In this March 2021 photo provided by Pfizer, vials of the Pfizer-BioNTech COVID-19 vaccine are prepared for packaging at the company’s facility in Puurs, Belgium. Pfizer is about to seek U.S. authorization for a third dose of its COVID-19 vaccine, saying Thursday, July 8, 2021, that another shot within 12 months could dramatically boost immunity and maybe help ward off the latest worrisome coronavirus mutant. (Pfizer via AP)

NASHUA – While the Gate City and other surrounding towns have fared well with vaccinations and reduced vaccine hesitancy, public health officials and advocates are concerned about pocket areas in the state – some remote, some not as much – that are experiencing low numbers of inoculations and reluctance to get the COVID-19 vaccine, especially as the highly contagious Delta variant spreads and the new school year is just weeks away.

In some rural areas that show minimal numbers of vaccines administered, vaccine access is also an issue.

According to the New Hampshire Department of Health and Human Services, vaccine rates in 18 communities, with a combined population greater than 30,000, level off at 35 percent or less.

Health officials warn that those without vaccinations comprise nearly all new cases.

Politics also plays a part.

The U.S. vaccine map looks a lot like a map of how states vote in presidential elections, with most blue states vaccinating at levels well above the national average and GOP states bringing up the rear.

Even Gov. Chris Sununu recently encouraged those without vaccines to get inoculated.

“The surge we talk about that is likely to come in the fall, the vast majority, my guess is 99 percent of that is going to be on the unvaccinated,” he said.

Environmental consultant Mindi Messmer, co-founder of the nonprofit New Hampshire Science and Public Health, said vaccine hesitancy is a problem, even in the Granite State.

“The only thing that you can use as a metric is the rates of vaccinations across the towns and cities,” she said. “There’s a wide range of places where there is ample coverage and places where there is pretty low coverage. In the towns of low coverage, we sought to see what those reasons might be.”

In a study conducted by NHSPH, Messmer found that it has to do with people rejecting the science and the politics behind them.

“There is ideological opposition,” she said. “And there are also clearly other factors, like access. We have a lot of remote areas in the state of New Hampshire. There is an issue with access.”

Messmer cited places like Columbia or Unity, New Hampshire, which are at the top of the state.

“They are really out in the sticks and it’s hard for people to find access to vaccines,” she said. “That was one of our big concerns.”

A recent University of New Hampshire Survey Center poll found those who said they voted for Trump were five times more likely to not get vaccinated than supporters of President Joe Biden.

Messmer said that’s not the only factor.

“We compared the voting record for the 2020 election,” she explained. “What towns and cities voted more for Trump versus what towns and cities voted more for Biden. And there is a relationship between those places that voted for Trump that have low levels of vaccination and the places that voted for Biden, that have higher rates.”

Messmer suspects that data in places such as Durham is erroneous because students used their home addresses instead of their Durham addresses when getting vaccinated.

“It makes it look like the vaccination rate is really low because they were included in the census,” she said. “But then you look at Hanover, which is extremely high, perhaps because there are so many medical professionals there.”

The goal of the study was to show that ideology was playing a part, and Messmer said it is, though it is not the only factor.

As Sununu suggested that the unvaccinated would be more likely to become sick versus those who are vaccinated, Messmer said the reason for conducting the study was because of the concern for the Delta variant being present in New Hampshire already.

“That’s why we did this,” she said. “We thought, ‘Maybe we can overcome access issues. Maybe we can overcome some of these ideological issues by having the right people be communicators or getting the van that supplies rural vaccine access to the right areas. That was the impetus for the study.”

If it’s not the Delta variant, Messmer said, it’s going to be another variant.

“The more that we allow the virus to circulate in communities, the more likely it is that this will create more efficient ways to get around vaccines,” she stated. “So, it is extremely important that we get out in front of the Delta variant here.”

With children returning to school soon, having more people vaccinated is also crucial.

“That was our big concern too,” Messmer said. “We want the kids to be in school. There are some places in the world, that instead of focusing on having people go back to restaurants and bars, they focused on having the schools open. And that was successful. The schools are reflective of the community case rates. We want to make sure that we protect the children who cannot get vaccinated.”

More than 100 organizations have requested a visit from the state’s COVID-19 vaccine van as infections continue to rise. The van started running on July 14. Since then, it has visited five locations and delivered vaccines to some 50 people, according to chief of the state’s bureau of infectious disease control Elizabeth Daly.

With fall and winter around the corner, Messmer is concerned that infected rates could climb again soon.

“Absolutely,” she said. “If people are not masked inside and are congregating in closed quarters with not a lot of ventilation in the air like in restaurants and schools, that’s definitely a big concern of ours’.”

Masks are a proven piece to the layered strategy, and Messmer said they work.

“I know that the CDC just revised their guidance on Wednesday,” she said. “They’re telling people to wear masks in areas where there is high rates of transmission. But it’s almost too late when there are high rates of transmission. As a prudent measure, we should be doing that right now.”

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