Fewer and fewer people are getting vaccinated at Nashville’s primary hub for COVID shots. So first doses will stop being offered at the Music City Center on May 7.

The site will close completely at the end of May, giving everyone time to get their second dose at the same place. The facility will also be able to return to hosting meetings and conferences.

“We’re just seeing a significant fall off in the number of people that are coming through to get vaccinated, and it doesn’t make sense to have that much space when we’re only seeing smaller and smaller numbers there,” says Dr. Gill Wright, interim health director for the city.

Until closing, the city will also offer as many as 1,000 walk-in vaccinations on weekdays. The option to come without an appointment only started this week, but only about 150 a day have been showing up.

Curious Nashville: Tell WPLN News Why You’re Holding Off On The Vaccine

The Metro Public Health Department will continue its new drive-thru site on Murfreesboro Road and pop-up vaccination events at houses of worship and community centers. Private health systems will also continue to provide vaccines, and they have plenty of supply at this point.

“You literally could walk down the street and get a vaccine right now,” Dr. Alex Jahangir, the city’s coronavirus task force chair, said at Thursday morning’s press conference. “We have made every ample opportunity for people.”

Nashville’s vaccination rate, with roughly 38% of residents having at least one dose, is higher than most other counties in the state. Still, the city will likely fall short of its goal to hit 50% by May 1.

Public health officials say the recent hesitancy can be attributed to a combination of factors: the news of the safety concerns about the Johnson & Johnson vaccine as well as the continued plateauing decline of new COVID cases in Tennessee.

Southern states are seeing a pretty sharp drop off in the pace of COVID vaccinations — and the slowness can’t be blamed on supply. In Tennessee, the vaccination numbers on Monday were less than half of the highest days in recent months, with plenty of shots on hand.

Neighboring states like Mississippi are seeing a similar trend, and this is likely the beginning of a slowdown that was expected, state health officials say. The people who really wanted a shot now have it, and convincing those who don’t is getting harder.

Clint Satterfield is the superintendent of schools in Trousdale County and was hoping to increase his vaccine numbers by offering teachers the one-shot Johnson & Johnson vaccine, which has now been pulled from use for an additional safety review.

“It just raises more skepticism with people, and that’s unfortunate,” he says.

At an event in Trousdale County last week, a company partnering with the schools, AdhereRx, offered Pfizer shots instead, but no teachers stopped by. Franklin-based Adhere Health has been piloting pop-up vaccination clinics in rural communities.

One of the company’s executives, Cyndi Alexander, says her telepharmacy company specializes in “motivational interviewing” to help patients take the medication they’re sent. Similarly with COVID, she says it seems like there are often barriers that could be overcome.

For instance, many think they could contract COVID from the shots, she says, which is easily demystified. They also are concerned about money. At the Trousdale County event, they added the word “free” to the sign because so many people asked about cost.

“There is missing information or there is misinformed information,” Alexander says. “Those are the two reasons they don’t come.”

Rural counties in Tennessee are seeing the slowest uptake. The state’s vaccine tracker shows Grundy County has just 17% of residents with at least one dose. By contrast in the Nashville area, Williamson County, which is also the state’s wealthiest, has topped 40%.

But even urban areas are seeing demand soften. Davidson County is now offering walk-up vaccines at Music City Center. Fewer than 150 people a day are showing up without appointments, though the city was planning for at least 500.

More than half of Tennesseans are still hesitant to get the COVID-19 vaccine, according to state-based surveying conducted this month by the Tennessee Department of Health. But the “why” is often more complicated than a multiple-choice survey can handle.

I know from my own on-the-ground reporting that people have their reasons. So to help us make our coverage more detailed and nuanced, we’re asking you to fill in the form below to tell WPLN News why you’re not getting the shot, at least not yet.

This weekend was the first one in a long time when restaurants and bars could stay open until 3 a.m. with increased capacity. Sporting events and concerts can now have slightly larger crowds, as well. And private gatherings can include as many as 15 people.

Dr. Alex Jahangir, who chairs the city’s coronavirus taskforce, said last week the plan is to continue reopening, despite the presence of COVID cases. He says public health’s mission is to curb disease through restrictions only when there isn’t an alternative.

“We are now getting to the point with the vaccine that there is a readily available intervention that is available to anyone at anytime,” he said. “So I think as a matter of policy, we really need to start evaluating what that means.”

