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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