A marquee sign along Central Street in Millinocket informs people where to register for a COVID-19 vaccine on March 26, 2021. Credit: Linda Coan O'Kresik / BDN

Rural Maine has presented a challenge for public health officials in their efforts to improve COVID -19 vaccination rates across the state. But there is a bright spot in Penobscot County.

At Millinocket Regional Hospital, 98 percent of staff have been vaccinated against COVID-19. It’s the highest rate in the state – and a position that the hospital has held for months.

If you had asked Lacy Jones, an ER nurse at Millinocket Regional Hospital, whether she would get the COVID-19 vaccine when it first came out, the answer would have been no.

“I was at staunch refusal. I said there was no way I was ever going to roll up my sleeve,” Jones said.

Even though the Millinocket area was the origin of the state’s worst COVID-19 outbreak, stemming from a summer wedding last year, Jones thought the vaccine was rushed and she worried it wasn’t safe. But when she expressed those fears to higher-ups at work, the hospital’s infection prevention expert, Todd Phillips, sat down with her to find out why she didn’t want the vaccine. Jones says that conversation continued for weeks. She’d call and text Phillips when she had questions after seeing something on TV or social media.

“He’s probably really tired of screenshots of, what about this? What about this? And, you know, is this true? And, help me, help me research this,” Jones said.

Every question she had, Phillips found answers. By the end of February, Jones says she had enough time – and information- to decide to get the shot.

“I got the vaccine because I want to be part of the solution, not the problem,” Jones says.

She’s one of the now 98 percent of hospital staff that have been vaccinated, though Phillips acknowledges that a fair number have been hesitant, and it hasn’t been easy.

“When we got to 72 percent, I cried. I really genuinely cried. Because I never would have thought my staff would have responded that way,” Phillips said.

He said the key was getting out in front of questions that doubters had, and being diligent about keeping up on research and sharing it. He holds up a half-inch thick stack of research papers he gave to one staff member concerned that the vaccine would affect fertility.

“Doing the work to begin with is what really made us successful. And so to try to double back in those efforts to make them work, now, people are dug their heels in, they already have their belief systems, and now they have as much alternative facts to support it,” Phillips said.

Being a small hospital with 200 staff is also an advantage. Phillips says he stopped by different departments to actively seek out conversations. He also went out into the community and talked at school board and town council meetings. He’s even encouraged local business owners, like Matthew Polstein of the New England Outdoor Center, to require employees to be vaccinated.

“I was thinking about it. And I got a call from Todd……who, in his sort of mission to move vaccinations forward in the area said, ‘Hey, you know, you’re a progressive business, would you think about this?’ And I said, ‘I’m thinking about it, Todd.’ And he goes, ‘Let’s talk because I want to help you make it happen’,” Polstein said.

After talking with Phillips about the science behind the vaccines, Polstein decided to make it a condition of employment. That was back in May. The requirement has made it harder to hire staff, but Polstein says he has no regrets.

“I think the business community and individuals need to help solve this problem. We can’t wait for the government to mandate that we do it because I think the political will, has slipped to be firm on COVID,” Polstein says.

There are still challenges in the area. The town of Millinocket has a relatively high vaccination rate of 80 percent. But that number drops off in surrounding towns. East Millinocket is at 73 percent. Medway is at just 57 percent. Before a recent school board meeting for Medway Middle School, principal Alyssa Dickinson said she and the local COVID-19 response team agreed to recommend that masks be made mandatory.

“I think we also knew that we weren’t sure where our recommendations were going to go at that meeting, and that we would make our best case and hope it went our way,” Dickinson says.

It didn’t. The board voted three to one to make masks optional. And the school lost a new hire in the process- a sorely needed special education teacher who said they didn’t feel safe. The Superintendent overruled the decision a week later after receiving community feedback. But the board will take up the mask issue again in mid-September.

The resistance to safety protocols has become a major issue for Randy Bossie who works on the ambulance crew for the town of Patten, at the northern part of Millinocket Regional Hospital’s service area.

“Oh I’m very frustrated,” Bossie says.

Bossie said he’s one of just three people on the ambulance crew, working 24/7 to cover 13 towns. If one of them gets COVID, he says, the unit can’t function.

“People don’t understand we’re wearing a Tyvek suit, with a rain suit over it, with a face shield, gloves, and goggles, and an N95 mask just to go get somebody’s that’s got a broken ankle because we don’t know if they’re positive or not. You get there and the first question you ask is, are you vaccinated – and that gives you a little bit of relief if they say ‘yes,'” Bossie said.

Bossie said some of his own family members refuse to get the vaccine, even though they know what he faces in his job.

“I mean I see it every day. I’ve transported 6 or 8 COVID patients, and when you see someone struggling for that next breath, you kinda say, I don’t know why everybody’s not getting it. Because to watch someone struggling for that last breath is quite a sight,” Bossie said.

Bossie helped organize a recent vaccine clinic in Patten in partnership with Millinocket Regional Hospital. Over the course of four hours, 10 people came. Phillips, the infection preventionist at the hospital, said every vaccination is an accomplishment.

“I would like people to realize that those of us in rural areas that are getting these really fantastic numbers, comes at us at a cost to us personally and physically and emotionally and mentally. We fought hard for these percentages,” Phillips said.

And Phillips says, the effort to raise them even higher – in some areas, by 20 or 30 percent to reach herd immunity, will be monumental.

This article appears through a media partnership with Maine Public.