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A West Virginia pharmacist on how the state became a vaccine success story

West Virginia’s high vaccination rate is in part due to its high number of locally run pharmacies that have gained trust in the community.

West Virginians receive vaccines at the Charleston Convention Center and Coliseum in Charleston, West Virginia in February. The state has one of the leading vaccination rates in the nation.
Stephen Zenner/SOPA Images/LightRocket via Getty Images

As the Covid-19 vaccine rollout continues across America, it’s become clear that the process is anything but streamlined — many have been left feeling confused and helpless about getting an appointment scheduled, the privileged seem to have easier access to vaccines, and states are going about the process in highly individualized ways.

One success story, however, has been vaccination in West Virginia. The state isn’t typically known for great health outcomes — it has one of the worst life expectancies in the nation due to high rates of drug overdose, diabetes, and heart disease. But West Virginia has become a national leader on vaccination, boasting one of the highest rates in the world.

The state’s success is due in part to its history of turning to the National Guard to help handle emergencies like flooding and other disasters. Given that, it’s no surprise that Gov. Jim Justice decided to skip the federal plan, which partnered with CVS and Walgreens, instead relying on the National Guard and a strong network of local pharmacies to handle the distribution.

In West Virginia, due to a 1963 law, local pharmacies outnumber the national chains. Many are operated by people who grew up in the community, know their customers well, and have existing relationships with nursing homes for distributing flu vaccines. The result has been swift and decisive: To date, 15 percent of the population has received the first vaccine shot, 9.3 percent are fully vaccinated, and 108.1 percent of the state’s total doses have been used (they were able to achieve above 100 percent by squeezing extra doses out of some of the vaccine vials they received).

Drew Massey is in charge of vaccinations at Fruth Pharmacy, a small family-owned general store and pharmacy chain based in Point Pleasant, West Virginia. (Since its first store opened in 1952, Fruth has expanded and includes 29 stores, mostly in West Virginia but also in Ohio and Kentucky.) Massey grew up in rural West Virginia in a family of educators and coal miners and spent more than a decade working as a pharmacist at Kmart before moving to Fruth in 2014, where he has worked his way up to director of pharmacy operations.

Massey says he’s delivered more than 6,000 vaccinations — at nursing facilities, schools, and community events. “To date,” he told Vox, “we have not wasted a single dose.”

Here’s what it’s been like for Massey to deliver vaccines to small communities across West Virginia.

At Fruth, I oversee all the clinical services, the scheduling, and the staffing. I’m one of about six people on our leadership team. It’s a very tight-knit, close team. At the end of my first day at Fruth, we had done several hundred prescriptions. In my old life, I would have gone home feeling like somebody had just basically dragged me over a bunch of hot coals. But I told my wife, “You know what? I have totally had it wrong for so many years. I don’t even feel like I’ve done a thing today.”

At one of our stores, older clientele come in, get a root beer out of the machine, sit down, and, honest-to-goodness, if it’s queued three hours to fill the prescription they wouldn’t care. It’s like an episode out of Andy Griffith. Honestly, you don’t see that anymore.

When Covid-19 started, we saw lockdowns coming and tried to figure out how to protect ourselves and other people. We noticed early on that people didn’t want to go into places that they considered crowded — so they would come to our stores to pick up staples or food because they didn’t want to go to the big grocery stores or Walmart. On a very small leadership team, you don’t have to go through legal departments and all those other hoops to get [Covid-19 safety] things approved. For example, we started with shower curtains to set up as temporary barriers for Covid-19 safety. We had everything in place before anybody in our area even thought of it.

Our leadership team does our drive-through testing. I think this is what’s amazing about a small pharmacy versus a big pharmacy — I would never even see the leaders of one of the big chains. But my customers can interact with everybody who makes decisions in the company. They can talk about things that were good or bad. It makes them feel like the pharmacy team is more like a family than a company.

Here’s how we started vaccinations: Basically, Governor Justice decided that he wanted to get the nursing homes done and asked me how many nursing homes I can distribute to. I looked through my schedule and said, “I could probably do four to six facilities a week, if they’re big.” That’s if you’re going to do 100 to 300 shots — and I could do four to six a week to fit around my regular work.

We started to see what we could do. I figured out the sweet spots for how many pharmacists I needed to have, and how many people I needed on data entry. But the main thing I told the pharmacists was: “We’re not wasting a dose.”

