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Diminishing returns? Pop-up clinics vaccinate stragglers — but only a few

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A few months ago, the boxy, teal truck parked outside a McDonald’s in San Bernardino might have drawn hundreds of people willing to stand in line for hours under the scorching sun.

The truck is San Bernardino County’s mobile COVID-19 vaccination unit. But on July 15, only 22 people got a shot during the four hours it sat there.

Roughly 12 feet away, more people were seen waiting by a red canopy for free smartphones, government-subsidized for those with low incomes, than were stepping up for the potentially lifesaving shots.

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Barry Luque, a 37-year-old car wash worker who visited the red canopy that day for a free phone, was lured by the truck. He had been eligible for a COVID vaccination since April but never got around to making an appointment. Had he not seen the truck in the parking lot on his day off, “this wouldn’t have gotten done,” he said.

It’s Luque’s job to guide drivers into the car wash, but his boss won’t let him take his mask off unless he can show proof he’s vaccinated.

“People come in from different lives, different styles, different moods, at different times,” he said after getting his first dose of the Pfizer-BioNTech vaccine. “I’ve got to guide them carefully and gently, and it’s kinda hard for them to see the smile on my face.”

Luque and the other 21 people who got vaccinated that day — in addition to the scores who drove by or waited in the McDonald’s drive-through line without seeking a shot — offer a snapshot of California’s stalling vaccination effort.

Some who finally got the shot, like Luque, were motivated by mandates from employers or are tired of wearing masks. Some want to visit other countries, and vaccinations may help ease travel or quarantine requirements. Others were persuaded, at long last, by family and friends.

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Those who continue to hold out primarily cite potential side effects and distrust of the medical system.

Recent polling shows that no matter which tactics are used, a strong majority of unvaccinated people are unlikely to budge on getting a shot, creating an increasingly dangerous scenario as the highly contagious Delta variant burns through the country. In California on Wednesday, about 2,800 people were hospitalized for COVID or suspected COVID — more than twice as many as six weeks earlier.

About 61% of Californians age 12 and up were fully vaccinated by then, according to the U.S. Centers for Disease Control and Prevention.

But the overall rate masks deep disparities among, and even within, regions. In geographically and ethnically diverse San Bernardino County, about 47% of eligible residents were fully vaccinated as of Wednesday, with the lowest rates among young people, men, Latino and Black residents and those who live in the poorest and unhealthiest communities. Statewide, the profile of unvaccinated people is largely the same.

One way local and state leaders are trying to get shots into residents’ arms is by hosting pop-up clinics that make COVID-19 vaccinations more convenient and accessible for those who can’t or won’t sign up for an appointment.

San Bernardino County is organizing pop-up events at supermarkets, schools, churches and community centers. The state is also funding vaccination clinics, including 155 events at more than 80 McDonald’s locations in 11 counties as of Wednesday.

The pop-ups require significant resources and are showing diminishing returns. About 2,500 doses have been administered at the McDonald’s clinics so far — an average of 16 shots per event. The California Department of Public Health declined to say how much these events cost.

At the McDonald’s in San Bernardino, a city of more than 200,000 that serves as the county seat, eight staffers were on hand to check people in, administer shots and watch for side effects from 9 a.m. to 1 p.m. They also scheduled the necessary second dose, to be administered at a subsequent local pop-up event.

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Jeisel Estabillo, 36, hadn’t been vaccinated, even though she is a registered nurse who sometimes cares for COVID-19 patients at a local hospital. She was one of the first people in the county to become eligible for vaccinations, in December, but avoided getting a shot because she wanted to wait and see how it would affect others. She tested positive for the virus during the winter surge.

But Estabillo changed her mind and visited the vaccination clinic with her father and teenage son because they plan to vacation in the Philippines next year and hope vaccination will reduce travel restrictions or quarantines. Estabillo also likes that vaccinated people can forgo masks in most public places, although that perk may slip away as more California counties respond to the Delta surge by calling on residents to mask up again indoors.

But Jasmine Woodson continued to hold out against the vaccine, even though she was hired to provide security and direct traffic for the clinic. Woodson, 24, is studying to become a pharmacy technician and has been tracking vaccination news. She said she was alarmed by the brief pause in the administration of the one-shot Johnson & Johnson vaccine over concern about blood clots, and by reports of rare heart inflammation linked to the Pfizer and Moderna vaccines. She also knows that no COVID vaccine has been fully approved by the Food and Drug Administration, which puts her on high alert.

Woodson, who is Black, is also wary because mobile vaccination events seem to take place in low-income Black and Latino neighborhoods — a tactic public health officials say is meant to increase uptake in these communities.

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“Every day there’s always something new. You’re not meant to live that long, so if you get it, you get it, and if you don’t, you don’t,” Woodson said of the coronavirus.

Maxine Luna, 69, who came to the red canopy to get a free phone, also was not swayed. A longtime smoker whose doctor has been pleading with her to get a COVID-19 shot, she fears side effects, mentioning a friend who battled two weeks of headaches, diarrhea and vomiting after getting vaccinated.

To mitigate her risk, Luna sticks close to her home, which she shares with her brother, who is vaccinated, and her sister and brother-in-law, who are not.

“We’re not out and about; we don’t go to shows, and we don’t go to crowded places,” she said.

Concern about side effects is the most common reason holdouts cite for not getting the COVID-19 vaccination, said Ashley Kirzinger, associate director of public opinion and survey research for the Kaiser Family Foundation. (The Kaiser Health News newsroom is an editorially independent program of KFF.) This is followed by fear that the vaccine is too new or hasn’t been sufficiently tested.

Kirzinger said it’s important to acknowledge that some people simply can’t be persuaded.

“They don’t see themselves at risk for COVID. They think that the vaccine is a greater risk to their health than the virus itself, and there’s really no incentive, no stick, no message, no messenger that’s going to convince these populations,” she said. “It’s going to be really hard to reach the goals set by public health officials, with the decreasing enthusiasm around the vaccine that we have seen in the past several weeks.”

This story was produced by Kaiser Health News, one of the three major operating programs at the nonprofit Kaiser Family Foundation.

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