SCOTT DEPOT, WV — In a pharmacy parking lot, Drew Massey is preparing his tools of the trade: administering COVID-19 vaccines.

“I’ve been giving shots since day one, so it’s been busy,” said Massey, who is a pharmacist. “Honestly, I could probably give these in my sleep or in the dark.”

Massey works for Fruth Pharmacy in the town of Scott Depot, West Virginia.

“We’ll get everybody off the list,” he told people as he vaccinated them. “Get you protected and get it to where you can go out in public without masks and eat.”

The pharmacy where Massey works was founded more than 50 years ago by Lynne Fruth’s father, Jack.

“I’ve known half a dozen of these people that have come through today because of being in the community,” she said.

On one February day, the line of people waiting for their shot included people who were 65 and older, as well as teachers.

“I think the thing about West Virginia that really sets us apart is people just know each other,” Fruth said.

There’s something else that sets the state apart: its COVID-19 vaccination rate.

West Virginia initially had one of the highest rates of people who received both COVID-19 vaccination doses, not just in the country, but in the world. They’ve since fallen to third place, behind Alaska and New Mexico. Still, all three are states that share some common traits.

So why have smaller, less well-off, and more rural states seem to have better success in not just distributing the vaccines, but in getting people to get it? It may come down to trust.

That includes trust in the family-owned pharmacies that are often the hallmark of small-town life and part of the structure of West Virginia’s vaccination effort.

“A lot of times people go, ‘Okay, you know what? I trust what you’re saying. I’m going to go ahead and get the shot,’” Fruth said.

Then, there are also the levels of the organization behind it that make it possible.

“People are so excited to get their vaccine,” said Kathleen Napier, nursing director for the Cabell-Huntington, WV health department.

Before the vaccines were even approved last year, West Virginia began planning for its distribution.

“We did use time to plan,” Napier recalled.

Cabell-Huntington, West Virginia’s health department director, Dr. Michael Kilkenny, said that made mass vaccinations possible, like one recently held at an old department store.

“We all meet regularly. Actually, we were meeting or before we came out here,” he said. “Since we’ve been doing this, we’ve seen a remarkable decrease in the number of hospitalizations and deaths.”

It’s a level of protection people there were looking for.

“It’s great to have the shots and be safer,” said Mary Ann Sayre, who got her first shot at the mass vaccination site.

Back in the pharmacy parking lot, Drew Massey was nearly done for the day.

“We tell the employees that you’ll probably look back on this years later and say, ‘I gave all these vaccines, did all these COVID tests and you’re actually affecting and saving peoples’ lives,’” Massey said. “So, it makes a big difference.”

It’s a big difference that lies in a small syringe.

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