Increasingly, Jahangir says people who get sick would have had a way to avoid it.

More than 30% of Nashvillians are vaccinated, and the city is now taking walk-ins at the Music City Center vaccination site.

Tennessee is looking for messaging that might overcome COVID vaccine reluctance in rural communities, as health officials prepare public service announcements to be used in the coming months.

A marketing firm hired by the state found Tennesseans reluctant to get the vaccine and drilled down to understand why and what might change their mind. Most people interviewed said there wasn’t much that could convince them. Few were moved by arguments about personal responsibility or reopening the economy.

But there is more openness to the idea of getting vaccinated for the health of their loved ones, according to the firm.

More: Download the results here.

“We don’t want to discount anybody, even though there may be some folks who indicated they are extremely unwilling to get the vaccine,” says Sarah Tanksley, communications director for the Tennessee Department of Health. “At any point in time, there may be something that resonates with them, or they have a lightbulb moment.”

Beyond a public service campaign that will first be online, then on broadcast, state health officials also plan to informally offer their findings as talking points to community leaders.

They have a steep hill to climb: A health department survey also released this week found 45% of white, rural conservatives are unwilling to even consider getting the COVID vaccine right now.

Nashville takes a big step toward opening vaccine access next week, for the first time inviting walk-ins to the Music City Center.

On Thursday, the Metro Public Health Department announced that for the first time, vaccine appointments have been going unfilled. The city has been giving about 2,000 shots a day at the convention center.

“We had planned at some point to be able to open it up to walk-ins,” says Dr. Gill Wright, the city’s medical director. “This just triggered that happening at this point in time.”

The first 500 people to arrive each day (between 9 a.m. and 3 p.m.) can receive the vaccine without an appointment starting on Monday. Currently, the site is using the two-dose Pfizer vaccine.

The transition toward appointment-less vaccination is one of the first signs that demand for shots is letting up in Davidson County, which has had stronger uptake than most of Tennessee.

Currently, just shy of 36% of Davidson County residents have at least one dose. The goal set by Mayor John Cooper is to get to 50% by May.

Full reopening appears imminent

As of Friday, Nashville restaurants and bars can stay open until 3 a.m. with increased capacity. Indoor gatherings with as many as 15 people are ok. The crowd sizes at sporting events and concerts can be slightly larger, as well. 

Reopening Update:

Corresponding with over 30% of Nashville residents having received a vaccine, the following capacity increases go into effect on Friday.

Visit https://t.co/0pJXgPi0hQ to sign up to get your vaccine! #50by5 pic.twitter.com/LyKM9q111E

— Mayor John Cooper (@JohnCooper4Nash) April 14, 2021

Dr. Alex Jahangir, who chairs the city’s coronavirus taskforce, says the plan is to continue reopening, despite the presence of new COVID cases. He says public health’s mission is to curb disease through restrictions only when there is no alternative. 

“We are now getting to the point with the vaccine that there is a readily available intervention that is available to anyone at anytime,” he said Thursday. “So I think as a matter of policy, we really need to start evaluating what that means.”

Increasingly, Jahangir says people who get sick would have had a way to avoid it. 

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Some Nashville residents and business owners are still financially spiraling because of the COVID-19 pandemic. WPLN News checked in to see how much and where the city spent past CARES Act money and the impact it has had on its recipients.

A woman from East Nashville hospitalized with severe blood clots is believed to be one of the handful suffering from the syndrome after receiving the Johnson & Johnson COVID vaccine.

The case was reported Wednesday in the Nashville Scene, which says she’s been in a hospital bed for a week, unable to get up because of swelling in her legs. The clots have also blurred her vision, and some have even made it to her brain, though they are in veins, which is less concerning.

Through it all, she still tells the Scene she’d get the vaccine again.

“I think vaccines are incredibly important and life-saving,” she says. “I want to be clear that my case is extraordinarily rare and is still being researched. A very talented team of doctors is working to determine what made me more susceptible to this reaction, and I’m confident that we’ll have answers soon and a more definitive list of folks for whom the J&J vaccine is safe.”

She’s unnamed by the Scene to protect her privacy, but reporter Steve Cavendish says her case has been reported to the Vaccine Adverse Event Reporting System and that her physicians at Ascension Saint Thomas have been in communication with the Centers for Disease Control and Prevention.