To date, we have not wasted a single dose.

Nowadays we distribute our vaccines at community vaccination events, with makeshift clinics opened in every single West Virginia county. But in the early days, we would just take some vaccines and drive to our customers’ homes to see who we could give them to. That first week we got the doses, I was driving out to the homes of people who I had identified were either health care workers that needed to be immunized, or people over 80 who had multiple health conditions, to give them shots.

At first, I had to figure that out myself. In small communities you learn a certain amount just through family members asking for assistance, but I also got a list from the health department of citizens who had called in to say they were unable to leave their house to get a shot. After that, we identified people with the health department and the people who registered in our stores, so I could basically have a list of people to give the extra shot to.

On a typical day, I’d be out driving around 6:30 am and would give shots from 8 until roughly 5 or 6 pm, and sometimes up until 10 pm. I’d be going from place to place giving shots. At this point, I’ve given probably 6,000 shots.

I’ll never forget the 94-year-old lady I vaccinated who lives in Hometown, West Virginia, a tiny town, located 45 minutes from Point Pleasant, with probably 500 or 600 people.

I met her grandson on the way over, and we pulled up to her little modest house on the river. I walked up to the door and started talking to this lady — at 94, she’s sweet as pie and sharp as a tack. She looks at me and she’s like, “Honey, I would just like to get to the store. My kids have had me locked in this house since March, and I’m thinking maybe if I get these shots, I can get to the store.”

One of the biggest things that has been a success for West Virginia is the fact that people value our opinion — and that’s because we’re their most accessible health care professional.

How many times have you called your doctor’s office to talk to your doctor and your doctor actually finds the time to talk to you? How many times have you called the pharmacy and asked for a pharmacist and talked to one of us? You can get a hold of us, and people put a lot of trust into that and my promises. It’s a lot of responsibility, too, because we need to have good information.

West Virginia has a higher percentage of independent pharmacies than much of the rest of the country. We depend on our people to stay in business. When Walmart loses a customer, for example, even if they’re pharmacy customers, they’re probably still going to shop at the store. But if you lose a pharmacy customer at a Fruth, they don’t come back and shop at your store — you lose them completely.

I’ve had several people who are nervous about the shot, and I’ll talk them through the process. I try to make them more comfortable by discussing the procedure and risks. Then I ask them, “Are you ready to do this?” and most of the time they’ll say that they are.

For those who are unsure about taking it, I say: “Look at how well the shot works in comparison to other things.” It’s unprecedented to see shots that say they protect you in the 90 percentile range. It’s a lot of protection. Then I’ll tell people, “You’re protecting others too.” From the pharmacist feedback I hear, most of the people who are on the fence are the younger people who are thinking they can just push through Covid-19. Or they’ve already pushed through it — and they didn’t have a problem with it.

You have to tell them: “The protection’s not for you, the protection’s for everybody you’re around. It’s for the lady who lives across the street from you. It’s for your grandmother at home, or people who have health problems and may not be able to fend it off because you may be an asymptomatic carrier.”

Secondly, I tell them: “If you don’t take the vaccine now, you don’t know when it will be available to you again.” I can guarantee you that once it’s available to the masses, and the vaccine supply starts to get tighter, it’s going to be more difficult to go back and get a shot.

One lady broke my heart, and I’m not a softy. I didn’t even give any shots that day except for hers. It was at the gym in Hurricane High School. I was walking around checking on things and saw this lady who was crying. There were a couple of ladies with her and they were talking to her. I think they were trying to console her. In my mind, I thought, “Oh my gosh, this lady’s afraid of shots. I’m going to calm her down.”

I go over and ask, “Honey, are you comfortable? Are you okay and not just afraid of shots?” The woman behind her, I read her lips — which is a challenge now with a mask — saying “No, she’s not afraid of the shot.” She completed her registration and I walked her to the vaccination station, put on a pair of gloves, and quickly gave her the vaccine. Sometimes you can tell someone just needs a hug, so I gave her one as her friends escorted her to the observation area.

The two ladies came back and said, “Bless you.” Her husband passed away unexpectedly that morning. He died from a brain tumor that he didn’t know he had. She lost her husband that morning with no fair warning.

She knew that he would have wanted her to get a shot. So she pulled herself together and came over to the building to get it, her friends said — the very same day.

I cannot think of a more motivational story about knowing just how important this vaccine is.

As told to Hope Reese.