This story was published in partnership with Southerly, an independent, non-profit media organization that covers the intersection of ecology, justice and culture in the American South.
Ruby Gosey tried to get a COVID-19 vaccination appointment, but they were hard to come by in Vinton, La., a small town near the Texas state line that got devastated by Hurricanes Laura and Delta last year. Getting a shot often required driving on the interstate to Sulphur or Lake Charles, and finding the time to do that — among the other priorities that come with hurricane recovery — was tough.
“Everybody just lost so much, and it’s been so long,” Gosey said. The storms destroyed her house, so she lived with her daughter for four or five months before moving into a trailer provided by the Federal Emergency Management Agency.
When she caught word that the Vinton Senior Center — which she frequented before the hurricanes shuttered it for months — would be offering vaccinations on April 30, she jumped at the opportunity. Trucks piled high with debris hurtled down the two-lane road as she waited the 15 minutes recommended after receiving her shot. Gosey said she was grateful the vaccine had become available close to home. “It’s very convenient for us here in Vinton,” she said.
In recent weeks, vaccination rates have slowed in Louisiana and nationwide, as healthcare providers run up against persistent vaccine hesitancy and barriers to access. The Gulf South states of Mississippi, Alabama, and Louisiana have the three lowest vaccination rates of any in the nation. In Louisiana, 32.4% of people have received at least one dose, compared to 45% nationally, according to data compiled by the New York Times.
Last year’s back-to-back hurricanes are setting southwest Louisiana back even further: the region’s vaccination rates are the lowest in the state.
“A lot of people are displaced,” Vetra Simon, a nurse with Southwest Louisiana Area Health Education Center said as she administered vaccine doses in Vinton. “Their main focus is getting back into a home or a place of their own. A lot of people are not going to focus on getting a COVID vaccination, because their main focus is finding a place to stay.”
The Vinton vaccination event was part of the Bring Back Louisiana campaign, an effort by the Louisiana Department of Health to provide vaccinations and “meet people where they are” through targeted events and outreach in partnership with local groups, according to the LDH website. The department has selected a zip code to target in each of nine regions in the state for its initial rollout of the program, which began in April.
Dr. Lacey Cavanaugh, director of Region 5 — which serves Allen, Beauregard, Calcasieu, Cameron, and Jefferson Davis parishes — said LDH chose to focus on the western edge of Calcasieu Parish because hurricane damage there was not quite as extreme.
“We specifically selected our Bring Back Louisiana campaign in an area that we thought would still be conducive to door knocking,” she said. “Some neighborhoods are so severely damaged that even door knocking now with all the debris that may still be in those communities could still be hazardous.”
During the last two weeks of April, canvassers with La Louisianne, a Black-led consulting firm based in Lafayette, knocked on doors in town, providing residents with information about vaccines and fielding their questions.
Dustin Cravins, vice president of La Louisianne, said the firm has experience canvassing in rural areas for political campaigns. In a lot of ways, vaccine outreach needs to take into account the same limitations: access to the internet or a smartphone, and transportation, can’t be taken for granted. “The hurricane really kind of exposes some of those disparities,” he said.
A Monmouth University poll from mid-April found that “partisanship remains the main distinguishing factor” for vaccine avoidance nationwide, with 43% of Republicans saying they would avoid receiving the vaccine altogether, compared to 5% of Democrats. Southwest Louisiana overwhelmingly voted for former President Donald Trump in 2020.
“We have a lot of people in this area that say they don’t take any vaccinations,” Simon said.
Cravins is concerned about apprehension among communities of color. “I don’t think the Johnson & Johnson pause helped at all, particularly in the African American community,” he said. (The Centers for Disease Control and Prevention and the Food and Drug Administration lifted the pause on the Johnson & Johnson vaccine on April 23).
However, Cravins found that an in-person conversation can sway someone on whether they’ll get vaccinated. “My charge has been to get to those zip codes that have these really low numbers, and move the needle,” he said.
Simon said she was seeing better turnout there than at many recent vaccination events the Southwest Louisiana Area Health Education Center has held. At the Vinton Senior Center, 33 people received a shot.
That turnout could have been thanks to the door-knocking effort. “Some people need to mentally prepare for [the vaccine],” Simon said. “They may want it and have worries or concerns about it.” With the targeted outreach, people have time to research and think before the event. “They may be then decided by the day we come here,” she said.
