go to them.

“Want to walk to the bar?” Profitt asks.

Neace pops to her feet, and together they head for the door.

‘A shot for a shot’

The old high school, now a community center, stands just a few blocks from the Long Branch Tavern on Pearl Street. Profitt and Neace can make it there on foot in about five minutes.

The Long Branch is a popular hangout among locals and a favorite stop for the BrokeAss Bikers motorcycle club, which rides through Laurel most Monday nights, including this one.

The trip to the bar isn’t a spur-of-the-moment decision. It’s a contingency plan. Worried about turnout at the clinic, Profitt arranged a few days earlier to come to the Long Branch with an offer: Anyone who got vaccinated would get a free shot of liquor.

She calls the deal “a shot for a shot.”

It’s no longer raining, but thick, dark clouds churn overhead as Profitt and Neace, dressed in blue scrubs with masks dangling from their wrists, make their way to the Long Branch.

Profitt’s mind is on the six shots back at the cafeteria. They have little flexibility on time. Once the vial is open, it can’t be stored for later use. The thought of failing, of wasting something she considers so valuable, gnaws at her.

“God, I hope we’re successful,” she says.

Neace tells her not to get her hopes up. In her practice, which covers much of Franklin County, she’s had many conversations with patients about their vaccine hesitancy. It takes time to build trust, she says, which is why her expectations for the Long Branch are modest.

“One vaccination is a success,” Neace says.

Profitt, a public health consultant with degrees in biochemistry and English, knows Neace is right. She’s been trying for months to convince and cajole Franklin County’s 23,000 residents to join the 150 million Americans who’ve been fully vaccinated.

She’s spoken to Pentecostal preachers and Masonic lodge leaders, she’s organized focus groups to better understand residents’ concerns, and she’s helped run a vaccination clinic at a flea market next to a tent where the Amish sell furniture.

Despite those efforts, she and other health officials have consistently fallen short of their goals. The flea market clinic was part of a campaign to vaccinate as many as 2,000 people in Franklin County, but it got just 700.

Profitt is determined to keep at it. She remembers too well the outbreaks that sickened and killed dozens here last year. And she remembers the cries of an elderly neighbor whose husband died of COVID-19, a wail so loud Profitt could hear it from her bedroom window.

Months later, when the vaccines came out, her neighbor lamented that her husband had fallen ill too soon. “I sure wish my Tom could’ve got that shot,” she told Profitt.

As she and Neace approach the Long Branch, Profitt reminds herself to be patient, despite the urgency she feels, despite the time running down on her six vaccine doses.

Don’t push too hard, she thinks. Don’t push people away.

Then she tugs open the door and walks inside.

Fear, skepticism and conspiracy theories

Profitt and Neace enter the bar around 7:05 and head to a table in the back, where two men are drinking beer and playing pool. Country music booms from the jukebox. A sign behind the bar reads, “We don’t dial 911.”

One of the guys playing pool notices their scrubs and walks closer to the table, cue in hand. Word had gotten around about why they are there.

“You seriously giving a shot out in bars?” he asks.

The pool player tells them he spent five days in the hospital with COVID-19. His lungs are now “fried,” he says, but he isn’t vaccinated and isn’t sure he wants to be. Neace tells him they have shots if he’s interested.

He shakes his head. “I think I’m all right.”

Profitt and Neace have heard this before. People are curious but wary. Even those they expect to be receptive often raise concerns about the vaccine.

A nursing director in Oldenburg told Profitt a week earlier that 40% of her staff and most of her own family, including her husband, brothers and three of her adult children, turned down vaccinations this spring. A recent meeting Profitt had with paramedics in Brookville ended with several questioning the need for vaccinations.

The skeptics say they worry about the speed of vaccine development and the uncertainty of long-term health effects. Some repeat disproven conspiracy theories involving infertility, aborted fetal tissue and plots against former President Donald Trump.

Profitt and Neace believe the best way to make the case for the vaccine is to avoid arguing and stick to the science. Their message is simple: Most vaccinated people experience mild side effects and appear to get a high degree of protection from COVID-19.

“You just have to walk softly,” Neace says after the pool player goes back to his game. “They’re a group of people who don’t want to be told what to do.”

To her, having doubts makes sense, especially among poor, rural or minority communities that feel neglected by the government and medical establishment. Now, those same institutions are telling people here to put their faith in the system and get the shot.

Franklin County residents don’t need a lecture, Neace says. They just need time.

Time is running out, though, on those six doses of vaccine. The clock is closing in on 7:30, leaving little more than a half-hour to use them. Profitt starts chatting up the dozen or so people at the bar, hoping to find some takers.

Several turn her down, but Lisa Walker and Michael Bannon say they’ve been thinking about the vaccine for a while. Bannon, wearing a black T-shirt that says, “Live Hard, Ride Hard,” tells Profitt he recently lost a friend to COVID-19.

“That’s one of the reasons I want to get it,” he says of the vaccine.

Profitt left the syringes on the cafeteria table in case they were needed there, but she tells Bannon she’ll be back with some shots in a few minutes.

