Editor’s note: The goal of the Biden Administration is to have 70% of U.S. adults get at least one vaccine shot by July 4. An earlier version of the story misstated the goal.

Nathan Bridges, a retired Customs and Border Protection officer from Newnan, didn’t want to get vaccinated against COVID-19. He questioned how the vaccines were developed so quickly. The federal government was pushing them suspiciously hard. When Georgia’s state mass vaccination sites last week announced their wind-down, it was no loss to Bridges, who had no intention of darkening their doors.

Something did change Bridges’ mind, though: a conversation with his doctor when he went for his checkup.

Georgia is at a major turning point in the vaccination effort, and the numbers are troubling. At the moment when the state is running out of people eager to get the shot, only about 25% of all Georgians are fully vaccinated, while another 10% have had one of two shots needed. Although no one knows what exact level will constitute herd immunity, Georgia’s numbers aren’t anywhere close. They’re also worse than those of most other states.

Getting to and sustaining a semblance of normalcy will depend on reaching millions of people who, for different reasons, have not had shots. Some, like Bridges, hang back out of concerns about the vaccines. Others face a range of obstacles, which may exist in different combinations for each person: Some have unpredictable schedules that foreclose a set vaccination time, or work two jobs, or lack paid time off if they get sick with side effects. People may lack a computer, or a doctor, or child care, or access to a car. Or they may fear needles.

Millions more might be unreachable, so entrenched in their opposition to vaccines that they won’t budge.

There are strategies that may work on the persuadable, however, people involved in the effort say: going directly to them, making time off easy, speaking face to face, networking, bringing answers and facts.

U.S. Army soldiers from Fort Stewart help some of the elderly through the process of getting their first vaccination at Mercedes-Benz Stadium in March. (Curtis Compton / Curtis.Compton@ajc.com)

Credit: Curtis Compton / Curtis.Compton@ajc.com

icon to expand image

Credit: Curtis Compton / Curtis.Compton@ajc.com

It’s just an open question whether Georgia, with its already lagging record fighting the pandemic, can do what it takes.

Those on the front lines of the inoculation fight say those effective strategies take staff and money — and a lot of it, to be truly comprehensive. Some say the state Department of Public Health is too stretched to do that.

Take what happened with Bridges, who turned around when he heard from the doctor he knows. Bridges said his longtime family medicine physician’s belief in vaccination persuaded him. “I trust him, and he feels like it’s doing what it’s supposed to do,” he said of Dr. Cecil Bennett.

Bridges still has not been vaccinated, however. That’s because Bennett has yet to receive doses for his practice. Bennett said he registered for doses on March 15. The state says it didn’t receive his first order, though, until May 3. His practice is to get the vaccine next week.

“It should not be this hard,” Bennett said.

Precision work

Nationwide the hope of reaching herd immunity — the point where so many people are immune that infection chains must die out — is fading.

“We don’t have (a chance at) herd immunity anymore,” said Eva Lee, a Georgia-based epidemic computer model expert. “We were too late. Forget about that. It’s not going to happen.”

Another expert, Amber Schmidtke, says Georgia may eventually wind up with herd immunity. But it might be the hard way, as the virus rips through millions of unprotected people, rather than through the protective blanket of vaccination.

Vaccinations slowing in Georgia

Credit: For the AJC

icon to expand image

Credit: For the AJC

Leaders are moving on. On Tuesday, President Biden announced a different goal: to have 70% of American adults get at least one dose by July 4.

Experts say that although that would not necessarily bring herd immunity, it would bring a large measure of freedom. Yet even that will be a heavy lift, not just because of the number of people who have not been vaccinated, but because of the work it will take to reach them.

Roswell resident Galo Ivan Navas, 56, who said he tested positive for COVID-19 three months ago, works long hours during the week. He tried to make an appointment through some pharmacies, but he said he couldn’t secure a weekend appointment. Navas, originally from Ecuador, eventually made his appointment at the Mexican Consulate, where the Morehouse School of Medicine set up a clinic one day and posted it on Facebook.

Fourth-year Morehouse School of Medicine medical student Nikki Jones administers a COVID-19 vaccine to Rosibel Nava Munivez at the Mexican Consulate in Atlanta earlier this week. (Steve Schaefer for The Atlanta Journal-Constitution)

Credit: Steve Schaefer

icon to expand image

Credit: Steve Schaefer

Mexican Consul General F. Javier Díaz said those on the frontlines of Georgia’s vaccination effort must be more present in places people trust, such as places of worship and community centers, as the state and nation reach a critical juncture in the pandemic.

