Can’t Get a Covid Vaccine? In This County, Everybody is Eligible

By Simon Romero

The rural area outside Phoenix is one of the first places in the U.S. to open vaccinations up to the general public. This is what success looks like.

Cobre Valley Regional Medical Center in Gila County, Ariz., is providing Covid-19 vaccinations to residents 18 years and older.
Cobre Valley Regional Medical Center in Gila County, Ariz., is providing Covid-19 vaccinations to residents 18 years and older.Credit...Juan Arredondo for The New York Times

GLOBE, Ariz. — In most parts of the country, getting a coronavirus vaccine can feel like trying to win the lottery, scouring the internet for appointments under complex eligibility standards that vary from state to state, and even county to county.

In Kentucky and Indiana, anyone over 60 can get vaccinated but you have to be 65 or 70 most everywhere else. About 18 states are offering shots to grocery workers, and 32 are vaccinating teachers. Cancer or heart problems? It depends on where you live.

Then there is Gila County, Ariz., where any resident over the age of 18 can walk into a clinic without an appointment right now and get a vaccine.

“The whole process is incredibly easy,” said Frank Struck, 24, an electrician and maintenance worker who got inoculated at a hospital in Globe, a town in the county, which stretches across the desert and pine forests about 90 miles east and northeast of Phoenix. “No bureaucracy, no crazy lines — you just go in, get the shot and come out with peace of mind.”

With a limited supply of vaccine to offer to the millions of Americans clamoring for it, the country has faced a choice from the beginning: Deliver shots as swiftly as possible by allowing anyone who wanted one to get one, or target scarce supplies to the most vulnerable first.

The federal Centers for Disease Control and Prevention recommended the latter course, and as a result, state officials have agonized over who is entitled and who is not — in some cases, slowing deliveries to make sure the neediest went first.

Gila County started off with a set of qualifying standards as well. But it has been so successful at vaccinating its residents that it is now one of the first places in the United States to open eligibility to the general population, offering a glimpse of what vaccination could start to look like in the rest of the country weeks or months from now.

ImageA couple left the Cobre Valley Regional Medical Center in Globe after being vaccinated.
A couple left the Cobre Valley Regional Medical Center in Globe after being vaccinated.Credit...Juan Arredondo for The New York Times

“I guess you can penalize us for giving out too many vaccines,” said Neil Jensen, the chief executive of the Cobre Valley Regional Medical Center, a hospital system that hired more than 20 people in recent weeks to expand its vaccination effort. “We just don’t think that’s going to happen.”

During a pandemic that has claimed the lives of at least 209 county residents, many people in the county of 54,000 people are welcoming the broader availability of the vaccines, a boon that follows a harrowing surge in hospitalizations around the start of the year. The expanded vaccination campaign has coincided over the past two weeks with a 52 percent plunge in new cases.

“I’m so thankful to be in this position right now,” said Gina Paul, 53, a retired municipal clerk who was getting her second dose on Friday at the hospital in Globe, the county seat of 7,500 people, which was founded in the 1870s as a mining camp.

Ms. Paul said she got her first dose a few weeks ago, after taking her mother-in-law to get vaccinated and telling hospital staff members that she was open to it as well if they had any leftovers at the end of a day. They called Ms. Paul back, and she promptly got a shot. Now she is trying to persuade her 19-year-old son to get one.

Health officials and elected leaders warn that big challenges persist in Gila County, in part because, in a county where anybody can get the vaccine, not everybody wants it. There has been skepticism about the vaccine, as well as resistance to mask-wearing and social distancing measures, among some people in the deeply conservative county, where President Biden lost by 34 percentage points even while winning Arizona as a whole in the November 2020 election.

Unlike some rural counties, Gila County has hospitals in Globe, the county seat, and in its other main town where residents can be vaccinated. Credit...Juan Arredondo for The New York Times

For the moment, many residents seem to be in a wait-and-see mode. Bars and restaurants have been open for indoor business during most of the pandemic, with only a few limits, though some aspects of daily life in the county, like high school sports, have had cancellations or delays.

