As interest in COVID-19 vaccination wanes and cases begin to surge again, one Southern health system has been trying multiple approaches to alleviating vaccine hesitancy—including offering cash.

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South Mississippi’s Hattiesburg Clinic—a member of the AMA Health System Program—initially considered the six $2,500 awards it was giving away as a “thank you” to staff and patients for helping keep their facilities and community safe. But now clinic officials acknowledge it is also working as an incentive to boost sagging vaccination rates.

Hattiesburg Clinic—the largest private multispecialty clinic in South Mississippi with more than 300 physicians—had a head start on addressing vaccine hesitancy and educating patients by participating in the Moderna clinical trial. That created an opportunity to provide messaging to the community long before the clinic started its COVID-19 vaccination rollout and distribution.

Angel M. Johnson, MD, MPH, and Jawauna T. Stewart, MD
Angel M. Johnson, MD, MPH, left, and Jawauna T. Stewart, MD, staff a Hattiesburg Clinic back-to-school vaccine community event.

“Like many parts of the country, there was a tremendous early response and enthusiasm for getting vaccinated,” Hattiesburg Clinic CEO Bryan Batson, MD, said. “It was an encouraging first few months even though there were certainly frustrations sometimes with the supply.”

Dr. Batson reports that more than 80% of the physician staff has been vaccinated. But, for the two primary counties the clinic serves, Forest and Lamar, vaccination rates aren’t even half that amount.

As of July 27, there have been more than 2.15 million vaccine doses administered in Mississippi with about 1.026 million people, or 32% of the population, fully vaccinated, according to Mississippi State Department of Health. In Lamar County, about 39% of the population is fully vaccinated. While in Forrest County, only 27% of the population is fully vaccinated.

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“We saw the divergence in county experiences very early,” Dr. Batson said. “The demographics are much different even though they’re adjacent.”

Lamar County is 75.7% White, 21% Black and 2.9% Hispanic. The median household income is $60,328 and 16% of the population lives below the poverty line, according to U.S. Census data. Forrest County is 59.2% white, 37.8% Black, and 3% Hispanic. The median household income is $39.840 and 23.3% of the population lives below the poverty line.

“Our vaccination rate is not reflective of the effort of the health department and health care institutions to make it accessible and available,” said Steven E. Farrell, MD, the system’s chair of medicine and chief medical officer at Forrest General Hospital. “It’s more of an issue of acceptance and overcoming that fear barrier.”

Dr. Batson agreed.

Vaccines are available at all Hattiesburg Clinic facilities, including physician offices. They’ve brought vaccines into people’s homes, workplaces and deep into sparsely populated rural areas.

“We took our efforts into underserved parts of our community and met those patients where they were and extended our presence beyond our walls to get as many people vaccinated as possible,” he said.

Overcoming vaccine hesitance

Hesitancy is a combination of things, said Dr. Batson. Some are concerned it was developed and authorized too fast, while others acknowledge vaccines work but feel they may not need it because they believe the disease is not that severe.

“So, now we’re throwing some incentive money at it to see if that might work,” he said. “We’re giving people another reason to make that leap to get vaccinated.”

Two $2,500 awards will go to clinic staff chosen at random, another two will go to Forrest Hospital staff, and the last pair will go to patients who aren’t employed by either.

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When the awards were first conceived months ago, they were envisioned as a “thank you” to staff with the hope that the high vaccination rates and the low community infection rates would continue to trend in the right direction.

“We value our employees very much and appreciate that they’re trying to make our facilities safer at a time when we absolutely need our workforce to be healthy and available,” Dr. Batson said.

While Hattiesburg Clinic is not vaccinating as many people as it was in January and February, Dr. Batson said appointments are trending upward, which he explained can be a reaction to reports of rising infection rates in the state, a response to the cash incentives being offered, or a combination of both.

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