COVID-19 Vaccination Rate Widens Rural and Urban Gap: Shot

In some rural areas, poverty and disability are associated with lower immunization rates. Vans sponsored by the Vaccination Transportation Initiative will help rural residents obtain the COVID-19 vaccine in rural Mississippi. This effort is working to overcome the situation where rural residents do not have access to transportation and technology.

Via Rory Doyle / Bloomberg, Getty Images

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Via Rory Doyle / Bloomberg, Getty Images

In some rural areas, poverty and disability are associated with lower immunization rates. Vans sponsored by the Vaccination Transportation Initiative will help rural residents obtain the COVID-19 vaccine in rural Mississippi. This effort is working to overcome the situation where rural residents do not have access to transportation and technology.

Via Rory Doyle / Bloomberg, Getty Images

As President Joe Biden’s goal of reaching 70% of U.S. adults on July 4 approaches the horizon, non-U.S. Urban communities lag further behind in vaccination competition against COVID-19. I will.

Alaska is the only state since April 19 that the average rural rate of fully vaccinated people has risen faster than the urban rate. All states have released shots to everyone Ages 16 and up, according to the latest NPR analysis of county-level vaccination data from the Centers for Disease Control and Prevention.

Elsewhere, the rate of urban counties is higher than that of rural counties.

Dozens of states Seven weeks ago, the rural population exceeded the urban population Turned over, they are now chasing an urban opponent. Rural areas are 9 points behind urban areas in Oregon, and Maine is currently 7 points behind.

Florida, Massachusetts, and Nebraska have the largest disparities, with rural counties lagging 14 percentage points. For Florida and Nebraska, these gaps are about twice as large as in mid-April.

These gaps are clear, as the data reveal that many rural and urban areas, well above average, are at a standstill, but hide the more complex story of vaccination rates. There may be.

“Let’s call it a lot of judgment in the rural community,” said Mark Holmes, a professor at the University of North Carolina at Gillings School of Global Public Health. “Overall continuity, all big areas are doing well, but all rural areas. It’s not as simple as it isn’t working. “

surely, CDC report Since mid-May, it has included one detail that surprised Holmes. His state’s largest cities, Charlotte and Raleigh, and the suburban counties surrounding North Carolina have higher vaccination rates than the city center. It was significantly lower.

Not only that, these suburbs were less secure than the rural counties scattered throughout the state. According to a CDC analysis, counties around Minneapolis, Birmingham, Alabama, Seattle, Denver, and Portland, Oregon all repeat this pattern, with suburbs following both urban and rural counties in the state.

According to experts, lower vaccination rates are a problem for people around the world. According to Keith Mueller, director of the Institute for Rural Policy at the University of Iowa, an epidemic of a new coronavirus infection in unvaccinated regions or suburbs is likely to spread to neighboring cities. That is.

“If we learned something from the 18 months of this pandemic, we knew that it could spread from everywhere to everywhere. We are a society that moves too much,” says Mueller.

As COVID-19 restrictions are relaxed and the summer travel season heats up, more Americans are more likely to travel to local national parks and other outdoor destinations.

“When you stop to get gas, suddenly it becomes your contact,” Holmes says. “Looking at the border and saying it’s there, whether it’s a country, state, or county, doesn’t work. It’s not here.”

Socio-economically vulnerable counties are struggling even harder

Ah Second CDC report Beginning in early June, the demographic and social factors associated with lower vaccination coverage in all counties, whether rural or urban, will be highlighted.

The CDC ranks more than 3,000 counties across the country. Social vulnerability index It measures 15 factors that undermine the community’s ability to respond to disasters, including poverty, poor transportation, and crowded housing.

Researchers divided the counties into four categories: large cities, suburbs, small and medium-sized cities, and rural areas, and investigated which demographic profile was associated with lower vaccination coverage. In all these categories, households with children, people with disabilities, and single-parent households tend to have lower vaccination rates. And researchers say these gaps are especially noticeable in suburban and rural counties. Is called.

According to the CDC report, counties with high mobile housing and poorly educated counties are also far behind other counties in the rural and urban categories.

“In rural communities, the proportion of residents aged 65 and over is often high, they do not have health insurance, they live with underlying illnesses and disabilities, and they have access to medical facilities where intensive care is available. You may be vulnerable to illness or you may die from COVID-19 because of your restrictions, “said Vaughn, a CDC epidemiologist and one of the lead authors of the report. Barry says.

Hesitation for battle should be “hyperlocal”

The CDC report points to hesitation in vaccines as the main cause Barriers to reach rural areas And call on public health leaders to take more action to overcome it. According to one survey, one in five rural Americans said they would never get the vaccine. Kaiser Family Foundation Poll Published in April. Most resistance among Republicans, Caucasian evangelical Christians, non-health key workers, and adults under the age of 50.

Strategies to overcome that hesitation appear to vary from hundreds of rural counties across the country, said Marcella Nunez Smith, chairman of the White House’s COVID-19 Health Inequalities Commission. It may share one important aspect.

“It’s imperative to work with trusted local community leaders. Equity jobs are always hyperlocal. The community is an expert on what they need,” Nunez Smith said at a press conference in May. “

Once one of the country’s most devastated areas, Navajo Nation doctors have been in constant communication with tribal members about fighting the COVID-19 “monsters” in this remote area. Said it helped to achieve the highest vaccination coverage in New Mexico. Arizona.

Like other Native American tribes, Navajo Nation has dozens of community health representatives working with Indian health services to expand and establish relationships in rural areas.

“They know their area very well. They all speak the language,” says Dr. Loretta Christensen, Deputy Chief Medical Officer of Indian Health Services, a member of Navajo Nation. “They can accept it one-on-one with people who may be hesitant.”

Friends and family are the most influential in persuading those who hesitate, adds Dr. Chris Percy of the Northern Navajo Medical Center in Ship Rock, New Mexico.

Patients often tell him why they persuaded them to attend a recent vaccination event.

Christensen and Percy say they can’t refuse to vaccinate patients who don’t have the data or powerful weapons, but what they can do seems welcome and lowers all barriers. That is.

“The system we set up in Navajo doesn’t have a pre-registration component, which means we have to do these five things before we can make a reservation,” says Percy. “If you can come on Tuesday, come …. we’ll be here when you’re determined and ready.”

Barry’s report, like Percy, suggests a walk-in clinic with flexible night and weekend times to accommodate work schedules and approach people in socially vulnerable communities. .. CDC researchers also suggest that organizing vaccine clinics near childcare facilities and partnering with schools may improve the low incidence observed in single-parent households in suburban and rural counties. doing.