Resistance to mitigation measures has endured as case numbers have plunged in recent weeks. At the Safeway grocery store in the town of Payson one afternoon last week, about a quarter of the customers did not wear masks, including some men who were openly carrying firearms while shopping for food.

The risk that the virus could surge again worries some local officials. “I don’t want people to think we’re out of the woods just yet,” said Al Gameros, the mayor of Globe.

Doctors and nurses on the front lines in Gila County said they were able to open up vaccinations for all adult residents only after meeting targets for vaccinating high-risk groups like seniors and essential workers. Because they did so well, Arizona state officials allotted the county a larger number of doses, enabling it to become one of the few places in the country that could offer the vaccine to whole adult population.

Another is Sitka, Alaska, a town of about 8,600 that is administering vaccines to anyone 16 and up.

Some places, like Amarillo in the Texas Panhandle, have become known for their willingness to set aside residency issues and vaccinate people from other states and counties who show up at their sites. But Gila County sticks strictly to its own residents.

About 28 percent of county residents have received at least one dose so far, dwarfing the nationwide level of 14 percent, according to local health officials. Rhonda Mason, the chief nursing officer at the hospital in Globe, said the vaccination process was going smoothly but that the challenge ahead was to overcome misinformation and skepticism and get even more people vaccinated.

The hospital had expected a surge in calls after opening vaccinations to all adult residents. Instead, the flow of people seeking shots has been somewhat steady. The hospital’s vaccine site, which before the opening was administering more than 200 shots twice a week for people with appointments, had a walk-in session on Wednesday where about 180 people got vaccinated.

“It’s a little slow going, if we’re looking at getting to 70 percent for herd immunity,” Ms. Mason said.

Mayor Al Gameros of Globe (left) fist-bumped with Frank Stapleton, a hospital executive, after receiving his second dose of the Moderna vaccine on Friday at the Cobre Valley Regional Medical Center.Credit...Juan Arredondo for The New York Times

Health officials were on their way to vaccinating nearly 2,000 people over the weekend at a drive-through clinic in a high school football field in Payson; hundreds of others are set to get the vaccine at hospitals or small rural walk-in clinics in the next few days.

County health officials said a number of factors allowed the county to speed through its priority target groups and open up vaccinations to everyone.

The county’s rural character may have made it easier to promote vaccine awareness — among those generally willing to get vaccinations — on social media and in local newspaper and radio coverage, said Dr. James Schouten, a family doctor in Payson.

The Church of Jesus Christ of Latter-day Saints deployed volunteers to help get vaccinations organized.

It was also helpful that many residents were able to drive to sites in Phoenix, about 90 minutes away, easing the early demand for vaccines in Gila County.

Kay Ratcliff received her second dose at the medical center in Globe. Credit...Juan Arredondo for The New York Times

Another factor was that Gila County has hospitals in both its main towns, Payson and Globe, where residents could be vaccinated. Some rural counties in Arizona have no hospital at all.

Health officials say they also adopted a more imaginative approach to vaccinations, especially after Gila County moved past the phases for vaccinating teachers, child care workers and people 65 and older.

“We used a fairly loose definition of essential worker: those who work at the grocery store, the Dollar Store, the gas station, basically anybody who’s working with the community,” said Ms. Mason, the chief nursing officer at the hospital in Globe.

And still the county had more vaccines to offer. That’s when they decided to throw open the doors.

Some residents appeared to be amazed at their good luck.

“I just feel very fortunate to be one of the people to get it,” said Jordan Pace, 22, a college student who was vaccinated recently in Globe. “I can’t imagine what would happen to my family if I get the virus and then expose them to it.”

Patients waited in an observation area for 15 minutes after receiving their second vaccine doses, in case they experienced side effects. Credit...Juan Arredondo for The New York Times

At the hospital on Friday, some of those walking in for vaccines expressed surprise about the ease of the entire process. Chris Guthrie, a manager at a broadband company, said he had called the hospital just hoping to get some basic information about the vaccine.

“They told me, ‘Well, you’re an essential worker, we can get to you in 45 minutes,’” said Mr. Guthrie, 46. “Of course, I jumped at the chance.”

Natasha Rodriguez in New York and Shaena Montanari in Phoenix contributed reporting.