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As COVID-19 shots slow, doctors turn to 1-on-1 conversations

SIOUX FALLS, S.D. (AP) — The number of South Dakota residents receiving an initial dose of a COVID-19 vaccination has slowed dramatically in recent weeks, prompting medical experts and community leaders to turn to personal conversations to battle misinformation around getting a shot.

Just over 4,000 people statewide received their first shot last week, according to the Department of Health — a big drop-off from the end of March, when the state recorded a high mark of over 26,000 people receiving their first shot in a week.

At that point, vaccine sites were doing brisk business and the state seemed to defy a trend of skepticism around COVID-19 shots in states dominated by Republican politics. South Dakota had boasted one the highest vaccination percentage rates in the nation; just weeks later, its ranking has tumbled to 24th.


“Demand just plummeted,” said Julia Yoder, a spokeswoman for the Brookings Health system who has also been overseeing mass vaccination sites for Brookings County. “Before you couldn’t keep enough in stock, and then it went to crickets. We couldn’t convince people to sign up.”

South Dakota appears to have run into what Alan Morgan, the head of the National Rural Health Association, calls a “rural wall” of vaccine hesitancy. Reaching those holding out against getting vaccinated will be crucial to avoiding further waves of the virus, but instead of mass campaigns, medical providers are planning the next phase of vaccinations around personal conversations and convenience, hoping that trusted doctors and faith leaders can assuage fears.

They plan to make the case to get vaccinated through an array of strategies: another push around the Pfizer vaccine being authorized for children as young as 12, one-on-one conversations with doctors and encouraging faith leaders to become proponents of getting a shot.

Morgan said that much of the messaging around vaccinations has not been “relevant” to rural communities, adding “politicians, government officials and movie stars” are not the best messengers to reach people in rural communities.

“In a rural context, this has to be local,” he said.


In South Dakota, several rural counties have dragged far behind the state’s population centers in vaccination rates, according to the Centers for Disease Control and Prevention. Harding and McPherson counties, sparsely populated areas on the state’s northern border, have yet to break 15% of people eligible for the vaccine receiving a shot, according to the CDC.

The Department of Health has reported that statewide 57% of people eligible for a vaccine have received at least one shot. Republican Gov. Kristi Noem has said she believes the state is “very, very close” to herd immunity, given the rate of vaccinations and people who have recovered from the virus. But the Department of Health has a goal of vaccinating at least 70% of people eligible for shots. To reach that goal, almost 80,000 more people would need to get a vaccine. Unless the rate of vaccinations picks up dramatically, that would take at least the next four months.

State health officials say their counts do not include shots administered by federal agencies like Indian Health Services or Veterans Affairs.

Misty Rudebusch, the medical director of a network of rural health clinics called Horizon Health Care, has found herself addressing concerns her patients have after reading about the vaccines on social media.

“What I have found most effective is … really letting them voice their biggest concerns and finding what we need to focus on for them,” she said. “Everybody has a little different question.”

Rudebusch said health care providers are looking for new ways to spark those conversations, including prompting during dental visits and by reaching out to schools to help deliver credible information on vaccines. Medical experts are also encouraging religious leaders such as pastors and priests to discuss vaccinations.

Herman Perez, a pastor who works with several rural Latino communities, has tried to address concerns people have after watching YouTube videos filled with misinformation. He said it’s important to be sensitive, while using the trust he has as a pastor to encourage getting a shot.

“They ask me if it’s OK to be vaccinated,” he said. “I leave the door open. I tell them it’s a personal decision, but I think it’s a good idea.”


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