Simon said everyone she vaccinated at the senior center told her this was the first time someone had come to give injections in Vinton, and expressed their gratitude. According to the LDH website, vaccines are also available at the Vinton Medical Clinic, and LDH had offered vaccines in the area three times previously, Kevin Litten, LDH spokesperson, wrote in an email. “We were pleased that we were still able to increase the number of vaccines in that zip code,” he said.
Carol Pettyjohn was thankful to get vaccinated near her home. She has cancer, and was waiting on approval from her oncologist before getting a shot. “I’m thrilled that this is here, that this is available to us, in our little town,” Pettyjohn said. The convenience saved her a trip on the highway.
“The remote areas need something,” said Anna LeBlanc, who drove Pettyjohn to the senior center.
Brian Burton, the chief executive officer of SWLAHEC, said that when the organization offered COVID-19 tests in southwest Louisiana, “we didn’t have to find [residents]; they came to us.” But “when it came to vaccinations, it’s not a case of ‘if you build it they will come,’” he said. More work has been needed to reach people.
“We don’t expect these people to come in right at the beginning,” Burton said. “We want them to get used to seeing us there, and know that we’re there to be able to ask a question.”
The Bring Back Louisiana campaign is still in its early phases, said Litten. “Just like in a political campaign, you kind of start small,” he said. The health department is analyzing the initial rounds of canvassing to assess how the program has worked so far, and where it can improve.
“We’re very hopeful that it will get larger,” Litten said. “We’re trying to get very creative, to do anything that we can to get people vaccinated easily–to make it easy for them.”
Since the COVID-19 vaccine became widely available to Louisiana residents in March, vaccination rates in southwest Louisiana have consistently lagged behind that of every other region in the state. Data compiled by LDH on April 29 shows that 18.32% of the 2018 population of Region 5 has completed its vaccinations. In Region 4, which encompasses Lafayette, 21.8% of the population has been fully vaccinated; in Region 1, which contains New Orleans, that number is 33.72%. The parish with the lowest vaccination rate in the state isCameron, a rural parish where Hurricanes Laura and Delta made landfall. Only 8.66% of the 2018 population has completed their vaccinations.
But that data isn’t comprehensive: The population numbers used by LDH are Census Bureau estimates from 2018 and don’t account for the massive displacement. The denominator the state is using to calculate Region 5’s vaccination rate “doesn’t reflect the up-to-date reality of the population living in that region after the hurricanes,” said Allison Plyer, chief demographer at the Data Center, a nonprofit think tank in southeast Louisiana.
Little information is available on who has returned to southwest Louisiana since the storms, and who is still displaced, as Southerly analyzed last week. In an analysis of change-of-address requests to the U.S. Postal Service in 2020, the New York Times Upshot found that Lake Charles had the biggest change in net out-migration of 926 metro areas surveyed, meaning it shrunk more than any other U.S. city last year. The hurricanes worsened a pre-existing housing crisis, and evictions, rising rents, and lack of FEMA aid have made it difficult for many people to return home. The exodus has put pressure on markets down the road, like in Lafayette and New Orleans.
“Some of our most vulnerable citizens are the ones who have not been able to return,” said Dr. Cavanaugh. Despite flaws in the data, she still feels it’s important to use. She, Cravins, and Simon all largely attributed the slow vaccine uptake to the fact that many residents are still in triage mode after the hurricanes.
“I hear folks who are not necessarily unwilling to get the vaccine, but who just are having difficulty prioritizing getting it because they just have so much on their plate,” Cavanaugh said. “They don’t have shelter and food in all the cases, so it’s really hard to think about, ‘How can I make time to stop by a vaccine site?’”
Getting shots in arms is particularly urgent in southwest Louisiana: COVID-19 cases spiked there after the February winter storm. In mid-March, the region saw an increase of the highly transmissible U.K. coronavirus variant. Later that month, intensive care units at local hospitals were at or near capacity: Christus Ochsner St. Patrick Hospital’s ICU was 99% full as of March 29, and Lake Charles Memorial Hospital’s ICU was 89% full, according to a WWNO report based on the New York Times database of ICU capacity around the country.
Cases and hospitalizations have since decreased; deaths have remained level. Still, Cameron and Calcasieu Parishes are both considered to have the highest level of community risk designated by LDH.
“We’re kind of just in this holding pattern,” Cavanaugh said.“ We’re really pushing hard to get the vaccine out so we can combat all of this, because it’s still a very real threat in our community.”