Franklin, a city of roughly 7,000 on the banks of Bayou Teche, employs about nine firefighters, and Chief Chuck Bourgeois said the nature of their work put them in frequent contact with people infected with COVID-19 over the past year.

Bourgeois himself caught the virus about six months ago. He didn’t need hospitalization, but is still not back to 100%, he said from outside his daughter’s house on a recent gloomy weekday. He gets short-winded and can’t do “half of what I used to be able to do.”

But when the COVID-19 vaccine became available at the department, only two of Bourgeois’ nine firefighters took it, he said. Bourgeois was not among them.

“I want to see a little bit more before I take the shot,” Bourgeois said. “They want to see. They want to make sure there’s no bad side effects they have to worry about.”

After an initial stampede of thousands of Louisianans who were eager to get vaccinated as soon as possible, the state’s effort to reach herd immunity is hitting a snag. No longer is a lack of supply the biggest roadblock, at least in some parts of the state. As doses have rolled into Louisiana in greater numbers, persuading people to get the shot has become a bigger challenge.

Hesitancy among Black residents was pinpointed early on as an obstacle in the effort to vaccinate a large share of Louisianans, though some data shows those attitudes are changing. Now, polling and interviews with experts and residents suggest that hesitancy in rural areas, especially among White residents in conservative strongholds, is a bigger culprit in holding back the state’s ability to reach herd immunity.

But it’s not only attitudes about the vaccine. Rural areas also have far fewer health care sites than cities like New Orleans and Baton Rouge. An hour-long drive to get a shot is a big ask of residents, experts say, and many rural folks say they prefer the one-shot Johnson & Johnson vaccine as a result. Internet access -- which can be crucial in scheduling an appointment -- is spotty in much of rural Louisiana.

Recognizing these challenges, the state Health Department is launching an unprecedented effort to send workers and volunteers into far-flung communities to knock on doors, educate people about vaccines and get them shots.

As that begins in nine underserved ZIP codes this week, state officials are hoping that most of the people who are reluctant are at least open-minded.

“When we talk to individuals, do focus groups, we actually don’t hear a lot of ‘I’m not going to do it, period,’” said Dr. Joe Kanter, Louisiana’s state health officer.

“There’s no question there’s geographic variability right now in vaccine uptake,” he added. “To me, that just means we have an opportunity.”

In large swaths of rural Louisiana, shots have lagged the more populated parts of the state.

Statewide, about 24% of Louisianans have received at least one shot, which ranks Louisiana 40th in the nation in uptake rate, according to the U.S. Centers for Disease Control.

But data released by the Health Department this week highlight several factors that affect the likelihood someone will get vaccinated.

For instance, people in census tracts where vaccination rates are higher are more than three times as likely to be college-educated as those in the lowest 20% of tracts.

The share of the population that has been vaccinated varies dramatically by parish. In nearly 40 of Louisiana’s 64 parishes, mostly small, rural ones, fewer than 20% of residents have received at least one shot. The top 10 for that metric includes Orleans, East Baton Rouge, St. Tammany and Jefferson parishes, as well as some smaller parishes.

St. Mary Parish, home to Franklin, lags the state’s rate of vaccinations by 5 percentage points, with just 19% of residents receiving at least one shot.

While many residents who haven’t gotten vaccinated yet say they may still do it, some are adamantly against it.

Shawn Beard, who served as head of the Red River Parish Police Jury until stepping down in November, feuded for months with the Department of Health over the agency’s COVID data, as he claimed the threat of the virus was low in his parish.

In an interview, Beard, a Republican, said he wouldn’t take the COVID-19 vaccine “for nothing in the world.”

“I don’t know if it’s safe or not. I see absolutely no need in it,” he said. “I understand it’s supposedly taken lives. The flu does that as well. Car crashes do that, motorcycle crashes do that. God is the controller of life and death. He’s the author of it.”

Sammy Daniel, who grinds stumps for a living and lives in Franklin, likewise said he’s not getting the shot.

“If God’s ready for you, God’s going to take you,” he said.

His friend William Parker, who was visiting from Texas, echoed that sentiment. He said if he catches COVID, so be it.

“It’s experimental,” he said of the vaccine. “There’s nothing carved into stone about it.”

