According to public health professionals, the best strategy to prevent coronavirus transmission, stimulate economic recovery, and save lives is to achieve high vaccine coverage. However, according to the US Centers for Disease Control and Prevention, just 66.6 percent of adults in the United States were completely vaccinated as of September 2021.

According to a new study published in the Journal of Rural Health, a combination of a larger Trump vote share and lower educational attainment may help explain why rural areas of the United States have lower COVID-19 vaccination rates.

“Rural-urban and within-rural differences in COVID-19 vaccination rates,” said the study authors who compared COVID-19 vaccination rates across the U.S. rural-urban continuum and found the main causes of lower vaccination rate in rural counties.

The study says:

• According to the Centers for Disease Control and Prevention, vaccination rates vary significantly across the United States, with some counties approaching 100% coverage and others falling below 5%.
• As of August 11, 2021, 46% of adults in rural counties had received all recommended vaccines, compared to 60% in urban counties.
• Increased Trump support in the 2020 presidential election and lower educational attainment both contribute to rural vaccination rates being lower.
• At the national level, Trump vote share is the single strongest predictor of county-level variation in COVID-19 vaccination rates; each standard deviation rise in Trump vote share results in a 6.25 percentage point reduction in vaccination rates.
• Counties with a higher proportion of non-Hispanic Black citizens also have significantly lower vaccination rates, but counties with a higher median household income and a higher physician-to-population ratio have significantly higher vaccination rates.
• Vaccination rates are lowest in agriculture and mining-dependent counties and highest in recreation-dependent counties. According to the researchers, the disparities are explained by a mix of educational attainment, health care infrastructure, and Trump vote share.

“The vaccination rate disparity is concerning given that COVID-19 infection and mortality rates are higher in rural areas, and rural hospitals have less capacity to deal with surges in severe cases,” said the study authors.

“Right now, unvaccinated people are filling up emergency rooms and putting us all at risk. What happens when there are no beds available for people who have other serious illnesses or injuries?

“Vaccines are an effective tool we have at our disposal to get us out of this pandemic,” Monnat added. “We simply must get vaccination rates up across the entire country.”

The results of the study appeared in the Journal of Rural Health (2021). DOI: 10.1111/jrh.12625.

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