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According to researchers, the COVID-19 vaccination rate in rural US states is nearly seven percentage points lower compared to urban counties – an inequality they said could hinder progress in ending the pandemic.
“As residents of rural communities are at increased risk of serious COVID-19-related diseases and deaths, vaccination differences between urban and rural areas could hamper efforts to reduce morbidity and mortality from COVID-19 at the national level.” Bhavini Murthy, MD, MPH, A CDC medical epidemiologist and colleagues wrote in MMWR.
Source: Murthy BP et al. MMWR Morbid Mortal Wkly Rep. 2021; doi: 10.15585 / mmwr.mmmm7020e3.
“Public health practitioners should continue to work with health care providers, pharmacies, community organizations, religious leaders and local employers to address vaccine hesitation and ensure equitable access and distribution of vaccines, especially in rural areas,” they wrote. “These targeted multi-partner efforts can help increase vaccination rates nationwide and reduce morbidity and mortality from COVID-19.”
Murthy and colleagues analyzed county-level vaccine data reported between December 14, 2020 and April 10, 2021 from adults 18 years of age and older who received the first dose of the Pfizer BioNTech or Moderna vaccine or a single dose from the Johnson & Johnson vaccine.
They examined differences in vaccination rates between urban and rural communities, which often have more people living with comorbidities, people 65 and over, people with limited access to ICU healthcare facilities, and people without health insurance.
The researchers found that the COVID-19 vaccination rate was 38.9% in rural areas and 45.7% in urban areas. The differences in vaccination rates between rural and urban dwellers continued to exist in people aged 18 to 64 years (29.1% versus 37.7%) and people aged 65 and over (67.6% versus 76.1%) %) and women (41.7% versus 48.4%)) and men (35.3% versus 41.9%).
The limitations of the analysis included that the residential district was not available to 9.2% of people, jurisdictions where population subgroups were prioritized differently, vaccine supplies changed during the course of the analysis, the status of the urban-rural classification may have been out of date and race and ethnicity not accounted for 40% of the people.
“Improved data completeness is critical to measuring and eliminating racial and ethnic differences in vaccination rates,” the authors wrote.
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Raghavendra Tirupathi, MD, FACP
This new study by the CDC, highlighting the obvious differences in COVID-19 vaccination in rural communities, does not surprise us rural doctors, who see a high prevalence of vaccine reluctance in the communities where we operate. The article also highlights the challenges to successful vaccination efforts, including inadequate access to vaccinations due to the lack of vaccination sites in their own districts (people have to travel to neighboring districts), the lack of reliable public transport and the inability of people to get away from it all Work take off for vaccinations and inadequate reporting mechanisms for vaccine uptake. There is also an energetic anti-vaccine social media campaign that only further hinders efforts. Racial and ethnic differences are very evident with vaccinations, as is with COVID-19. The CDC and NIH, in partnership with community and faith-based organizations, should invest in further research to find out where and how we can better address the hesitation about life-saving vaccines.
Raghavendra Tirupathi, MD, FACP
Infectious Disease News Editorial Board Member
Medical Director, Keystone Infectious Diseases / HIV
Infection Prevention Chair, Summit Health
Clinical Assistant Professor of Medicine
Penn State University Medical School
Disclosure: Tirupathi does not report any relevant financial information.
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