A Florida vaccine warrior

Trying to change stubborn minds, one at a time.

Last week, a chilling bit of news emerged from Orlando, Florida: The city was calling on residents to pause watering their lawns. That’s unsettling enough news in America, a nation that embraces golf courses in deserts, but the reason was much more frightening: The city needed the liquid oxygen usually used in water treatment for Covid-19 patients, struggling to breathe with their own lungs.

This is happening even though Florida has a higher percentage of the population that’s vaccinated than neighboring states. 62.9% of the population have had one dose, and over 50% are fully vaccinated, compared to just 48.6% with at least one dose in Alabama, according to the Mayo Clinic. That probably reflects Florida’s older population—87.3% of their 65+ population is fully vaccinated, but for those 18-64, it’s just 55.8%. Yet the pandemic is worse than ever there. The New York Times reported Wednesday that there is an average of 227 Covid deaths a day in Florida, and the daily case rate is 30 percent higher than it was in the January wave. The vaccinated are extremely well protected, but the unvaccinated are catching the virus more than ever, and ICUs are packed.

To stop the spread of this deadly disease, more intervention is needed; it would surely help, for example, if the state’s governor stopped doing Psycho Republican Things like promising to withhold the salaries of school officials that impose mask mandates in their schools. (The AP reported that just over half of school children in the state will nonetheless be required to wear masks, which still means just under half… won’t.) And, of course, more younger people need to be vaccinated. The vaccine is still the single greatest tool against people dying from Covid-19, it is free, and we have a lot of it.

Today’s interview is with Sharon, which is not her real name. She helps her family run a store in a small town in Northern Florida, not far from the Alabama border. The median annual income there is $20,000 lower than the national median. (I’m concealing the city’s name because, as Sharon told me, it’s a small town where everyone knows each other.) When she’s at her job every day, Sharon talks to people about the vaccine. Have they managed to get it yet? If not, what’s holding them back? She told me she offers to go with them, and has done so in the past, to hold their hand if they’re afraid of needles. She told me many people just say no; recently, one customer told her that they’re taking Ivermectin, so it’s no big deal. Some of them send her links to right-wing websites with the ‘real facts’ about the vaccine. Her doctor even told her that he’s seen people he knows are vaccinated posting misinformation about the vaccine, she said.

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But for the ones that are interested, if hesitant or frightened, other barriers exist. The county vaccination site is open two hours a week. Some pharmacies insist on ID, even when their policy is not to require ID if the customer can’t provide it. Policies do vary on this by state and pharmacy chain; Walgreens issued a reminder of the policy not to insist on ID to their Massachusetts stores earlier this year. (ID rules matter even less now that the shots are available to anyone eligible in any state, unlike earlier this year.) Sharon specifically emailed one local chain’s regional manager, and was told it was not required; that message has not filtered down to all the store’s workers, it seems.

Sharon suspects the pharmacies won’t be able to get reimbursed without the ID, and that’s why they insist on it. You might remember that’s also what Rachel, whose mom was denied a vaccine back in February because of a Medicare issue, suspected too. Whether that is the case or it’s just a misguided application of rules—after all, everything in America usually requires a bunch of stupid bureaucracy—it can end up in a missed opportunity to vaccinate someone. When we spoke on the phone, Sharon told me that she also hears from people that they’re worried about getting bills; even when they know the vaccine is supposed to be free, they’ve heard about cases where people get a bill regardless.

Sharon told me she does this because many people in her community are dying. She’s patiently and doggedly pursuing this track with people, as far as she can, because she doesn’t “like the idea of giving up on people,” and this town has been her home all her life. Some of these people might not ever be reachable, but she’s chipping away at them, every day.

Note: This interview was conducted via Twitter direct message, but I had a very similar conversation with Sharon on the phone earlier that day. (I lost the recording due to being very stupid.)

Sick Note: How did you start talking to people about getting the shot?

Sharon: I run a small repair/retail type store with my family, & we have been in business in the community going back to the early 2000's. It's a rural community, small town, we did service for other small businesses in the area & thus had a lot of relationships. When the first CARES Act money came, whatever the first version of that was called, it had that payroll protection loan so I emailed all the biz owners we knew with instructions on how to apply because I’m good at paperwork and most people are not. As vaccines eventually became available, I emailed people with information on where to get one locally, & by this time we had closed the storefront to the public & had people call for service, then I would come outside & do curbside check-ins of devices they needed repaired. A lot of our customers are elderly, so as soon as the shot became available I started offering to help make appointments when I interacted with my oldest customers since they were a high risk group.

Sick Note: What reasons have people given recently for why they haven't gotten the shot?

Sharon: Several of the local retailers and independent pharmacy chains in town absolutely will not vaccinate you without ID, which undocumented people, homeless people, etc may not have. Being turned away once makes them nervous & unlikely to try again. The county does a vaccine day on this end of the county one day, and the other end of the county another day. Each site is open for 2 hours & that's it. This is due to lack of demand, as in even though our vaccination rate is around 35%, only 1 or 2 people show up to the shot site, and that is happening because of another vaccine resistant population: the politically motivated partisans.

