What Accounts for Differing Vaccination Rates?

Jan Plotczyk • August 3, 2021

We would not expect every Eastern Shore county to have identical covid-19 vaccination rates, and they don’t — but what accounts for the differences that range from 43% to 65% vaccinated? We’ll look to politics, social vulnerability, and race/ethnicity for answers.

Vaccination Rate Differences and Politics

It’s been pretty well documented that there’s a correlation between covid-19 vaccination levels and 2020 presidential election voting patterns. Numbers show that, overall, states and counties that voted for Biden have higher vaccination rates than states and counties that voted for Trump.

Numerous polls (KFF, Monmouth, Washington Post-ABC News, and others) have consistently found that Republicans are much more likely to say that they definitely do not want to get vaccinated and Democrats are much more likely to report having been vaccinated.

Data show that the top 22 states (including D.C.) with the highest adult vaccination rates all went for Joe Biden in the 2020 presidential election. Maryland is number six on that list, as of July 28. Trump won 17 of the 18 states with the lowest adult vaccination rates. Almost all U.S. counties below 20 percent vaccination rates lean Republican, and almost all above 65 percent lean Democratic.

Do the nine counties of the Eastern Shore follow this pattern? Let’s look at the data for percent of total population that has gotten at least one shot, as of July 27. Because these are rates of total population, they are much lower than rates calculated with only adults.

The two counties that went for Biden — Talbot and Kent — have the highest (65.9%) and third highest (61.5%) vaccination rates in this group. Worcester County is the outlier — it went for Trump by 17 points, but has the second highest vaccination rate (63.1%). Wicomico County was close in the election; it went for Trump by only 1.9 points, but has the second lowest vaccination rate (47.3%) in this group.

For comparison, Maryland’s vaccination rate is 59.6%. In the U.S. it is 56.9%.

Overall, the pattern mostly holds true for the Eastern Shore counties, although it is not the case that vaccination rate is proportional to support of either candidate.

In the past few weeks, some GOP lawmakers and conservative media figures have changed course and are now encouraging hesitant people to get vaccinated. The current sudden rise of cases, hospitalizations, and deaths due to the extremely contagious and virulent delta variant is overwhelmingly in states and counties that have lower vaccination rates. CDC Director Rochelle Walensky called it a “pandemic of the unvaccinated.”

Vaccination Rates and Social Vulnerability Index

It is clear that vaccination rates for counties do not depend solely on partisanship. For an insight into what some of those other factors could be, let’s take a look at vaccination rates and the Social Vulnerability Index.

The Social Vulnerability Index was created by the Centers for Disease Control and Prevention more than 20 years ago to help emergency response planners and public health officials identify and map communities that will most likely need support before, during, and after a hazardous event. The coronavirus pandemic is one such hazardous event.

The index assesses four themes in each community — socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. Scores are used to determine the degree to which these factors would influence the ability of local officials to react effectively to disasters and disease outbreaks.

Scores are generated at the overall county level and for each theme. They are ranked on a scale of 0 to 1, with 1 being the most vulnerable.

Social Vulnerability Index Themes Defined:

We would expect to see that counties with higher social vulnerability scores would have lower vaccination rates, due to difficulties in reaching populations of elderly residents, people with limited English proficiency, those without transportation, etc.

Queen Anne's County has a Social Vulnerability Index of 0.00 in the chart above — the lowest vulnerability score. We see that the four counties with the lowest social vulnerability scores — Talbot, Worcester, Kent, and Queen Anne’s — have the four highest vaccination rates in the group. The five counties with the highest vulnerability scores have the lowest vaccination rates in the group.

Vaccination Rate Disparity by Race/Ethnicity

Finally, what role does race/ethnicity play in vaccination rates? Unfortunately, there are no public data on vaccination status by race/ethnicity at the county level, so we’ll have to look at Maryland as a whole.

The Kaiser Family Foundation looked at vaccinations by race/ethnicity for the 40 states that reported those data. They found that across all these states, the percent of White people who have received at least one covid-19 vaccine dose (48%) was roughly 1.3 times higher than the rate for Black people (36%) and 1.2 times higher than the rate for Hispanic people (41%) as of July 19.

Maryland has done a bit better. Higher percentages of each group have been vaccinated compared with the 40-state composite, but disparities still exist. The percent of White people who have received at least one dose as of July 19 is 61%. This is 1.2 times higher than the rate for Black people (51%) and 1.1 times higher than the rate for Hispanic people (54%).