Government experts and other health professionals have repeatedly said all three vaccines authorized in the U.S. are safe and effective. While they were developed in record time, officials say no steps were skipped.

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Providers in several rural parishes say demand for the shots, which initially greatly exceeded supply, has waned recently.

George Book, the owner of Book’s Pharmacy in Vidalia, said there is still skepticism about the vaccine. He hears from people every day who believe it hasn’t been tested enough.

Even though Book got the shot, he said he too has questions.

“To be totally honest, I don't try to dispute them,” Book said. “Because it’s hard to get good information, even us. I just try to say as little as possible. ... I don’t want my name attached to it.”

Book also said he doesn’t think anywhere near 70% of residents in Concordia Parish, where Vidalia is located, will get the vaccine. That’s roughly the goal officials are aiming for statewide.

The Department of Health divides Louisiana into nine regions. In Region 6, encompassing much of Louisiana’s midsection including Alexandria, only 10% of the population has completed their vaccine series, the second-worst rate among regions, after southwest Louisiana. In the greater New Orleans region, that number is pushing 17%, and in the Baton Rouge and northshore regions, it’s about 14%.

Dr. David Holcombe, medical director for Region 6, said signups for drive-through vaccine sites waned last week, with only a couple dozen people signing up for some sites, even though 100 doses are available at each. About 2,400 Pfizer doses allocated to his region were recently sent to New Orleans because there wasn’t enough demand, he said.

Holcombe said elderly people in the region were jumping at the opportunity to get vaccinated. But persuading younger people to take it will be a heavy lift. He pointed to the region’s poor health outcomes generally, which he said is related to things like poorer education attainment and lower incomes.

“Any time you’re dealing with populations that have low education levels, have low incomes and have low social status, you’re going to run into problems,” he said. “I will not underestimate the effort….It’ll be the law of diminishing returns.”

The Franklin Foundation Hospital has been around for decades, serving St. Mary Parish. But in the mid-aughts, it got a new facility and a critical access hospital designation, meaning it gets a better federal reimbursement rate in exchange for serving rural populations, where many hospitals have closed over the past several decades.

During the height of the pandemic, about half of the hospital’s 22 acute care beds were full of COVID patients. Now, the number is closer to between three and five.

Stephanie Guidry, the CEO, said the hospital was the first in the area to get the COVID vaccine. The share of her staff that has been vaccinated has risen from about 30% at first to over 60% now, she said.

“Just like everybody else in the population, they’re waiting to see the effects on people getting them,” she said.

As rain drizzled outside Thursday, a few dozen patients filtered into the facility to get their shot. A board room was transformed into a vaccination room, with a tablet serving as translator to Spanish-speaking migrant workers.

Erin Wiggins, 49, was hesitant about the shot. She said she was more concerned about side effects than the risks of COVID. Thursday morning, she decided to get the shot, partly to protect her elderly parents, and traveled the 20 minutes from Berwick to the hospital to get it.

“My parents are older, so I needed to do it for them,” she said.

Jerry Marcotte, a 60-year-old oilfield retiree, said he’s been getting the flu shot for 20 years, with great results. He sees no reason not to trust the COVID vaccine. He and his wife, Chris, go on a cruise every year, a treat the pandemic has halted.

“If this is what it takes to get back to a normal life, we’re ready for it,” he said. “We miss our cruises, we miss social situations. Having to go around with a mask ... if this is what it takes to get it over with, let’s do it.”

On Franklin’s Main Street, Polito’s Cafe was open but empty Thursday around noon, save for a regular who came in to play video poker. The place smelled faintly of cigarettes. Brittanie Picard, an employee, said the governor’s COVID restrictions hadn’t had much impact, because the bar rarely saw more than a handful of customers.

Picard said she has an immunocompromised 9-year-old daughter whom she’s been home-schooling during the pandemic. Still, she’s in no hurry to get vaccinated. She doesn’t like shots to begin with, and she thinks they “rushed” the development.

Even still, Picard said the vaccines are giving her hope.

“I do think we’re moving in the right direction,” she said. “I just don’t want to get a vaccine that was rushed until I know what the side effects are.”

Staff writer Jeff Adelson contributed to this story

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