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Staff Photo by Matt Hamilton / Nurse practitioner Meghan Whitehead gives a COVID-19 vaccination to Lookout Mountain resident Kizer Burbank, 7, on Friday, Nov. 13, 2021, at the downtown branch of the Chattanooga Public Library. Lifespring Community Health was providing vaccination shots to children as young as 5 years old.

Dora Rangel, a mother living in Murray County, Georgia, said she never questioned her choice to get her children vaccinated against COVID-19. She also said it wasn't a very difficult decision for her to make.

Her children range in age from 7 to 19. Lilly, her oldest daughter, chose to get vaccinated on her own as an adult as soon as she was eligible. Her two younger children, 13-year-old Angelis and 7-year-old Angel, got vaccinated as soon as they were, too.

"When they became available for teenagers, we went and got our 13-year-old vaccinated," Rangel said. "We had to wait a little while to get the youngest, who is 7, vaccinated. I was scared he might get COVID."

Members of the Rangel family, including Angel's father, have asthma. When Angel gets sick, Dora Rangel said he sometimes has trouble breathing, even if he only has a cold.

"I was afraid he might die if he got COVID," Rangel said. "I've seen on the news that kids can get COVID and die. I didn't want to risk my son that way."

(READ MORE: Five-year-old son of Whitfield County deputy dies of COVID-19)

In Murray County, Georgia, where the Rangel family resides, 36% of the overall population is fully vaccinated, and 16% of people aged 5-19 have received the first dose of a COVID-19 vaccine, making a fully-vaccinated family like the Rangels relatively rare.

That trend continues throughout North Georgia and across the Chattanooga region.

While some parents eagerly awaited the authorization of COVID-19 vaccines for children, childhood vaccination rates across the region remain low — with around 1-2% of the population ages 5-9 having received their first dose in many more rural counties since they became available for younger children in early November.

In Hamilton County, 11.4% of children ages 5-11 are at least partially vaccinated, up from 5% two weeks ago.

Meanwhile, Grundy County has yet to vaccinate a single child 11 and under based on data from the Tennessee Department of Health updated on Tuesday.

Only Hamilton County has vaccinated more than 30% of its 5- to 19-year-old population, while Whitfield County has vaccinated 23% of that age group followed by Meigs County at 22%.

Grundy County has the lowest vaccine coverage among those younger than 20, with 8% of its 5-19 population having received at least one vaccine dose.

Since pediatricians are normally concentrated in more urban and metro areas, many rural and sparsely populated counties turn to nurses and pharmacists for vaccine information and to get a shot.

Jacob Standefer, a pharmacist and the CEO of four local pharmacies administering COVID-19 vaccines across Southeast Tennessee — Jasper Drugs in Marion County, Cates Street Pharmacy in Sequatchie County, Standefer Pharmacy in Bledsoe County and Access Family Pharmacy in Hamilton County — said that lower childhood vaccination rates in certain counties are reflective of those areas' lower adult vaccination rates.

"We've got pharmacists here, and I've got two pediatric nurses that work for me, so we're all able to vaccinate, and the nurses have a lot of experience with young kids," Standefer said. "But I think it's more so just those counties in specific. It's not necessarily the kids, it's if mom and dad aren't getting the shot, they're not going to take their kid to get it either."

Residents in rural counties often face more barriers to health care, such as transportation challenges and lack of providers. With fewer vaccination sites in general, rural residents often have to travel longer distances to get vaccinated, which can become even more problematic when you have to get more than one shot.

Rural counties also experience higher rates of vaccine hesitancy, according to a March 2021 poll by the Kaiser Family Foundation.

According to the poll, 21% of rural residents said that they would "definitely not" get a vaccine, compared to 10% of urban residents. Among the rural respondents, 45% of adults aged 18-64 stated that they would "definitely not" get a vaccine compared with 8% of adults 60-69 years old.

"When you look at the vaccination rates in Marion County, our Jasper drugstore — compared to here in Hamilton County, obviously we've had a lot more kids and adults — in some of the more rural counties, the vaccination rates just aren't as high," Standefer said.

Access Pharmacy in Hamilton County is administering on average over 1,000 COVID-19 shots per week still, including booster shots, whereas the more rural stores on average give around 100-150 shots per week, he said.

Logan Boss of the Georgia Department of Public Health's Northwest Health District — which includes Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk and Walker counties — confirmed that the number of shots being distributed in rural areas has declined.

(READ MORE: North Georgia public health leaders warn that there could be another holiday COVID-19 surge)

"Truthfully, that's happening everywhere for every age group. There has been very little interest in the 5-11 [age group] vaccines through us at the health departments, and that's what I am hearing from local pediatricians, too," he said. "I would call the amount of interest a trickle."

Asked why he thinks interest is so low, Boss said he believes many parents in Northwest Georgia are playing a waiting game to see how the first round of vaccinations go. It is similar to what many people did at the start of the pandemic when vaccines were first available for adults, he said, in that people want to see how others are affected first.

"Research shows about a third of all parents are waiting to see what happens with other people and how they feel about it," he said. "But to be clear, we are encouraging people to get their children vaccinated the same way we encourage adults to get themselves vaccinated. It is still the best way to prevent extreme cases of COVID."

A vaccine authorized or approved for any age group goes through a highly vetted process, but Rangel said some people have criticized her for getting her children vaccinated so early on in the rollout process. Some people have questioned her decision to get them vaccinated at all. Still, Rangel remains confident that she did the right thing for her family.

She believes in the research and science that went into producing the vaccines and doesn't fear them because there are vaccines for so many other types of illness. It helped, too, that she and her husband got the vaccine before it was available for the children. They didn't have any negative symptoms, which she said made her even more comfortable with the thought of allowing her children to get the shot.

"I didn't want to wait and then let my kid get sick and have to ask why. I don't want my kid to die and then have to ask myself why they died. Was it my fault because I didn't vaccinate them? Where I live, there are a lot of anti-vaxxers. They don't believe in masks," Rangel said. "So for me, it's very important to get them the vaccine to make sure they're protected."

Contact Elizabeth Fite at efite@timesfreepress.com or follow her on Twitter @ecfite.

Contact Kelcey Caulder at kcaulder@timesfreepress.com or 423-757-6327. Follow her on Twitter @kelceycaulder.

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