As Profitt walks away, a woman sitting near Bannon and Walker takes a long drag on her cigarette. She says she won’t be joining them when Profitt returns with the vaccine.

“I ain’t putting that crap in my body,” she says.

Politics and the pandemic

The nurses back at the cafeteria give two shots while Profitt and Neace are gone, leaving four that must be used by the 8 p.m. deadline.

The clinic’s patients so far include a retired pizza shop owner who wants to start traveling again, a man whose father spent 65 days in the hospital with COVID-19 and a young woman who got the vaccine only because her boss paid her $750 to do it.

Gus Adams, who lives across the street and helped set up the clinic that afternoon, knows many of them because he taught high school and coached basketball in Franklin County for decades before retiring this spring.

But he hasn’t seen any of his neighbors in Laurel come in yet for a vaccination. So before Profitt and Neace left for the Long Branch that evening, Adams went outside to ask around.

Down the street, in a light drizzle, he found Anthony and Katie Neukam hanging out in their garage. Anthony was working on his motorcycle while Katie, still wearing scrubs from her job at a pharmacy, kept an eye on two of their three kids.

From the bottom of their driveway, Adams could see the bright red and white “VACCINE CLINIC” signs Profitt and her team had put up around the old high school a few hours earlier. He asked the couple if they had considered getting a shot.

“No way,” Anthony said.

“We’re not real big on shots,” Katie agreed.

She told Adams she’d read about the vaccine on the internet and believes it could make her infertile. She said she also worries it contains “aborted baby cells” and mercury, even though the manufacturers and the government say that’s untrue.

“They say it’s not in there,” Katie said, “but it is.”

Adams asked his neighbors if they’re Trump voters, and both said yes. Trump won 80% of the vote in Franklin County last year, so the answer wasn’t surprising.

Trump voters are significantly less likely to get vaccinated than their fellow Americans, and those views have had an impact: Three out of four U.S. counties, many of them in deep red states, report vaccination rates lower than the national rate of 45%.

“I personally think it was a plandemic, not a pandemic,” Anthony said. “I think it’s all made up.”

Adams, who was vaccinated in March, didn't challenge the assertion. He’s heard similar things from friends, students and neighbors since the pandemic began. Like Profitt, he sees no point in arguing.

Instead, he shook hands, said goodbye and began the short walk back to the clinic.

Running out of time

Profitt and Neace hustle from the Long Branch to the cafeteria and quickly pack the four remaining syringes, along with some alcohol swabs, latex gloves and Band-Aids. They return to the bar around 7:35 and get to work.

Everyone has a job to do. Profitt goes to the bar and rounds up Bannon, Walker and Wilbur Gray, a late volunteer who tells her he’s wanted a shot for months but couldn’t get to a pharmacy or hospital because he doesn’t own a car.

Mary Burk, the clinic’s registrar, opens her laptop on a table near the dance floor and starts signing people in. And Neace, who will give the shots, sits at an adjacent table with the syringes and swabs.

“This is called 'get ‘er done,'” Neace says. “Whatever else happens, we made some friends. We built some trust.”

One by one, Bannon, Walker and Gray take turns answering a few questions about their health, giving consent to receive the vaccine and sitting down next to Neace for a shot.

“Little stick,” Neace tells Walker before the jab.

Walker winces and watches Neace roll on a Band-Aid. “Thank you,” she says.

By 7:50, all three are done and drinking their second shot, paid for, Profitt says, by an anonymous donor. Walker got tequila, Bannon got Crown Royal and Gray ordered a Fireball.

But Profitt still has one syringe left. She’s got 10 minutes to find an arm for it.

“A shot for a shot!” she shouts toward the bar, trying to be heard over the jukebox. “It’s your choice!”

As she watches the minutes tick away on her phone, Profitt makes a final trip around the bar and back to the pool table. No luck.

She’s out of time. The last of the four shots will go to waste.

Profitt is disappointed but still considers the evening a success. They’ve brought the vaccine to people who wouldn’t otherwise have got it. They’ve made progress.

When they get back to the cafeteria, they learn a few more people had come in to the makeshift clinic for a shot while they were gone, bringing the total for the day to 15, including those from the Long Branch. But there’s a new problem.

A squirrel has chewed into an electrical line behind the high school, knocking out power. With daylight fading and more rain moving in, a darkening gloom falls over the cafeteria.

Profitt wants to keep the clinic running for another hour or two. They still have plenty of vaccine vials in the cooler and can open more if a late rush ever materializes, but they can’t give shots in the dark.

“We’re losing daylight,” Profitt says.

She and a few others scroll their cell phone contacts to see if anyone might know someone who wants a shot. They walk to the Masonic Lodge. They make a last circuit around the neighborhood.

Finding no takers, the team starts packing its gear and folding up the chairs and tables in the cafeteria, using cell phones for light.

Profitt gathers the signs outside and stuffs them into the trunk of her 2005 Mercury Marquis, where they’ll stay until she needs them again, at another clinic, in another town. Profitt thinks maybe they’ll try a library next.

For now, though, her work is over. The rain is falling, again, and it’s time to go home.