Black people account for 30% of Maryland’s population, but only 26% of total vaccinations; 37% of covid deaths were among Black people. Covid-19 cases were not reported by race/ethnicity in Maryland.

Hispanic people account for 11% of Maryland’s population, but only 10% of total vaccinations; 9% of covid deaths were among Hispanic people.

White people account for 55% of Maryland’s population and 56% of total vaccinations; 50% of covid deaths were among Whites.

The share of vaccinated Black and Hispanic people has been growing recently relative to White people.

Recent surveys reveal that the population of unvaccinated can actually be subset into two groups: those who are adamant in their refusal of the vaccine (the “definitely nots” — 45% of unvaccinated), and those who are open to being persuaded (the “wait and sees” — 35% of unvaccinated). The former group is overwhelmingly White, Republican, and younger, and represents 15% of Americans; the latter group includes many younger people, Black and Hispanic Americans, and Democrats.

Among the “definitely nots, ” 83% believe that the seriousness of covid-19 is exaggerated, and 88% are not worried about getting sick from covid. Among the “wait and sees,” 78% believe the vaccines are not as safe as they are said to be, 44% say they would be more likely to get vaccinated if the vaccines gained FDA approval (rather than provisional approval), and 46% state they would be more likely to get vaccinated if they could do it at their own doctor’s office.

There didn’t look like there was much hope of vaccinating our way out of this pandemic voluntarily. But people may be changing their minds — vaccinations have recently risen in areas hard hit by the delta variant. And lately, some private companies, some local and state governments, and the federal government have decided to require that employees either be vaccinated or wear masks and social distance and get tested weekly or more often. A few private companies are making vaccination a condition of employment. And some businesses (restaurants and theaters, for example) are requiring their patrons be vaccinated. This may be the way out of the mess we’re in.

Sources:

The Red/Blue Divide in COVID-19 Vaccination Rates is Growing. Jennifer Kates, Jennifer Tolbert, Kendal Orgera, Kaiser Family Foundation.

https://www.kff.org/policy-watch/the-red-blue-divide-in-covid-19-vaccination-rates-is-growing/

KFF Covid-19 Vaccine Monitor.

https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid-19-vaccine-monitor-dashboard/

Monmouth University Poll.

https://www.monmouth.edu/polling-institute/documents/monmouthpoll_us_062321.pdf/

A Third of White Conservatives Refuse to get Vaccinated. Philip Bump, Washington Post.

https://www.washingtonpost.com/politics/2021/07/06/third-white-conservatives-refuse-get-vaccine-refusal-shown-both-polling-real-world/

States ranked by percentage of population fully vaccinated: July 28. Katie Adams, Becker’s Hospital Review.

https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-population-vaccinated-march-15.html

The 4 main fault lines that divide the vaccinated from the unvaccinated. Umair Irfan, Vox

https://www.vox.com/22587443/covid-19-vaccine-refusal-hesitancy-variant-delta-cases-rate

2020 U.S. County Level Presidential Results. Tony McGovern.

https://github.com/tonmcg/US_County_Level_Election_Results_08-20/blob/master/2020_US_County_Level_Presidential_Results.csv

COVID-19 Integrated County View. CDC, July 27, 2021

https://covid.cdc.gov/covid-data-tracker/#county-view

Covid-19 Vaccine Equity

https://covid.cdc.gov/covid-data-tracker/#vaccination-equity

At A Glance: CDC/ATSDR Social Vulnerability Index.

https://www.atsdr.cdc.gov/placeandhealth/svi/at-a-glance_svi.html

CDC/ATSDR SVI Data and Documentation Download.

https://www.atsdr.cdc.gov/placeandhealth/svi/data_documentation_download.html

Latest Data on COVID-19 Vaccinations by Race/Ethnicity.

Nambi Ndugga, Olivia Pham, Latoya Hill, Samantha Artiga, Noah Parker, Kaiser Family Foundation.

https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

KFF COVID-19 Vaccine Monitor: Profile Of The Unvaccinated. Grace Sparks, Ashley Kirzinger, Mollyann Brodie, Kaiser Family Foundation.

https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-profile-of-the-unvaccinated/

AP Poll Finds 45% of Unvaccinated Americans say they will definitely not get a shot. Boston Globe, July 23.

https://www.bostonglobe.com/2021/07/23/nation/associated-press-poll-finds-45-unvaccinated-americans-say-they-will-definitely-not-get-shot/

As Delta surges, poll data suggests that unvaccinated America’s opposition to the shots is declining, IPSOS.

https://www.ipsos.com/en-us/news-polls/axios-ipsos-coronavirus-index

Jan Plotczyk spent 25 years as a survey and education statistician with the federal government, at the Census Bureau and the National Center for Education Statistics. She retired to Rock Hall.

