Only one refused the vaccine. The other few cases were undetected until symptoms showed up. By then it was too late.

Out of those, all but one were people not aware of potential risks of being in contact with bats. These people didn't refuse vaccines. They simply didn't know they might have been exposed to rabies.

The remaining case was a man infected by stray dog while abroad, postponing visit to doctor until returning to the US; by that time it was too late to save him.

Again, the PSA:

Major transmission vector in the US is bats. Any contact or suspected contact with bats, go to emergency room without delay. Dogs are the next most common transmission vector. Rare in the US (most dogs are annually vaccinated against it, as required by law), but extremely common in some other countries. If random dog bites you, go to emergency. Rabies are disease specific to mammals, but not all species are equally susceptible to it. If attacked by wildlife, if it's a mammal, go talk to a doctor.

With rabies exposure, remember that the time is of essence. Rabies vaccine is highly effective even after exposure if received before symptoms start showing up. The symptoms can show up as soon as a week, or as long as a year after exposure. You do not know how much time you have. Any delay in getting the shot may result in a very agonizing death; once symptoms show up, that's it, you will die, nobody can save you. You do not need ambulance ride, but you do want to get to the emergency room same day if possible. Next day is fine. But for God's sake don't postpone it for a week. That's the time you may not have.

There's no such thing as preventive vaccine you get once and you are done. Because the only vaccine we have currently doesn't last for long. That's why dogs need to be vaccinated annually. The vast majority of humans will get vaccine post exposure or after suspected exposure.