COVID-19 Vaccines in Missouri: Where does the Show-Me State stand?
Right now, approximately one in five Missourians are vaccinated against COVID-19 and the number of Show-me-staters putting needles to arms grows every day. Missouri is encouraging residents to get vaccinated at many different sites around the state including medical clinics and mass vaccination events at well-known landmarks. Missouri is also making it possible for more medical professionals to administer the COVID-19 vaccine including dentists, veterinarians, midwives, optometrists, and therapists. Policymakers in Missouri hope measures to expand access to the vaccine will improve the state’s current rate of vaccination. Missouri ranks 41st out of 50 states for the number of people getting at least one dose of vaccine, and 44th for the percentage of people who got both doses according to publicly available CDC data.
Current Vaccination Rate in Missouri
In Missouri, just over 770 thousand people have been completely vaccinated. The vaccination rate is slowly increasing with about a third of the total number of vaccinations happening in the last seven days. Medical professionals are giving an average of 35,000 vaccinations per day according to the state’s COVID-19 dashboard.
The number of Missourians getting a COVID-19 vaccine is expected to grow. Right now, vaccines are open to anyone considered to be in the Phase 1 cohort including, Patient-facing healthcare workers, Long-term care facility residents and staff, EMS, police, firefighters, emergency services workers, public health infrastructure workers, adults 65+, adults with high-risk medical conditions, education (K-12) and childcare workers, and Essential infrastructure workers. Missouri will move to Phase 2 of its vaccine plan on March 29th which includes other essential workers and vulnerable populations. Phase 3 is expected in April and will include the entire population.
Vaccine Eligibility in Missouri
NOW:
•Phase 1A: Patient-facing healthcare workers, Long-term care facility residents and staff, EMS
•Phase 1B, Tier 1: First responders (police, fire, etc.), Emergency services workers, Public health infrastructure workers
•Phase 1B, Tier 2: Adults 65+, Adults with high-risk medical conditions
•Phase 1B, Tier 3: Education (K-12) and childcare workers, Essential infrastructure workers (communications, dams, energy, food & agriculture, government, IT, etc.)March 29, 2021
•Phase 2: Other essential workers, Vulnerable populationsApril 9, 2021
•Phase 3: General public
Virus Variants in Missouri
Missouri’s Department of Health and Senior Services (DHSS) says Missouri is a leader among other states for its testing strategy for COVID-19. Investigators are analyzing sewage from 23 municipalities across the state for variants of the SARS-Cov-2 virus that causes COVID-19. DHSS looks for specific parts of the genome in each variant of the SARS-Cov-2 virus to determine if it is present. Missouri is required to report the most concerning variants of the virus to the Centers for Disease Control and Prevention (CDC).
Currently the most concerning variants include the South Africa (known as B.1.351), Brazil (known as P.1), and the UK variant (known as B.1.1.7). DHSS reports only one person has been found in Missouri with the UK variant and none with the South African or Brazilian variant. An other concerning variant is the California variant (known as B.1.427 or B.1.429), which is thought to spread more quickly that other variants. Missouri is not required to report instances of the California variant to the CDC.
It should be noted that that the U.S. is lagging other countries in identifying virus variants in patients for COVID-19. Sewage analysis further reveals that the UK variant is present in 15 of the 23 municipalities tested. Dr. Randall Williams, director of the DHSS said in a press release, “It is important to note that this is a point-in-time analysis that likely doesn’t reflect the true prevalence as it stands today in the areas of the state where samples were collected. This is the first set of samples analyzed, so we are limited in the conclusions we can draw from this information. The data is complex and is subject to epidemiological and laboratory analysis and interpretation from which to draw conclusions.”
Dr. Williams adds, “Although there are many unknowns at this time, we presume these variants are clinically present in Missouri. At this time, we do not know if these low variant virus levels will increase, so we must reemphasize that it is still really important to wash your hands well and often, maintain physical distance and wear masks if you can’t be distanced from others outside your household. We also continue to ask that individuals consider getting vaccinated when they are able. The vaccines that are currently available in the United States appear to be effective against these variant viruses.”