“I think we’ve done the easy things so far,” Díaz said.

Lorenzo Martinoli, 23, of Brookhaven had other things on his mind besides scheduling a vaccine. He works a restaurant job where his hours change week to week, making scheduling impossible. He loathes needles. But last week, a pharmacy a quick drive from home held a clinic with the one-shot Johnson & Johnson vaccine — and with a doctor promoting pain-blocking techniques. His mom saw the ad. They could go the next day. He said yes.

Martinoli’s mom, Pam Irvin, had waffled herself on the science around the vaccine, then tried scheduling through the state website but was offered slots only in Dalton and Valdosta. “If your doctor had it and all you had to do was go to a doctor and get it, it would have made a world of difference, in my opinion,” Irvin said.

The vaccination hurdles are the same ones that drag Georgia down in other areas of health and quality of life. Georgia ranks among the 11 worst states for the number of people in rural counties who don’t have access to a car. It ranks among the worst states for people forgoing medical care because they can’t afford it. Several Georgia counties have no doctor at all.


icon to expand image

Jodie Guest, vice chair of epidemiology at Emory University’s Rollins School of Public Health, has worked on vaccination with the Latino Community Fund Georgia and the Mexican Consulate. Many undocumented residents still fear being turned away for not having insurance or a driver’s license, or, worse, being turned over to federal immigration authorities. Their family members who are legal residents may fear that showing up could bring attention to the household.

If the state really cares about vaccinating significantly more people, Guest said, it must take seriously enough the barriers posed by people’s life circumstances.

“Every one of those is a rate-limiting factor,” Guest said. “We really need to make it so that vaccinations, you stumble upon them. There’s no way you don’t see a place to get a vaccination.”

A patchwork

The state says it is trying. In plans drawn up last year and in accomplishments touted this spring, DPH listed partnerships with churches and places of work.

Its work so far includes “significant community engagement with diverse populations — for example, mobile community vaccination sites have been held with African American faith communities, the Latinx community and the Mexican Consulate, incarcerated persons, migrant farmworkers in rural areas and essential workers in non-heath care setting, like poultry factories.”

“We really need to make it so that vaccinations, you stumble upon them. There's no way you don't see a place to get a vaccination."

- Jodie Guest, vice chair of epidemiology at Emory University’s Rollins School of Public Health

People involved in vaccination efforts across the state, in private pharmacies or hospitals or in government public health, confirm that.

But, there’s no indication the effort is enough to methodically blanket the state, proactively calling all congregations or workplaces county by county, calling back if they don’t reply and scheduling. And then sending mobile clinics to those places, to administer shots and talk to the hesitant face-to-face.

The Atlanta Journal-Constitution recently polled Georgians on vaccination. Among those who haven’t got their vaccines yet, about 13% are still eager; they said they would as soon as possible. One-third said they’d wait and see.

Half of the unvaccinated, though, said they don’t plan on getting a shot. Nearly two-thirds of Republicans and a quarter of Democrats say they won’t. One-third of Black voters who haven’t got their vaccine yet don’t intend to get one, and 45% are in wait-and-see mode.

Hugh Chancy runs Chancy Drugs in Hahira, and his business has taken on the mission to vaccinate people in surrounding counties. Chancy and his son go out to the events, and they take questions. They explain the 20 years of research that went into mRNA vaccines, Pfizer-BioNTech and Moderna.

Hugh Chancy, owner of Chancy Drugs of Hahira, speaks to locals at a community center about the COVID-19 vaccine and spends time answering their questions. “When somebody tells me no, I say, ‘I understand, but tell me why,’” Chancy said. (Courtesy of Hugh Chancy)

icon to expand image

“When somebody tells me no, I say, ‘I understand, but tell me why,’” Chancy said. “I think when you’re face to face you can tell how much I care — there’s a sincerity there that you can see. It does matter.” He vaccinated one man who hated needles and had not had a shot since 1969.

Chancy could do much more with more manpower, he said. With just the dozens of off-site events so far on top of vaccinations at his pharmacies, his employees “have had to do double time to make it happen.”

In Douglasville, pharmacist Bryan Green, who owns Premier Drugstore, takes vaccines to where people are with pop-up clinics, inoculating about 6,000. His most popular events have been at a bar, Tito’s Lounge.