This group has gotten more interested in vaccination since covid began to spike really hard in this 'Redneck Riviera' neck of the woods, but they do not want their peer group to ever find out that they have gotten the shot if they do decide to get it, & they are very distrustful of the institutions we are currently relying on to respond during a health crisis. I think this group could raise their rate by having access to the vaccine in their personal doctor's office because they trust their doctor more than the health department & also they can do it privately without anyone seeing them get the shot.

Sick Note: Do you have specific people in mind—people who you've tried to convince to get the shot but have either been turned away because of the ID thing or are afraid because they know they'll have to?

Sharon: Yeah, I do... I helped set up an appointment for someone undocumented that had been putting it off because it's obviously nerve-wracking. Because he once came here on the up & up, he did have an SS card and a reaaaaalllly old passport, I'm talking like black & white photo of him looking many decades younger. When I spoke to them over the phone they said that ID wasn’t required. But when I got there, what I guess was a head member of the staff overruled the person who was helping us & said they had to make a copy of some ID to move forward. And of course you don’t want anyone to suspect that there is a reason to feel nervous about that so he just gave in & did it. But he shouldn’t have had to.

I've sent other people to some of the chain retail locations with in store pharmacies to get the shot, & they got turned away for no ID. On one of them I even got up with a regional manager & have him saying in writing it’s policy to ASK, but to not turn away if the person doesn’t provide. So if necessary I can print that email out & send people with that in the future. They all seem convinced that they need that ID in order to get reimbursement from the federal government, they seem more focused on that reimbursement than the task at hand, & considering we have more supply than demand in the community, I despise the idea that they might turn somebody away and end up putting that shot in the trashcan because it expired.

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Sick Note: Why do you think people are so anti-vaccine even though there are so many deaths in your community?

Sharon: I had a conversation with my doctor when I was there for a monthly visit to manage a chronic health condition. When the vaccine was new, a lot of people rushed out to get it, there were long lines. Now we are down to the culture warriors who are wrapped up in the political games some of our leaders are playing, & those populations disenfranchised by the ID hurdles. I told my doctor that my family & I knew some people who would privately tell us they were vaccinated, but ask that we not share that with anyone else because they don’t want their friends or family to find out. They do not want their in-group, MAGA republicans, to turn on them. It's a small community, they all know each other, and each is still roleplaying to the others as a vaccine skeptic.

Then my doctor said he knew of people who he knew for a fact were vaccinated, but he would watch the local discussion boards on Facebook & see them posting vaccine misinformation & conspiracy theories. Since the state stopped reporting county level data in June, Facebook has become the primary information hub, to figure out who is hospitalized & who died via word of mouth, usually posts from family members of the deceased/hospitalized. It is never a good thing when Facebook becomes your primary hub for information. Facebook is why we have a large portion of this problem to begin with, conspiracy theories spread like wildfire there.

I also think people really do take signals from their leaders, and our school board & local government will never do a mask order or mandate local government employees get the shot. I'm sure you've seen some viral clips from our state of Facebook poisoned parents ranting at local government, that is not happening here because they are staying in lockstep with DeSantis, I think their biggest fear is that they cross him & he puts them on blast at a press conference & then they get bombarded by some of the uhh... more eccentric part of the public.

Sick Note: What's the number one thing you think federal (or state) leaders could do to help convince hesitant or resistant people to get vaccinated?

Sharon: I think shots in doctor's offices are the biggest. They have to absolutely make that happen. I asked my doctor why he didn't have shots & he said nobody had offered & he didn't think it was an available option, so there's an outreach failure happening there. In these rural communities a lot of folks have seen the same family doctor since they were kids, so small town doctors really do have some sway, plus adding the privacy factor, nobody is gonna see you getting it in the grocery store & tell everyone around town you got it. As more & more people in the community get very sick or die, some of these folks are starting to waver & consider getting the shot because it is a very scary wake up call when folks you personally know start dying.

I'm glad to say that as of today, I spoke to a helpful contact at my local health department & they told me they would contact my doctor to get him set up with shots. I know you said one thing, but the other helpful thing would be for the Biden administration to loudly urge any retail chain pharmacies doing shots to stop asking for those ID's, & reassure them that they will get reimbursement even if they don't make a copy of someone's ID.

Sick Note: You seem to have a lot of compassion for people who are resistant to vaccines. Is it hard to maintain empathy for the people you're helping?

Sharon: Sometimes, it is. Some people are unreachable & are like those parents ranting at school board meetings in south and central Florida. But a lot of people can be persuaded if we are willing to get creative & be persistent. People let down their walls when they're talking to someone who comes off as truly earnest to them, & not motivated by scoring points for partisan politics. I do not like the idea of giving up on people, not even older people that some would write off as a lost cause. Death is very final, & it's the snuffing out of possibilities. People can grow & change & now we'll never see the full potential within some of these people we have lost.

Besides, many of these folks are the relatives of more liberal minded peers my same age that I grew up with around here. I don't want people losing their parents & grandparents sooner than they had to just because their parents post really ignorant things on Facebook. I think it's possible to soften a lot of people up just by not coming at them all aggressively & making them feel stupid. We're back in the era of masking so I have to be the mask police again when people come in the store. And many of them get pissed & start spouting off things on Facebook they read about masks that aren't true. Rather than elevate that conversation into the fight they want to have, I tell them that a 31 year old I went to high school with died of covid & it has frightened me badly, & ask if they would put on the mask just as a personal favor to me to make me feel a little better, even if they think the mask doesn’t work.