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As demand has decreased, public health staff are focusing on encouraging people to get vaccinated

PMG PHOTO: ANNA DEL SAVIO - The Columbia County Public Health department has initiated a 'Columbia County Cares' campaign to encourage residents to get vaccinated against COVID-19.As COVID-19 vaccine supply has increased, public health staff are focusing their efforts on making the vaccine more accessible to Columbia County residents who have yet to be vaccinated.

As of June 1, 47.1% of Columbia County residents age 16 or older had received at least one shot, state data shows.

Counties with at least 65% of residents 16 or older are eligible to move into the "lower risk" category, loosening restrictions on social gatherings, restaurants and other businesses.

Oregon will also remove most restrictions statewide once 70% of residents 16 and older are fully or partially vaccinated. The state was at 62.4% as of June 1.

For now, Columbia County is stuck at "high risk," with tighter restrictions on business activity and gatherings. That's because case counts remain high, relative to the county's population, and the county is well short of meeting the 65% vaccinated benchmark.

In Columbia County, reaching 65% will require administering a first shot to roughly 8,000 more people, according to state data.

But the Oregon Health Authority's calculus might be undercounting the number of county residents who have received a vaccine — potentially by a lot.

For many North Columbia County residents, the closest and most familiar medical providers are across the Columbia River, in Longview, Washington.

The vaccination data published by the Oregon Health Authority only includes doses administered in Oregon, meaning that Columbia County residents who got their COVID-19 vaccination in Washington aren't credited toward the county's vaccination rate.

Columbia County Public Health director Mike Paul says his department is working to get that data, which he thinks could improve the county's vaccination rate by multiple percentage points.

The county is also working with OHSU Family Medicine to host weeknight vaccine clinics in Scappoose. The two-shot Pfizer vaccine is the only vaccine out of the three authorized by the U.S. Food and Drug Administration that is cleared to be administered to ages 12 and up. Moderna and Johnson & Johnson vaccines are only authorized for 18 and older.

Paul suggested Columbia County residents have been "inundated with how they can schedule an appointment."

He added, "What we're working on now is just making it as convenient as possible for the working people, for younger people."

Paul said the county is also working with school districts to make vaccine clinics available for students. Scappoose is the only school district in the county that doesn't have a school-based health center, but the high school is less than a mile from the OHSU vaccine clinics.

The county is also looking to make the vaccine more convenient by having shots available at community events, like the 13 Nights on the River concert series in St. Helens, which kicks off in June.

Andrew Lafrenz, an epidemiologist and professor at the University of Portland's school of nursing, created an online survey last month to ask Columbia County residents about their perception of the vaccine.

Lafrenz said he started the survey as a project for a class he was teaching, and because he lives in Scappoose.

Lafrenz also started working with the county's COVID-19 response team as a disease investigator last summer, so he already knew the local public health staff when he proposed the survey and offered up the findings to inform the county's messaging.

Respondents who had already received the vaccine or planned to get it said that their main motivations were to protect themselves, protect their families and protect community members.

The survey had received roughly 220 responses by mid-May, but Lafrenz acknowledged that people who had received the vaccine were overrepresented in responses.

Roughly 8.5% of respondents said they definitely would not get the vaccine, but Lafrenz said the actual percentage in the population is likely much higher. Two other groups — people who said they were not sure if they would get the vaccine or were going to wait to get it — are the groups Lafrenz said public health messaging has the best shot at convincing.PMG PHOTO: PAT KRUIS - An Oregon healthcare worker fills a syringe with the Moderna COVID-19 vaccine in March.

The county has seen demand decrease for vaccination appointments in recent weeks, Paul acknowledged, but he said there are a few factors "that we think are more telling than so-called vaccine hesitancy."

Paul said that many of the remaining unvaccinated residents are under 65 and are more likely to be busy with work and home obligations, so convenient appointments are a necessity. Younger residents without underlying health conditions have been told they're generally at lower risk for serious cases of COVID-19, so vaccination may not be a priority. And for residents who have health issues or disabilities, or don't speak English as a primary language, there are additional hurdles to vaccination.

"I would not deny that there are residents who would say they probably or definitely will not get vaccinated, but I am optimistic about getting 65% of our eligible residents vaccinated," Paul said.

Data collected annually for required school vaccinations suggests that relatively few people in Columbia County are opposed to vaccines, Paul explained.

From Lafrenz's survey, among those who had not received the vaccine, five top reasons emerged.

Above all, respondents said they believed the vaccine was too new and they wanted to wait and see how it works for others. Respondents also said that politics had played too much of a role in the vaccine development process, they were worried about possible side effects; they do not trust the government to make sure the vaccine is safe and effective; and they believed the risks of COVID-19 were exaggerated.

The survey showed a strong correlation between anti-vaccine or vaccine-hesitant attitudes and not wearing a mask or social distancing, which Lafrenz said was "not surprising, but it's really concerning."

Lafrenz said that messaging around vaccines should address those concerns and be tailored to Columbia County.

"I thought it was important that the county develop county-specific messaging, and not just adopt the OHA statewide, generic messaging," Lafrenz said.

What surprised Lafrenz was some of the responses he got from healthcare workers. Sixteen percent said they "definitely" wouldn't get vaccinated.

"That is higher than almost every other industry category," he added.

After collecting more data from North Columbia County zip codes, Lafrenz said there "is quite a bit more vaccine hesitancy and anti-vaccine attitudes the farther you move north up the county in zip codes."

The OHA's vaccination data backs that up, with the zip codes in and around Scappoose reporting a vaccination rate twice as high as in the Clatskanie and Rainier areas. Even factoring in Washington state data, North County is still expected to have lower rates of vaccination than in South Columbia County.

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