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Megan Outten Launches Campaign for Wicomico County Council, District 7

By Friends of Megan Outten • July 29, 2025

Megan Outten, a lifelong Wicomico County resident and former Salisbury City Councilwoman, officially announced her candidacy recently for Wicomico County Council, District 7. At 33, Outten brings the energy of a new generation combined with a proven record of public service and results-driven leadership. “I’m running because Wicomico deserves better,” Outten said. “Too often, our communities are expected to do more with less. We’re facing underfunded schools, limited economic opportunities, and years of neglected infrastructure. I believe Wicomico deserves leadership that listens, plans ahead, and delivers real, measurable results.” A Record of Action and A Vision for the Future On Salisbury’s City Council, Outten earned a reputation for her proactive, hands-on approach — working directly with residents to close infrastructure gaps, support first responders, and ensure everyday voices were heard. Now she’s bringing that same focus to the County Council, with priorities centered on affordability, public safety, and stronger, more resilient communities. Key Priorities for District 7: Fully fund public schools so every child has the opportunity to succeed. Fix aging infrastructure and county services through proactive investment. Keep Wicomico affordable with smarter planning and pathways to homeownership. Support first responders and safer neighborhoods through better tools, training, and prevention. Expand resources for seniors, youth, and underserved communities. Outten’s platform is rooted in real data and shaped by direct community engagement. With Wicomico now the fastest-growing school system on Maryland’s Eastern Shore — and 85% of students relying on extra resources — she points to the county’s lagging investment as a key area for action. “Strong schools lead to strong jobs, thriving industries, and healthier communities,” Outten said. “Our schools and infrastructure are at a tipping point. We need leadership that stops reacting after things break — and starts investing before they do.” A Commitment to Home and Service Born and raised in Wicomico, Megan Outten sees this campaign as a continuation of her lifelong service to her community. Her vision reflects what she’s hearing from neighbors across the county: a demand for fairness, opportunity, and accountability in local government. “Wicomico is my home; it’s where I grew up, built my life, and where I want to raise my family,” Outten said. “Our county is full of potential. We just need leaders who will listen, work hard, and get things done. That’s what I’ve always done, and that’s exactly what I’ll continue to do on the County Council.” Outten will be meeting with residents across District 7 in the months ahead and unveiling more details of her platform. For more information or to get involved, contact info@meganoutten.com

“Turtles All The Way Down”

