GILLETTE, Wyo. — As her beloved grandmother's health declined, Lauren Pfenning's family insisted that she get a COVID-19 vaccine before paying her a final visit.
She spent over a week researching vaccines on the internet and anguished over the decision during and after 12-hour shifts at her job hauling coal in an open-pit mine near Gillette, Wyoming. Her grandmother died earlier this month before she made a decision, but Pfenning stands by her choice to not get vaccinated.
Pfenning embodies the fiercely independent, deeply conservative Wyoming way of life that has defined the state's response to the pandemic and made it the second-least vaccinated state as of Tuesday, behind only West Virginia. Only 23% of residents in her county have been vaccinated, putting it among the bottom handful of places in America that have not cracked 25% with their COVID-19 immunization rates.
The vaccine hesitancy in Gillette is emblematic of the live-free, mind-your-own-business mentality toward the pandemic that is dominant across conservative America at a time when the delta variant is tearing through unvaccinated communities.
For every 100 people spotted around town in Gillette, the number wearing masks can be counted on one hand. Among a group of six people on a smoke break downtown, all said they had too many concerns about the vaccine to mess with it. Down the street, a black shirt displayed in a storefront warned, "ATTENTION SNOWFLAKES: THIS IS NOT A SAFE PLACE."
People bristle at the workplace vaccine mandate being pushed by President Joe Biden. When asked about workplace mandates and the option to bypass the requirement with regular virus testing, Pfenning's immediate response: "Test away!"
Anger over presidential meddling in Wyoming's affairs is dominant across the state, but in Gillette, it gets personal.
The area's vast coal industry has suffered a decade of decline amid competition from renewable energy and inexpensive natural gas, and coal regulations imposed by President Barack Obama — and lifted by President Donald Trump — have provoked fury among residents.
"It just feels like one attack after another. I think we're just wanting to fight back harder at this point. Wyoming as a whole is just sick of being pushed around," said Pfenning.
All the while, COVID-19 patients have been filling several of Wyoming's hospitals including the one in Gillette, the state's third-largest city.
At Campbell County Memorial Hospital, 17 of 27 intensive care and medical-surgical unit patients recently had severe COVID-19, leaving just two beds open while the very worst coronavirus cases got flown to more intensive treatment in neighboring states.
Meanwhile, a local surge — up 34% in a week — drove up COVID-19 cases to almost four times the national rate, according to the Centers for Disease Control and Prevention.
Statewide, more than 96% of those hospitalized with COVID-19 were unvaccinated. Yet the daily flow of COVID-19 failed to persuade many Campbell County Memorial Hospital employees to get the vaccine.
Only 39% of the hospital's workforce is vaccinated, and there are no plans to require or incentivize it, said the hospital's chief medical officer, Dr. Attila Barabas. Wyoming's statewide vaccination rate of 41% is well below the national rate of 55%.
"I'm a big believer in freedom of choice. I honestly think that's a fundamental aspect of being an American. And I think mandates can be troublesome and can cause a pushback to some degree," Barabas said.
The doctor got the vaccine and has encouraged relatives and patients to do the same. Ultimately, though, "that has to be a choice that you make," Barabas said.
Wyoming's view of vaccine mandates could come to a head soon. Wyoming officials are promising a vigorous fight against Biden's vaccine mandate, with talk about using the president's coronavirus relief funds to compensate businesses for fines levied against them for defying the mandate.
At the same time, they are gently encouraging people to get the jab.
In a television ad showing people line dancing to country music, a woman says she got vaccinated to be able to have "ladies' night out." Wyoming has spent $900,000 and plans to spend another $685,000 on such ads, according to the Wyoming Department of Health.
Striving for balance with COVID-19 policies has whipsawed Republican Gov. Mark Gordon at times. Preparing to impose an unpopular statewide mask mandate last year, Gordon lashed out at people who refused to take steps to control the virus, calling them "knuckleheads."
This year, as the delta variant brought more death and illness to the state, Gordon promised no mask mandate but said people should get vaccinated "if you're willing."
Vaccine resistance during the pandemic reflects a broader dilemma for public health officials in a region where prevailing attitudes cause high smoking and low flu immunization, cancer screening and seat belt use rates, said the department's interim director, Stefan Johansson.
"We just have a population that I think is indicative of the Mountain West culture that, you know, lives free and doesn't always take the health advice," Johansson said.
For Pfenning, the coal mine worker, the decision to not vaccinate came down to her belief that the approval process was rushed and there are too many risky side effects, despite the fact that hundreds of millions of people have safely gotten the shots and avoided serious illness and hospitalization.
"It has nothing to do with politics. I'm even picky on what I give my horses, I'm picky on what I give my dogs. And we over-vaccinate," said Pfenning.
And while Pfenning said her decision wasn't political, politics pervades. In November, Wyoming gave Trump his widest margin of victory of any state, 70%. Campbell County gave Trump his one of his widest margins of victory in Wyoming, 87%.
"The people are so conservative here that they have these grass roots of saying, 'Look, I don't like the government regulating my life,'" summed up Campbell County Commissioner Del Shelstad.
Scott Clem, pastor of Gillette's Central Baptist Church, is among the many in the city who are not vaccinated. The former Republican legislator led a mask-burning protest at the Wyoming Capitol in Cheyenne in January and says he trusts his immune system to protect him.
"It's none of your business whether I'm vaccinated or not," said Clem. "That, I think, in some sense, is being a busybody in other men's matters. I think that's some of the sentiment out here in Wyoming. We're pretty rugged individuals out here in the West."