In Preston, pharmacist Nikki Bryant said she couldn’t deal with the bureaucracy and unpredictable deliveries to sign up as a vaccine provider. But she invited Phoebe Putney Health System to bring one of its two mobile vaccine clinic trailers for an event at her store. Bryant, deeply connected in her community, promoted it on her Facebook page and directly to clients. When the trailer was there, she told people shopping in the aisles to consider getting a shot right then. It was one of the mobile clinic’s most successful events so far.

Phoebe Putney Health System, based in Albany, uses a mobile health unit to bring vaccination clinics to rural communities such as this one in Baker County. (Courtesy of Phoebe Putney Health System)

icon to expand image

Phoebe Putney, the main hospital system in southwest Georgia, sped up its plan to buy the two trailers in order to devote them to vaccination clinics. Will Peterson, Phoebe’s vice president for operations, believes that such events are the only way out of the pandemic.

He recalled one event where an older African American had not yet been vaccinated but registered through Phoebe’s mobile clinic. The man “pulled up in his golf cart,” Peterson recalled. “He said, ‘I’ll be right back.’

“And for the next two hours he brought us 14 individuals...Those are resources that we will never tap into unless we go to the communities.”

Falling short

At its initial sites and mass vaccination center, Phoebe administered 53,000 vaccinations, Peterson said. But his hope was 100,000, and Phoebe is now winding them down for lack of demand.

Given how hard COVID-19 hit the area, and how people saw members of their own community suffer, that is disappointing to him.

Peterson praises the local public health district’s leadership, but he said its resources are not enough to blanket the area. For example, the public health office gladly lent staff to help Phoebe begin mass vaccination. But it wasn’t long before the director was back on the phone asking for those staff back to do vaccinations there.

Premier Drugstore's most successful outside vaccination clinics have been at Tito's Lounge in Douglasville.  The lounge made up slogans like "Get your shot, Have a shot." (Courtesy of Bryan Green)

Credit: Courtesy of Bryan Green

icon to expand image

Credit: Courtesy of Bryan Green

Peterson believes that if someone had the staff to make calls, schedule stops and provide nurses and vehicles in a comprehensive effort, there is demand it would meet. From what he’s seen, DPH is too stretched for that.

“I’ve got to be honest with you, more than anything it’s resources,” Peterson said. “Human beings. The resources to provide vaccinations and put needles in arms.”

DPH acknowledges that there’s more work to be done, including getting more doses to more places, including local doctors’ offices.

“Communities of color, correctional facilities, and Georgia’s rural communities, however, continue to be of primary concern and focus,” spokeswoman Nancy Nydam told the AJC.

DPH did not request a budget increase this year, though, to deal with the pandemic.

Asked how many nurses and qualified vaccinators Georgia public health offices have on staff, Nydam said she would not answer. “that number by itself is irrelevant,” she said in an email. “Administering vaccine takes more people than the nurses who put the vaccine in someone’s arm. Nearly all (public health) staff have been deployed in some capacity to either vaccinate or handle logistics of vaccinations. Additionally, we have many volunteers who are helping us daily.” She added that DPH has always relied on partnerships with private organizations, and provided a list of dozens of vaccination events public health workers have held at churches, workplaces and community spaces across the state.

Not far away from Phoebe, historically Black Albany State University hosted a meeting last week with DPH Commissioner Dr. Kathleen Toomey and a dozen Black faith-based leaders in the Albany area. She came after the leaders said they tried to get doses administered at their locations, but were rebuffed by local health officials and left out of local campaigns to raise vaccine awareness.

Nydam, Toomey’s spokeswoman, responded that until a month ago, DPH’s vaccine supply was limited and so it was difficult to accommodate requests for pop-up or on-site clinics. She added that the freezer requirements and short windows of use for the early vaccines made mobile or pop-up clinics logistically challenging.

At the Albany session, “for the first time, there was a conversation between major stakeholders that was open and honest,” Mt. Zion Baptist Church Senior Pastor Daniel Simmons told the AJC. He said Toomey said she was unaware of the problem and would address their concerns.

Simmons credits the meeting for starting ongoing discussions with two organizations to send mobile units to people. The church held its first vaccine clinic after its worship service last Sunday, administering doses to nearly 50 members.

“We want (the vaccine),” Simmons said. “We want to be a part of the process.”