More: Johnson & Johnson Vaccine And Blood Clots — What You Need To Know

A Saint Thomas spokesperson has not yet confirmed that the hospital is treating one of the six known blood clotting cases related to the J&J vaccine. Leaders of the Metro Public Health Department tell WPLN News they were unaware of this case but that they wouldn’t necessarily be notified of reports to VAERS.

Nashville has administered roughly 15,000 doses of the one-dose vaccine, primarily through a one-day event at Nissan Stadium on March 20. Since that was nearly a month ago, health officials are not worried about those people having reactions at this point, since the cases being tracked by the CDC developed symptoms within two weeks. But the J&J shots were used within the past two weeks at a week-long event at Hadley Park in North Nashville.

CDC officials stress that the syndrome is extremely rare — still one in a million, at this point — but that patients should watching out for severe headache, abdominal pain, leg pain or shortness of breath. If if those symptoms develop, patients should seek medical treatment and disclose that they had been recently vaccinated.

So far, the cases have all involved women. Their ages range from 18 to 48. One woman, believed to be from Virginia, who died from the clots, was 45 years old.

But health officials say there are still not enough cases to know whether any particular group of people are more at risk from the J&J vaccine.

At this point, Tennessee has paused administering the J&J vaccine, but most appointments are still going forward using Pfizer and Moderna shots.

A major maker of COVID-19 testing swabs will create a new manufacturing and distribution operation in the town of Orlinda in Robertson County.

Puritan Medical Products will not far from Interstate 65, about 45 minutes north of Nashville and not far from the Kentucky border.

Tennessee officials announced Tuesday that Maine-based Puritan will pour in $220 million and hire at least 625 people in the next five years. That will expand the company workforce by nearly a third.

Officials tout Puritan as North America’s largest maker of COVID-19 testing swabs. Thanks to federal funding, the company has more than tripled its swab production during the coronavirus pandemic, and plans to push that pace higher.

The state has not specified what level of incentives will be given to the company.

Nashville’s new drive-thru vaccination site near Antioch is going to switch from the one-dose Johnson & Johnson shot to Pfizer, the city announced Tuesday. The Food and Drug Administration has recommended a nationwide pause on using the J&J vaccine because of half a dozen cases of blood clots.

In response to the news from the @US_FDA and @CDCgov, those with appointments at our drive-thru vaccination site at the former Kmart at 2491 Murfreesboro Pike will receive the Pfizer vaccine instead of the Johnson & Johnson vaccine. https://t.co/8MqWI2aqVF pic.twitter.com/tlycFZwWwW

— NashvilleHealth (@NashvilleHealth) April 13, 2021

In Tennessee, Nashville has been the primary user of the J&J doses, since demand in the city has remained higher than the rest of the state. But the state health commissioner, Dr. Lisa Piercey, said before the blood clot concerns that more counties were asking for the one-dose vaccine because people liked the convenience of “one and done.”

Those with existing appointments at the old Kmart site on Murfreesboro Road will be notified about the switch. The J&J pause will also slow down the city’s effort to vaccinate more people living in homeless camps, announced last week, which was relying on the one-dose vaccine.

With the J&J pause, some events are switching to other brands, and some are postponed. There’s hope the pause won’t undermine confidence in the one-dose vaccine, says Brian Haile, who leads Neighborhood Health which is one of the 17 organizations part of the two-month blitz of the city’s homeless community.

“If you stop because something happens less than one-in-a-million times, just to make doubly sure everything is really OK, then that should give people a lot of confidence,” Haile says.

The FDA’s pause related to six cases of blood clots has been explained by regulators as using an “abundance of caution.”

Nashville has not had any trouble with the J&J vaccine after using roughly 15,000 doses, according to city officials. The city administered 10,000 doses at a one-day event held at Nissan Stadium. A weeklong event at Hadley Park, targeting the historically Black neighborhoods of Nashville, also used the J&J vaccine without any documented problems.

“We’re going to do what’s safe for the community, we’re going to do what the science drives,” says Dr. Alex Jahangir, chair of the city’s coronavirus taskforce. “Do I wish we would still go full speed ahead with everything we have? Absolutely, because that’s the best way to beat this pandemic. But we’re going to do what we can here.”