Why Vaccination Rates Are Lower in Rural Areas of the U.S.
September 30 2021 - 10:25AM
A combination of higher Trump vote share and lower educational
attainment help explain the lower COVID-19 vaccination rates in
rural areas of the United States, according to a new study
published in the Journal of Rural Health.
The researchers conclude that as the pandemic enters its second
winter and vaccination rates vary widely across the U.S., mandates
may be the most effective strategy for increasing vaccination rates
and saving lives in rural areas.
“Very few people who haven’t gotten vaccinated are going to
change their minds at this point; they’ve dug in their heals, and
misinformation is rampant,” said researcher Shannon Monnat, an
associate professor of sociology at Syracuse University and
director of the Lerner Center for Public Health Promotion. “The
most effective way to prevent continued spread, reduce
hospitalizations and save lives is to mandate vaccines.”
According to public health officials, achieving high vaccination
coverage is the best way to prevent coronavirus spread, promote
economic recovery and save lives. But as of September 2021, only
66.6% of U.S. adults had been fully vaccinated, according to the
U.S. Centers for Disease Control and Prevention.
In their published study, “Rural-urban and within-rural
differences in COVID-19 vaccination rates,” researchers Monnat and
Lerner Graduate Fellow Yue Sun compared COVID-19 vaccination rates
across the U.S. rural-urban continuum and identified the major
contributors to lower rates of vaccination in rural counties.
The study is summarized in the Lerner Center for Public Health
Promotion research brief, “Why are COVID-19 Vaccination Rates Lower
in Rural than in Urban areas of the U.S.?”
Here are the researchers’ key findings:
• COVID-19 vaccination rates vary substantially across the
United States, with some counties nearing 100% vaccination while
others have rates under 5%, according to the Centers for Disease
Control and Prevention.
• As of August 11, 2021, 46% of adults in rural counties had
been fully vaccinated compared to 60% in urban counties.
• Higher Trump vote share in the 2020 presidential election and
lower educational attainment collectively explain lower rural
vaccination rates.
• Nationally, Trump vote share is the single largest contributor
to county-level variation in COVID-19 vaccination rates; each
standard deviation increase in Trump vote share is associated with
a 6.25 percentage point decline in the vaccination rate.
• Counties with larger shares of residents who are non-Hispanic
Black also have significantly lower vaccination rates, whereas
counties with higher median household income and more physicians
per capita have significantly higher vaccination rates.
• In rural counties, vaccination rates are lowest in farming and
mining-dependent counties and highest in recreation-dependent
counties. The differences are explained by a combination of
educational attainment, health care infrastructure and Trump vote
share, the researchers said.
“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,” Monnat said. “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.”
- 2020 Presidential Vote Share for Trump
Matt Michael
Syracuse University
315.254.9037
mmicha04@syr.edu