There was a first-dose COVID-19 vaccine clinic at Colby-Sawyer College before Emily Vrooman left campus for an internship on Cape Cod this summer, but she would have had to come back for the second dose, she said.

The information she received about the clinic “didn’t say anything about if you could do it somewhere else or not,” so she chose not to get the vaccine then.

Vrooman, who is 22 and graduated from the New London college last month with a degree in exercise science, said she plans to get the vaccine, but “I just don’t know where the sites are.”

Even as the Twin State economy continues to reopen from the worst of the pandemic, some people remain unvaccinated against COVID-19, including the majority of those age 29 and younger.

Because young people in the Twin States’ became eligible for vaccination later than older ones, they have had less time to get the jab. The youngest, those under 12, remain ineligible.

But there are also indications of other reasons younger people haven’t stepped up as quickly as their elders. Some, like Vrooman, simply haven’t gotten around to getting a vaccine, while others say they don’t want them out of safety concerns. Public health officials are now changing their tactics to try to get shots in the arms of the remaining unvaccinated.

A healthy majority of eligible residents in both states have gotten at one dose of the vaccine, but those percentages vary by age. More than 90 percent of Vermonters 65 and over have gotten at least one dose, while fewer than 50 percent of those in the 12-15 age group have, as of Friday according to the Vermont Department of Health.

Similarly in New Hampshire, nearly 90 percent of those in the 65-74 age group have gotten a shot, while less than 50 percent of those age 16-29 have, as of last Sunday according to the New Hampshire Department of Health and Human Services.

Dr. Michael Calderwood, chief quality officer and infectious disease specialist at Dartmouth-Hitchcock Medical Center, said he’s “a little concerned” about the rates of vaccination among young people in the Twin States and around the country.

Nationally, just 20 percent of those ages 12-15 have had at least one dose; 37 percent of those 16-17; 44 percent of those 18-24 and almost 50 percent of those 25-39, according to the Centers for Disease Control and Prevention.

While Calderwood said vaccine mandates may make sense in certain settings such as schools where children are required to have other vaccines, he said he’d prefer to start by getting people to step up voluntarily.

“I think we have to recognize that a reality of this is that a one-size-fits-all communication strategy just telling people, ‘Do it!’ is not going to work,” he said.

Instead, he said, the strategy should be to meet with people, hear their concerns and “make sure they’re getting the right information.”

He also acknowledged that young people are being asked to get vaccinated at a time when the number of cases, hospitalizations and deaths related to COVID-19 are declining across the U.S.

“I am really encouraged by where we are,” he said.

But, he said, some of the decline is seasonal. The region saw a decrease in case numbers last summer and then a spike in the fall, he noted. In order to resume in-person learning as normal, eliminate masks and reopen colleges fully, young people need to be vaccinated in larger percentages, he said.

Young people tend to live in more congregate settings and be more social, so they are “going to be a driver should the numbers go back up,” he said.

While younger people have lower rates of serious illness when they contract the virus, some do become seriously ill and others develop lingering symptoms that prevent them from a full recovery, he said. Unvaccinated people of any age can transmit the virus to others should they become infected.

Beth Daly, chief of the New Hampshire Bureau of Infectious Disease Control, said that she’s not worried about the rates of young people stepping up to get vaccinated, noting that the youngest, ages 12-15, only became eligible last month.

“I think we’re doing very well,” she said during a Thursday news conference. “It will improve with time.”

Royalton resident Raeanne Boule said in an exchange of Facebook messages that she does not plan to have her children vaccinated due to her concerns about the safety of the vaccines.

“My kids are allergic to the flu vaccine and I almost lost my youngest to something that’s been around for years,” she wrote. “I can’t take the chance with a vaccine it only took months to make.”

While the COVID-19 vaccines were created quickly in response to the pandemic, scientists, including some with ties to the Geisel School of Medicine at Dartmouth, have been laying the groundwork for them for decades. In addition, amid the pandemic the vaccines were manufactured at the same time they were being developed, which was aided by federal financial support.

Public health officials, including the Centers for Disease Control and Prevention, recommend the vaccines and say they are safe and effective.

Calderwood said the CDC has a specific hotline number for health care providers or health departments to call to ask questions about allergies and other safety issues related to the COVID-19 vaccine.

“I’ve done this for my own family,” he said.

Calderwood said he thinks there are a range of factors contributing to a smaller percentage of younger people having gotten vaccinated. He pointed to issues related to needing to take a day off from work and feeling ill following the shot. But he said he thinks such concerns have been “overblown” and that while some people do feel sick, most people are able to work following their vaccination.

He also noted that some people have been concerned about receiving the one-dose Johnson & Johnson vaccine, which was put on pause for 10 days in April due to a small number of serious blood clots in people who had received the vaccine. The clots were found at a rate of about 7 per 1 million vaccinated women between 18 and 49 years old, according to the CDC.