Vaccine Disparities in Missouri
Missouri is reporting some pronounced racial inequities in vaccination. So far, only 8.3% of Blacks in Missouri have had at least one shot of any COVID-19 vaccine. Asian Americans and native or indigenous populations in Missouri also lag with 5.3% and 2.1% of those groups with at least one shot respectively. Vaccination among Whites is more in line with the state average (23%) with 19.6% of White Missourians getting at least one shot. Women are leading the charge to get vaccinated in Missouri. The state COVID-19 dashboard reports more than 26% of women in the state have been vaccinated compared to just under 19% of men.
There are also geographical differences in vaccination rates across the state. Populated suburban counties in the Kansas City and St. Louis metropolitan areas are at or above the state average for vaccination. Urban counties like Jackson County (Kansas City) are behind with only 11% reported vaccinated by the COVID-19 data aggregator, COVID-19 Act Now. No information on the vaccination rate is currently available for St. Louis City. Rural counties also lag in vaccination rates. Pulaski, Platte, Jasper, McDonald, and Clay counties all have less than 10% of their population vaccinated.
The COVID-19 infection rate is down in Missouri with each person infected, passing on the virus to an average of one person. Health experts note that an infection rate above one indicates the disease is spreading. The infection rate in some rural counties remains high. Mississippi County in Southeastern Missouri reports a testing positivity rate of 26%, indicating a high infection rate. The infection rate in Dade County, Missouri is nearly 1.7, indicating one person infected will pass the virus on to 1.7 people on average.
Vaccine Histitancy
Vaccine hesitancy is a growing problem for health officials in Missouri. Media reports indicate many rural communities aren’t able to find enough residents to administer vaccines to. Last week, more than 7,700 vaccine doses went unused. According to reports, Putnam County, Missouri was left with nearly 1,500 COVID-19 vaccine doses after a mass vaccination event. Bollinger County, Missouri was only able to administer half of the available doses at another vaccination event. And Lewis County, Missouri reported it had to open vaccination to people from outside the county so that hundreds of extra doses were not wasted. The St. Louis Post-Dispatch reports one-quarter (25%) of Missourians may shun the COVID-19 vaccine. The newspaper published the results of a nationwide survey recently. Missouri’s vaccine hesitancy outpaces the national level of COVID-19 vaccine hesitancy of 21% who say they will not be vaccinated.
Research set to be released at the end of March from The Missouri Foundation for Health (MFFH) indicates there are many reasons Missourians may refuse the COVID-19 vaccine. For racial minorities, including Black and Hispanic adults, distrust of the vaccine is linked to structural inequities in government institutions and a history of racism in health care according to MFFH. For Whites, a recent study in the American Journal of Health-System Pharmacy indicates that people who report being politically conservative are three times more likely to shun the COVID-19 vaccine than others.
MFFH has suggestions for anyone working to ease fears about the vaccine. Based on research, MFFH investigators say the vaccine-hesitant should be reminded that getting vaccinated is their choice. Health workers should talk about the benefit to the community, particularly with Black and Hispanic audiences. MFFH suggests health workers address mistrust of government with a broad array of diverse validators. The Foundation recommends that people need to be reminded that COVID-19 vaccines are safe, tested, and free. Finally, health workers should talk about the desire for life to get back to normal, seeing friends and family, social gatherings, and returning to work.
MFFH suggestions on vax hesitancy
Based on the research, some considerations include:
•Remind people that getting vaccinated is their choice.
•Underscore the benefit to the community, particularly with Black and Hispanic audiences.
•Handle mistrust of government with a broad array of diverse validators.
•Continue to remind people that vaccines are safe, tested, and free.
•Reference everyone’s desire to get back to life as we know it — jobs, family gatherings, seeing friends, etc.
Learn More
The Missouri Foundation for Health is reporting its findings on March 31st at 11:30 AM CT. You can sign up to learn more about their research and their findings here. The Missouri Local Science Engagement Network is also hosting a roundtable discussion on rural vaccine equity at the end of April. Sign up for more information when it is available here.
