Mississippi’s top health official said Friday that lack of access isn’t the reason the state is last in the nation for COVID-19 vaccinations — it’s apathy.

State Health Officer Dr. Thomas Dobbs said he guarantees the state is among the easiest in the country to get a vaccine but many people refuse because they don’t think they need it.

“I think that’s something that we really struggle with because it’s part of our health care culture here,” he said during a virtual conversation with the Mississippi Medical Association.

Later, he said: “It’s really sad because people in foreign countries would saw off their small toe to get a COVID vaccine, and … we’re not gonna take five minutes as we walk by the Kroger pharmacy.”

About 911,000 of Mississippi’s 3 million residents are fully vaccinated, according to the state Department of Health. The state has seen more than 318,000 confirmed cases of coronavirus and 7,325 COVID-19-related deaths.

About 27% of the population is fully vaccinated, compared with the most vaccinated state in the U.S., Vermont, where about 56% of the population is vaccinated.

The COVID-19 vaccine is now available at state-run sites throughout Mississippi that don’t require appointments. It can be accessed at dozens of pharmacies, clinics and hospitals throughout the state, all listed on the Department of Health website.

Dobbs said he has been doing at-home visits personally to vaccinate homebound residents. The Department of Health has announced pop-up vaccination sites in underserved areas and made arrangements for churches and other community organizations to host their own vaccination events.

“It’s almost like you need to try to not get the vaccine,” Mississippi Medical Association Executive Director Dr. Claude Brunson said Friday.

Dr. Mark Horne, president of the Mississippi State Medical Association, asked Dobbs whether state leaders have thought about using incentives to encourage people to get vaccinated. Several states have hosted lottery events for people getting vaccinated.

“I think what we’ve seen in some other states is that people, they need a bonus, they need a little something to kind of push them over,” Horne said.

Dobbs said the Department of Health is exploring incentives and other measures that can be taken to encourage more vaccinations.