For most people, however, Calderwood said the “small risk of the blood clot is outweighed by logistics” and the simplicity of the one-dose vaccine.

He also said there have been a small number of cases of heart inflammation in adolescents and young adults following vaccination with the Pfizer and Moderna vaccines, but for most those symptoms are short-lived and leave no lasting impact.

Overall, Calderwood said, the risks of the vaccine are far outweighed by the benefits of protection against COVID-19.

Evolving strategy

Dr. Rudy Fedrizzi, public health services district director for the White River Junction office of the Vermont Department of Health, has been keeping a list of reasons why people who attend the vaccination clinics say their friends are holding out.

Some people say they’re waiting for the vaccines to move out of the emergency use status that the FDA has currently used to authorize them; others fear long-term effects; some younger people seem less concerned about developing serious illness should they get COVID-19; some simply haven’t had a way to get to a clinic.

Fedrizzi said he thinks that giving people access to the vaccines in their physicians’ offices will be a “game-changer.”

For example, Fedrizzi said, he thinks most parents will agree to have their children vaccinated if it is recommended to them by their pediatrician and available at the same time children are getting other vaccines.

In addition, Fedrizzi’s office is working to break down barriers to access by offering mobile clinics. The next one is on June 15, when the district will be bringing the one-shot Johnson & Johnson vaccine to the motels that are serving as shelters during the pandemic, as well as to Listen Community Services’ White River Junction meal site.

Fedrizzi said his office is also working with area businesses and schools to offer on-site clinics aimed at increasing access.

On Friday, Vermont Gov. Phil Scott announced a slew of pop-up, walk-in vaccination clinics, including one in Windsor and another in Sharon that were held on Friday, aimed at getting at least a first dose to 80 percent of Vermonters 12 and older. Shots also are available on a walk-in basis in Vermont at a number of pharmacies, including CVS, Hannaford, Walmart, Walgreens, Price Chopper, Rite Aid, Shaw’s and Costco.

“As we’re seeing a slowdown in the number of people being vaccinated, we need those who have not yet gotten their shot to find a clinic today,” Scott said in a news release. “It has never been easier, with hundreds of clinics across the state. Vaccines are free, safe and very effective — now is the time.”

As of Thursday, almost 79 percent of eligible Vermonters had gotten at least one dose with nearly 7,900 more to go to get to 80 percent, according to Scott’s release. Earlier in the week, the state published a town-by-town map of vaccination rates, which showed high rates of vaccination across the region. The areas with lower rates may look that way because residents used mailing addresses rather than physical addresses on their vaccination forms.

As of Friday, about 68 percent of eligible New Hampshire residents had been vaccinated, according to the CDC.

On-site shots

The Woodstock Inn hosted a second on-site COVID-19 vaccination clinic on Thursday, one of a series of clinics organized in conjunction with the Vermont Chamber of Commerce, the Vermont Department of Tourism and Marketing, and the Vermont Department of Health to target workers in the hospitality industry around the state.

“The convenience factor has proven effective in the state, so we are delighted to make it easier for our employees and community to be able to access the vaccine right here in the Village,” Courtney Lowe, the inn’s vice president of marketing and business development, said in an email.

“We do not require our employees to get vaccinated, yet we have ongoing campaign messaging to encourage and educate our employees on vaccination,” said Lowe, who is poised to become the inn’s president on July 1.

Sam Witcraft, a 27-year-old Barnard resident, said the convenience of the clinic’s location and the one-dose shot made it a good fit for him.

It was “just the easiest way to do it,” he said as he waited in a short line for his shot. He said that his girlfriend, who is immunocompromised, had to go to Rutland for her two shots.

“I was in no rush,” he said, citing his “pretty great immune system.”

But, he said, he is tired of wearing a mask, and his employer Twin Farms allowed him to attend the clinic without clocking out.

Chris Richardson, a 37-year-old Woodstock resident and a member of the Woodstock Inn’s culinary team, also said he was drawn to Thursday’s clinic by the convenience of one shot and not having to set up an appointment.

For 84-year-old Woodstock resident Joan Columbus, the tipping point that brought her to Thursday’s clinic was being the only one in a recent line dancing class that hadn’t yet had a vaccine.

“The community is what has prevailed upon me,” she said in a phone interview afterward. “Everyone I know had a vaccine. ... It’s just social pressure. I didn’t have to succumb.”

Though she still has concerns about the origins of the virus itself and about the vaccine, she said she thought the clinic was well-run and despite the “one oof” of getting her shot, she didn’t have any immediate side effects.

“That’s not the worst thing that’s ever happened to me in my life,” she said.

This article is being shared by a partner in The Granite State News Collaborative. For more information visit collaborativenh.org.