BEECHER FALLS — The village of Beecher Falls isn’t technically in the coverage area for Jesse Dimick, the vaccine clinic coordinator for Northeastern Vermont Regional Hospital.
The St. Johnsbury hospital is a 90-minute drive from the village, where roughly 200 residents live in a corner of the state wedged between the Canadian and New Hampshire borders.
It’s “about as remote as it gets,” Dimick said. But there’s also no closer Vermont hospital.
So on Monday, Dimick made the trip and stood up a Covid-19 vaccine clinic at the Beecher Falls volunteer fire department, which stands within sight of the U.S. Customs port of entry.
Dimick is one of a host of health care workers and government officials who are working to ensure that the state’s most isolated Northeast Kingdom residents can get a Covid-19 vaccine. Just 14% of Essex County residents have been fully vaccinated, compared to 21% of the state overall. The county has the lowest inoculation rate across every age bracket.
On Tuesday, Human Services Secretary Mike Smith acknowledged the “disparity between the other counties” and Essex. “We’re keeping an eye on that and trying to figure out what’s going on,” he said.
Canaan residents say the disparities are likely rooted in deep-seated cultural and logistical barriers — a combination of the region’s geographic isolation, the shortage of health care facilities, cross-border politics and limited broadband, as well as an ingrained individualism that can lead to governmental mistrust.
“There’s no one reason why Essex County, I think, has a low rate compared to other counties,” said Sharon Ellingwood White, director at Alice Ward Memorial Library in Canaan and an advocate for greater vaccine access. The challenges are many “to get here to the end of the line,” she said.
With an average of about 10 residents per square mile, Essex is the most remote county in the state. It is also the poorest and has the oldest median population. Its two gores and three unincorporated towns create vast swaths of open land. This week, last year’s stubble poked up through sweeping fields of snow. There’s not a single hospital or pharmacy in the entire county.
White is familiar with the challenges. As a librarian, she has become the de facto tech support person for fellow Canaan residents struggling to sign up for the vaccine.
Many, she said, have an inadequate internet connection. Some older residents have trouble navigating the state’s website. A few have inadvertently signed up for appointments in Essex Junction or in Essex County, New York, she said.
The most wealthy and able locals have managed to get an appointment, typically by driving an hour or more to St. Johnsbury or Newport for a shot. But older people may have trouble navigating snowy and rough roads to take the trip, and younger residents aren’t always able to take the time off work, she said.
White said the last first-dose clinic in Beecher Falls was about six weeks ago, on Feb. 12. “How are we going to put the 75-plus drivers in their cars in the middle of winter, you know, 30-below-zero in February, a 45-minute trip one way, and ask them to sign up with phone or internet?” she said. “That’s tough.”
She summed up the challenges this way: “It’s an inequity built upon an inequity.”
‘Nothing more than hard work’
Dimick’s clinic, which included 100 slots, was fully booked Monday. Patients sat in socially distanced folding chairs as they waited for their shots in front of the big bay doors.
They signed in at laptops powered by hotspots — there is no WiFi, Dimick said. But he pointed out a benefit of the site. The room, which was edged with hanging firefighters’ coats and boots, was spacious and heated — a rare find in the smallest Northeast Kingdom towns.
Anna St. John, who has Type 1 diabetes, drove more than an hour from her home in Gilman to get the shot. “I was going to drive anywhere I needed to,” she said. According to Dimick, at least one resident drove three hours from Essex Town for a dose. Most were locals, he said later in an interview, but he couldn’t say how many.
For Benoit Lemay of Canaan, it was an easy decision.
“You should take your shot no matter what,” he said. Vaccination may allow him to visit family and friends in Canada when the border opens, but he would have registered regardless. “It’s just common sense, that’s all,” he said.
Dimick said he knew the vaccination rate in the area was low but said he didn’t know why. “They’re not generally not showing up at the clinics having those conversations,” he said.
He downplayed the challenge of getting the vaccine to places like Beecher Falls. “It’s nothing more than hard work, really,” he said.
As the vaccination rate lags, Covid cases are ticking up. Northern Vermont has reported a growing number of cases per capita, which Health Commissioner Mark Levine attributed to community transmission. “We see it in work sites. We see it in schools. We see it in health care facilities,” Levine said at the press conference Tuesday. “It’s really across all sectors of society.”
Cross-border politics
For Canaan residents, the most convenient vaccination option is off limits: New Hampshire.
Most people in the area seek their medical care and pick up their prescriptions just across the Connecticut River in Colebrook, New Hampshire, White said.
While Vermont will grant a dose to New Hampshire residents who work or have a primary care doctor in the Green Mountain State, New Hampshire only vaccinates its own residents. That means that most Canaan residents cannot go to the doctor’s office they’re most comfortable with to get the vaccine.
White, who also serves on the hospital board, along with state officials, got hospital doctors to start providing their Vermont patients with relevant vaccine information.
It’s not ideal, said Mike Daley, who showed up at the Beecher Falls clinic for a dose on Monday. But Daley, who lives in Canaan and runs a supermarket in Stewartstown, New Hampshire, said it’s a dynamic that residents are constantly navigating. “It’s made it dysfunctional for 100 years,” he said. “The river is the only thing that runs between these communities.”
Even with widespread access to a vaccine, not everyone wants it. Recent studies reported that men who vote Republican are least likely to want a vaccine; roughly half said they wouldn’t get a dose, according to an NPR/PBS NewsHour/Marist study. Essex is the only Vermont county that went for Donald Trump in 2020, with 54% of the vote.
“This is a Trump stronghold, for sure,” Daley said. “That goes along with that whole mentality, like anti-government, anti-establishment and civil rights violations and stuff. That’s been churning for a while.”
Rep. Terri Williams, R-Granby, described it as an ethos of self-reliance. “We’re a pretty resilient district and independent,” she said. “We take care of ourselves, and there’s not a lot of complaining or concerns.”
Roadside outreach
Earlier this month, Williams joined other state officials and local officials on a call to brainstorm ways to boost turnout. One town clerk suggested putting up six blinking road signs with vaccine information and a phone number to call at intersections around the county. Town clerks and librarians agreed to hand out flyers and distribute additional information.
State officials also agreed to reach out to New Hampshire doctors to make sure they could provide information about vaccination to their Vermont patients.
Dimick, the vaccine clinic coordinator, also asked the state for Johnson & Johnson vaccines, which can be administered in a single dose. That would cut down the costs and time required to get to the state’s most remote regions, he said.
First, though, they’ll have to persuade residents that it’s worth the trouble.
Jonathan Marchand had a vaccine clinic flyer posted where he worked at Cunningham’s Full Service Station in Canaan, but the 33-year-old said he wouldn’t get a dose himself. “To me, everyone I know who’s had it isn’t that extreme,” he said. He didn’t usually bother with a mask. “Some people are just super scared of it.”
He would submit to a shot only if it was required to cross the border into Canada.
Ultimately, he said, it should be a matter of personal preference.
“If you feel like you want a vaccination, go get it,” he said. “I’m not the kind of person who’s going to force what I feel onto anybody else.”
To register for a vaccine appointment or get information on walk-in clinics, visit healthvermont.gov/MyVaccine or call 855-722-7878.
You will be asked to provide your name, date of birth, address, email (if available), phone number, and health insurance information (if available, but not required).
