Republican Gov. Jim Justice went on national news shows to declare West Virginia—a place that regularly ranks near the bottom in many health indicators—“the diamond in the rough.”

Nine months later, those days are a distant memory. Demand for the vaccine has almost dried up, the question of whether to get a shot has become a political hot button, and West Virginia’s vaccination rate has plummeted to the lowest among the states.

The governor, who spent months preaching the virtues of the vaccine to reluctant West Virginians, is still doing that but is also promoting a new law that would allow some exemptions to employer-imposed vaccination requirements.

And those shots? They’re mostly sitting on shelves.

“I’m afraid that while taking a victory lap, we discovered that there were more laps to go in the race,” Griffith, who is also a Democratic member of the state House of Delegates, said Monday of West Virginia’s descent from first to worst. The druggist has since turned his attention to preparing 3,000 pumpkins for a big Halloween event that was waylaid by the pandemic last year.

According to the Centers for Disease Control and Prevention, 41% of West Virginia’s 1.8 million residents are fully vaccinated against COVID-19, while 49% have had at least one dose. The state’s rate of about 89,000 doses administered per 100,000 population is the nation’s worst. Nationally, 57.5% of the population is fully vaccinated and 66.5% has gotten at least one dose.

In West Virginia, it wasn’t for lack of trying. For months, Justice offered an assortment of giveaways to encourage people to get vaccinated. Toting his dour-faced pet bulldog around the state, he dispensed cash, cars, pickup trucks, ATVs, riding lawn mowers, tickets to college athletic events and college scholarships.

It made for good photo opportunities. But the state’s vaccination rate barely budged.

By the fall, a new wave of sickness and death arrived. Hospitals saw a crush of patients, and the number of active cases, which had dipped below 1,000 in early July, ballooned to nearly 30,000 by mid-September before falling sharply. The number of deaths from the outbreak has soared to about 4,400.

West Virginia has the nation’s third-oldest population, with nearly 20% of its residents over 65. Health officials said most of the virus deaths have involved people in that vulnerable age group.

The governor continues to encourage residents to wear masks and stay out of crowds and has scolded the unvaccinated. “We should be very respectful of others,” he said recently. “The more of us that are vaccinated, the less will die.”

Griffith said he was proud of Justice’s nonstop effort to push vaccines “and the obvious love he has for the people of West Virginia.”

But Justice also ended a statewide indoor mask mandate in June and has opposed vaccination and mask requirements since. And in October he pushed through the GOP-controlled Legislature a bill allowing workers to use medical or religious exemptions to get out of employer-required COVID-19 vaccine mandates. The law takes effect in January.

The bill was introduced after President Joe Biden announced plans to require that federal contractors and employees at all U.S. businesses with 100 or more workers be fully vaccinated against COVID-19.

In part because of distrust of government and doubts about the safety of the vaccine, interest in COVID-19 vaccinations has waned in a state where President Donald Trump carried every county in the 2020 election.

Christopher Holmes, 44, of Sissonville, said he and his family were determined not to get vaccinated. Then in June, Holmes contracted the virus, spent 80 days in a hospital and lost 110 pounds. He had to learn to walk again and remains in rehabilitation.

When he went into the hospital, his daughter was the only vaccinated one in the family. By the time he got out, everyone had their shots.

“I don’t want anyone to go through what I went through,” Holmes said. “I hope everyone gets the shot because you don’t want to take it home to your family. If you save one life, it’s worth it.”

Last January, demand for the vaccine at Griffith & Feil Drug in Kenova along the Ohio and Kentucky line was so high that Griffith and his daughter, pharmacist Heidi Griffith Romero, had to limit the number of daily customers.

According to state data, at least 7.4% of West Virginia’s population received the first of two doses that month, and the per-capita vaccination rate was higher than that of any other state.

In the spring, reports surfaced of rare but potentially dangerous blood clots from the Johnson & Johnson vaccine. After a brief pause, the CDC and the Food and Drug Administration recommended that the single-dose vaccine be allowed to resume.

But “the public’s confidence never seemed to recover from that,” Romero said.

She now sees just five to 10 people per week coming in for their first doses. The pharmacy also administers shots in nursing homes to two to 10 people per week.

Romero said people are uncomfortable because claims about the shots’ safety have not been backed up by years of study.

Griffith said he will get the word out at this weekend’s Pumpkin House display, asking the expected thousands of visitors to wear masks and get their initial shots or their boosters.

He called the state’s low vaccine rate frustrating and acknowledged the giddiness of the early days may have been premature.

Griffith was led to paraphrase his favorite quote from Mark Twain.

‘’I’ve studied the human race,” the druggist said, “and I find the results humiliating.”

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