Rebekah Neff sank a lot of time and money into studying at Cox College to become a nurse. But on the day Cox Health, the hospital system where she was scheduled to train, announced it was requiring workers and nursing students to get the COVID-19 vaccine, she decided to drop out.
“It was really hard,” said Neff, of Republic. “A lot of tears were shed over that, because I put a lot of hard work into where I got. I still feel strongly that I made the right choice for myself.”
Neff, 29, had recently learned she was pregnant and feared the shot would harm her baby, which is due in April.
“To me, it's not morally right to push people into things that they don't want to do,” Neff said. “I feel like health freedom is a really important freedom, to be able to choose your own health choices … to be able to say: ‘I don't want to do that. I don't want to put that in my body.’”
There are a lot of Missourians who agree with her.
The number of people in the state getting vaccinated against the coronavirus has slowed to a crawl. About 10,000 doses are given each day in Missouri, and a sizable percentage of those are boosters for people who are already vaccinated. The vaccine has been widely available for nearly a year, and only about 55% of Missouri residents have received two doses. Just over 64% have received one dose.
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Doctors say the fastest and safest way out of the pandemic is to vaccinate a large portion of the population, and rigorous testing has shown that the shots are safe, including for pregnant people.
But in Missouri, many residents are touting their personal freedom to refuse the shot. Republican lawmakers claiming vaccine mandates amount to government overreach have fought back against local officials and public health departments. In more than two dozen counties, fewer than one-third of people are fully vaccinated.
Missouri’s tough road
According to the Pew Research Center, Republicans, evangelical Christians and those who live in rural areas are less likely to get the vaccine — and Missouri has a lot of them.
Neff doesn’t identify as a Republican or a Democrat — but she said her views align with the GOP's position on vaccine mandates.
As personal politics fuses with vaccine reluctance, it will be harder to convince people of the benefits of the COVID-19 vaccine, said Liz Hamel, director of public opinion and survey research at the Kaiser Family Foundation.
“Attitudes toward all kinds of things related to the pandemic, including vaccines, have been divided along party lines for a long time,” she said. “It’s interesting. If you ask people directly who say they don’t want to get the vaccine, they don’t mention politics for the most part. They mention things like newness and side effects and unknown long-term effects.”
However, political affiliation has become the biggest predictor of whether people will get the vaccine, Hamel said. Republicans aren’t getting it as much. In a state where all but four of 114 counties voted for former President Donald Trump, a Republican, in the last election, that’s a big deal.
“You can't just shame people into getting vaccinated,” she said. “But I think a lot of health experts are really frustrated at this point, almost a year into this vaccination effort, that people are still expressing concerns.”
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A plea for vaccination freedom
So, why don’t Republicans want the vaccine?
The vast majority of Republicans believe that getting the vaccine should be a personal choice, not the result of mandates from officials, according to Kaiser’s polling. In contrast, most Democrats believe they have a responsibility to others to get vaccinated to protect public health.
The right to personal freedom was at the center of a September rally in Jefferson City held by the anti-vaccine mandate group Take a Stand Now Missouri.
Jill White, who has been a nurse for eight years, attended with several of her colleagues to protest a federal vaccine mandate for health care workers. Missouri has challenged the requirement in court, but a ruling from the U.S. Supreme Court this month allowed the mandate to continue.
“I don’t agree with the vaccine itself,” White, who lives outside Springfield, said while standing in a long line to be let inside the Statehouse. “But apart from that, I think it's not the government's place to force health care options upon me.”
She doesn’t think the vaccine has been around long enough for her to feel safe taking it.
“You know, you shouldn’t be able to make me do something that I don’t agree with, for my livelihood to take that away from me,” White said.
The rotunda at the state Capitol was soon packed to the brim with rallygoers.
While the rally was open to people of all political parties, the event featured several Republican state lawmakers. Attendees also brought up several Republican talking points, including criticism of teaching elementary school children about transgender people and critical race theory — even though Missouri schools do not teach the graduate-level theory in history classes. One person held a huge “Impeach Biden” sign.
Another sign read “Reject Coersion, Mandates, Passports, Discrimination.”
“I'm retired military. If there was a vaccine, I got it,” said the sign’s holder, Mark Seery, also of Springfield. “So I side with the health care workers. I understand that feeling. I had to do it, and I'll never do it again. I won't be forced.”
Individual freedom vs. collective health
The unwillingness of many Missourians to get the vaccine has far-reaching consequences.
As an infectious disease doctor at Mercy and SSM Health in St. Louis, Dharushana Muthulingam sees the effects of anti-vaccine rhetoric firsthand. Once people are in the hospital, it’s often too late to change their minds.
“When I see somebody and they're coming in, they're gasping for breath and on a big machine. ... I try to be compassionate,” she said. “I just try to get the information, which is they're not vaccinated.”
It’s not just a matter of doctrine — people are getting bad information, Muthulingam said.
“You’re pushing against this other ecosystem that has other agendas,” she said. “They really genuinely, authentically don’t have a good sense of how to judge that information.”
Some people will never be convinced, Muthulingam said. But there’s a portion who could be. Missouri’s health officials say the state can increase its vaccination rate to as high as 70%. They think even the vaccine hesitant can be convinced, with some work.
But with Missouri’s high numbers of freedom-touting residents, they have their work cut out for them.
Follow Sarah on Twitter: @Petit_Smudge
