Study: COVID-19 Vaccines Still Lag in Rural, Underserved Communities


The analysis found that individuals in underserved communities were as much as 34% less likely to be vaccinated against COVID-19.

Several key obstacles are continuing to keep COVID-19 vaccination rates lower in rural and underserved communities, according to a new study published in Lancet Regional Health.

Vaccine hesitancy is just one reason that fewer people in some areas have been vaccinated against COVID-19. The study found that wide disparities in health care coverage, particularly in rural areas, have limited vaccination efforts during the pandemic, suggesting a hidden divide between those with easy geographic and financial access to health care and those without.

A team of researchers investigated disparities in vaccination rates across 2417 counties in the United States. The country has had a high rate of mortality compared to other developed nations and researchers point to failures of vaccination compared to other countries.

Epidemiologist Diego Cuadros, PhD, said the rate of vaccination varies widely. Although some individuals may be reluctant to get vaccinated because of unfounded fears or misinformation, that only tells part of the story, Cuadros said in a press release. Significant barriers include cost, insurance coverage, and transportation, according to the study.

“During the pandemic, we realized the huge health care disparity we have in this country,” he said.

In national surveys, approximately 20% of the US population has reported an unwillingness to be vaccinated. This does not account for the overall unvaccinated population, however. Although more than half of the population in every state is now fully vaccinated, some states are much further ahead than others.

Areas with low vaccination rates saw the highest rates of mortality from the virus during the delta and omicron waves, illustrating the impact that health disparities can have on underserved communities, according to the study.

The pandemic also caused significant disruptions to health care services, even in areas with relatively easy access. Patients saw their physicians much less frequently, leading to more undiagnosed cases of cancer and other diseases.

“Our study demonstrates that these disruptions were not uniform across the United States,” said co-author Neil MacKinnon, PhD, provost for Augusta University, in the press release. “Many counties, especially those in rural areas, experienced significant disruptions in health care, including the distribution of the COVID-19 vaccine itself.”

The analysis found that individuals in underserved communities were as much as 34% less likely to be vaccinated against COVID-19. These included counties in Nevada, Montana, North Dakota, South Dakota, and Nebraska, where vaccination rates were lowest.

“America’s health care system has improvements to be made to address historical disparities that, as shown in our study, can influence individual-level decision-making,” co-author Santiago Escobar said in the press release. “Our study suggests clear disparities that need to be addressed.”


COVID-19 vaccinations lag in rural, underserved communities. News release. EurekAlert; December 15, 2022. Accessed December 21, 2022.

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