RACHEL MARTIN, HOST:
New cases of COVID-19 have been dropping for weeks in most states, but there are outliers. Missouri has seen some of the biggest increases in the U.S. since mid-June, and that state also ranks near the bottom for the total number of vaccinations. Public health advocates say it's especially worrying in rural areas as the highly infectious Delta variant gets more dominant. Rebecca Smith with member station KBIA has the story.
REBECCA SMITH, BYLINE: Amanda Hedgpeth is a vice president at CoxHealth, a hospital system based in Springfield, Mo. She says the Delta variant has moved in fast.
AMANDA HEDGPETH: When you look back just several weeks ago, maybe 10% of the isolate sequencing came back as the Delta variant. Today, 90% of those isolates are coming back as the Delta variant.
SMITH: The number of COVID patients in the hospital system has more than quadrupled in the last six weeks. And they're younger, people mostly in their 30s and 40s who are unvaccinated. Hedgpeth says the area they serve has some of the highest numbers of new COVID cases in the state and some of the lowest rates of vaccination from 17% to 33%.
HEDGPETH: Patients that are less likely to get the vaccine tend to live in more rural areas, tend to live in more red areas or red states, those without a college education and those that are evangelical. And when you really look at the makeup of southwest Missouri, that is a lot of our patient population.
MARIDAN CHRISTENSEN: So this is the upstairs that we're using now, of course, and we have the foyer. And then you go into the sanctuary.
SMITH: At the Community of Christ church in Branson, Mo., Maridan Christensen is the co-pastor. A few months ago, her congregation returned to meeting in person, but with cases on the rise, a couple of weeks ago they reinstituted masking and social distancing, even though Christensen says much of the older congregation is already vaccinated.
CHRISTENSEN: We always err on the side of safety, so we don't want anyone to come to church and feel like they're unsafe, you know, or it's an unhealthy environment. So if we get to that point where we just need to say we're going to go back to only doing Zoom church services, everyone knows how to do them now. And then when the numbers go down, you know, we'll meet together.
SMITH: She says she had no idea the county's vaccination rate was so low. Now, Branson is a big tourist destination in the Midwest, and many people here are happy to see visitors enjoying attractions like Lakes Taneycomo and Table Rock and the Presleys' Country Jubilee. Many also tell me that they don't want the vaccine and think the COVID pandemic isn't as bad as the media says. But few want to go on tape. Dr. Andrew Pekosz, a public health professor at Johns Hopkins University, warns that hot spots with low vaccination rates like southwest Missouri create opportunities for the virus to further mutate and become even more infectious. And he adds that this current surge could be just a taste of what the fall looks like nationwide.
ANDREW PEKOSZ: So we're going to be bringing people together in environments where they're going to be in closer contact, where the virus is more easily spread. If we don't really make an effort to boost the vaccination rates in this country, we'll be setting up for a larger surge in the fall.
SMITH: Pekosz says the good news is that vaccines are proving effective against the Delta variant, but they only work if people get the shots. And Missouri's vaccination rate has dropped by about a third since the beginning of June. A spokesperson for the state of Missouri says it's currently exploring a variety of vaccine incentive options.
For NPR News, I'm Rebecca Smith in Columbia, Mo.
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