By John Christie • July 29, 2025

Way back in 1935, the Supreme Court determined that independent agencies like the Consumer Product Safety Commission (CPSC), the National Labor Relations Board (NLRB) and the Merit Systems Protection Board (MSPB) do not violate the Constitution’s separation of powers. Humphrey’s Executor v. United States (1935). Congress provided that the CPSC, like the NLRB and MSPB, would operate as an independent agency — a multi-member, bipartisan commission whose members serve staggered terms and could be removed only “for neglect of duty or malfeasance in office but for no other cause.” Rejecting a claim that the removal restriction interferes with the “executive power,” the Humphrey’s Court held that Congress has the authority to “forbid their [members’] removal except for cause” when creating such “quasi-legislative or quasi-judicial” bodies. As a result, these agencies have operated as independent agencies for many decades under many different presidencies. Shortly after assuming office in his second term, Donald Trump began to fire, without cause, the Democratic members of several of these agencies. The lower courts determined to reinstate the discharged members pending the ultimate outcome of the litigation, relying on Humphrey’s , resulting in yet another emergency appeal to the Supreme Court by the administration. In the first such case, a majority of the Court allowed President Trump to discharge the Democratic members of the NLRB and the MSPB while the litigation over the legality of the discharges continued. Trump v. Wilcox (May 22, 2025). The majority claimed that they do not now decide whether Humphrey’s should be overruled because “that question is better left for resolution after full briefing and argument.” However, hinting that these agency members have “considerable” executive power and suggesting that “the Government” faces greater “risk of harm” from an order allowing a removed officer to continue exercising the executive power than a wrongfully removed officer faces from being unable to perform her statutory duty,” the majority gave the President the green light to proceed. Justice Kagan, joined by Justices Sotomayor and Jackson, dissented, asserting that Humphrey’s remains good law until overturned and forecloses both the President’s firings and the Court’s decision to award emergency relief.” Our emergency docket, while fit for some things, should not be used to “overrule or revise existing law.” Moreover, the dissenters contend that the majority’s effort to explain their decision “hardly rises to the occasion.” Maybe by saying that the Commissioners exercise “considerable” executive power, the majority is suggesting that Humphrey’s is no longer good law but if that is what the majority means, then it has foretold a “massive change” in the law and done so on the emergency docket, “with little time, scant briefing, and no argument.” And, the “greater risk of harm” in fact is that Congress provided for these discharged members to serve their full terms, protected from a President’s desire to substitute his political allies. More recently, in the latest shadow docket ruling in the administration’s favor, the same majority of the Court again permitted President Trump to fire, without cause, the Democratic members of another independent agency, this time the Consumer Product Safety Commission (CPSC). Trump v. Boyle (July 23, 2025). The same three justices dissented, once more objecting to the use of the Court’s emergency docket to destroy the independence of an independent agency as established by Congress. The CPSC, like the NLRB and MSPB, was designed to operate as “a classic independent agency.” In Congress’s view, that structure would better enable the CPSC to achieve its mission — ensuring the safety of consumer products, from toys to appliances — than would a single-party agency under the full control of a single President. “By allowing the President to remove Commissioners for no reason other than their party affiliation, the majority has negated Congress’s choice of agency bipartisanship and independence.” The dissenters also assert that the majority’s sole professed basis for the more recent order in Boyle was its prior order in Wilcox . But in their opinion, Wilcox itself was minimally explained. So, the dissenters claim, the majority rejects the design of Congress for a whole class of agencies by “layering nothing on nothing.” “Next time, though, the majority will have two (if still under-reasoned) orders to cite. Truly, this is ‘turtles all the way down.’” Rapanos v. United States (2006). * ***** *In Rapanos , in a footnote to his plurality opinion, former Supreme Court Justice Scalia explained that this allusion is to a classic story told in different forms and attributed to various authors. His favorite version: An Eastern guru affirms that the earth is supported on the back of a tiger. When asked what supports the tiger, he says it stands upon an elephant; and when asked what supports the elephant, he says it is a giant turtle. When asked, finally, what supports the giant turtle, he is briefly taken aback, but quickly replies "Ah, after that it is turtles all the way down." John Christie was for many years a senior partner in a large Washington, D.C. law firm. He specialized in anti-trust litigation and developed a keen interest in the U.S. Supreme Court about which he lectures and writes.

“Andy Harris Just Made the Most Dangerous Vote of His Career”

By Shore Progress, Progessive Maryland, Progressive Harford Co • July 15, 2025

Marylanders will not forget this vote.

How Many Will Be Kicked Off Medicaid in MD-01 Because of Andy Harris?

By Jan Plotczyk • July 9, 2025

More than 30,000 of our neighbors in Maryland’s first congressional district will lose their health insurance through the Affordable Care Act and Medicaid because of provisions in the GOP’s heartless tax cut and spending bill passed last week.

Six Reasons Why the House Budget Bill Will Hurt Rural America

By Michael Chameides, Barn Raiser • May 21, 2025

Right now, Congress is working on a fast-track bill that would make historic cuts to basic needs programs in order to finance another round of tax breaks for the wealthy and big corporations.

Who Will SNAP Cuts Affect in Maryland? On the Eastern Shore?

By Catlin Nchako, Center on Budget and Policy Priorities • May 21, 2025

The House Agriculture Committee recently voted, along party lines, to advance legislation that would cut as much as $300 million from the Supplemental Nutrition Assistance Program. SNAP is the nation’s most important anti-hunger program, helping more than 41 million people in the U.S. pay for food. With potential cuts this large, it helps to know who benefits from this program in Maryland, and who would lose this assistance. The Center on Budget and Policy Priorities compiled data on SNAP beneficiaries by congressional district, cited below, and produced the Maryland state datasheet , shown below. In Maryland, in 2023-24, 1 in 9 people lived in a household with SNAP benefits. In Maryland’s First Congressional District, in 2023-24: Almost 34,000 households used SNAP benefits. Of those households, 43% had at least one senior (over age 60). 29% of SNAP recipients were people of color. 15% were Black, non-Hispanic, higher than 11.8% nationally. 6% were Hispanic (19.4% nationally). There were 24,700 total veterans (ages 18-64). Of those, 2,200 lived in households that used SNAP benefits (9%). The CBPP SNAP datasheet for Maryland is below. See data from all the states and download factsheets here.