In San Miguel County, home to fewer than 8,200 Coloradans in 2019, 77% of the 12-and-older residents have been vaccinated.

It’s the second-highest rate in the state, behind only tiny San Juan County, and San Miguel has consistently been near the top of Colorado’s 64 counties when it comes to inoculating its residents.

There has been considerable less vaccination success on the other side of Colorado in Bent and Crowley counties. The two counties, which together have fewer than 12,000 residents, have long had Colorado’s lowest vaccination rates. There’s been some improvement in Bent County of late, with just over a quarter of its eligible residents. Crowley’s rate rate stands at 17.6%.

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Bent and Crowley are not alone in lagging behind the state — and the nation — in vaccination rates. More than half of Colorado’s counties have vaccinated fewer than 50% of their eligible populations. In addition to Bent and Crowley, two others — Cheyenne and Washington — are below 30%.

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When the COVID-19 vaccines rolled out earlier this year, polling indicated rural residents and people in minority groups were more hesitant to get vaccinated against the virus. The Kaiser Family Foundation, a national health care think tank found in December 20% of rural residents nationwide said they would not be vaccinated. That number rose to 24% in June, according to the nonprofit’s website.

“From the data, we know we need to do more to get communities of color and rural Coloradans vaccinated, and we have a multifaceted approach to doing that,” Jessica Bralish, the communications director for the state Department of Public Health and Environment, said in an email.

The agency wouldn’t discuss vaccination efforts in Bent and Crowley counties.

“At this point in our statewide vaccination efforts, we know we must keep trying to reach people where they are, offering as much convenience, access, and information as possible to remove any remaining barriers to vaccination,” the agency said.

Increasingly, those efforts have fallen on individual providers. Colorado moved away from mass vaccination sites and toward primary care physicians, who have more intimate relationships with people. 

That’s true in Crowley and Bent, providers there said. While vaccination sites remain open, providers allowed for private appointments in clinics, said Evelyn Wiant, spokeswoman for Valley-Wide Health Systems, which is one of the few vaccine providers in Bent and Crowley. 

She said the decision to offer private appointments was driven in part by people hesitant to have their photographs taken, for promotional purposes, at the clinics.

“We never know if they’re trying to protect their own privacy,” Wiant said, “or if they don’t want to be seen there.”

Access to the vaccine is not what’s depressing the vaccination rates in Bent and Crowley, the providers said. 

“Here in Crowley County, I don’t think access is really an issue because the clinic here, the Valley Wide clinic — we’ve been offering vaccines,” said Amanda Maxwell, the site manager for the clinic in Ordway, the Crowley county seat.

Wiant said that providers are hearing from workers, especially those with multiple jobs, who’re concerned about getting time off to get vaccinated, or that they’ll need a day away from work due to side effects. The Johnson & Johnson pause — instituted in April after a very small number of people developed serious reactions — also “spooked” people, she said. 

There’s been a concerted on-foot effort to get the word out, said Nick Lara, the outreach coordinator for Valley-Wide. Valley-Wide sought faith leaders in those counties to help drive messaging. They didn’t hear back from any of them, Lara said. 

The providers suggested that the low rates may be driven by a combination of hesitancy, the warm weather and COVID-19’s presence falling across much of the state.

Meanwhile the delta variant of coronavirus — more transmissible and potentially more severe — is spreading statewide. Mesa County, which is larger than Bent and Crowley and has a higher vaccination rate, is being ravaged by the variant. Providers there have said that the situation there now is akin to the fall, when the state was besieged by another pandemic wave.

“There’s concern,” Lara said. “That’s where we’re continually trying to get out there and put our mobile unit out there and open up different appointments.”

“But again,” he said, “it comes down to the individual and their beliefs and those types of things. I think — we’re doing everything we can on our end to try to get people access.” 

Officials worry some people won’t get vaccinated until the severity of an outbreak drives home the need for inoculations. Statewide statistics show the pandemic is ebbing, with fewer people contracting the virus and fewer hospitalized with its symptoms.

But in January and February, Maxwell said, “there were a lot of obituaries in the newspaper every day,” she said. 

Back then, the clinics had a waiting list for vaccination. 

“I think that scared a lot of people,” Maxwell said of the fall spike. “… I think the if delta variant starts making its way and we start seeing it affecting someone local here, I think we will get more (vaccinations).”