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Rural America’s vaccination rate is growing, but not as fast it is in urban areas.

Last week, the percentage of the U.S. rural population that completed Covid-19 vaccination grew from 27.7% to 29.2%, according to a Daily Yonder analysis. That’s an increase of 1.6 percentage points.

In urban (or metropolitan) counties, the completed vaccination rate grew by 2.7 percentage points, from 32.6% to 35.3%.

The map compares vaccination rates in both rural and urban counties to a national adjusted average.*

  • Green (rural) and light green (urban) counties are performing at the national average or better.
  • Brown (rural) and tan (urban) counties have low rates of vaccination (up to 30% lower than the national rate).
  • Red (rural) and light red (urban) counties have very low vaccination rates (over 30% below the national average).
  • Gray counties (Texas and a handful of California counties) do not have CDC data available.

The map shows that the Northeast, Upper Midwest, Alaska, and portions of the West are leading the nation in vaccine rollout. On the other side of the coin, the Deep South and some Border States have the largest proportion of counties with very-low vaccination rates.

New Hampshire leads the nation in vaccinating its rural residents, with 57.3% of the rural population completely vaccinated. Two other New England states round out the top three: Connecticut (47.8%) and Maine (44.3%).

Georgia has the worst rural vaccination rate in the nation, at 9.3%, but it also has a very high rate of “unallocated vaccinations.” These vaccinations are not assigned to a specific county, so they can’t be used in analyzing rural and urban rates. Georgia’s statewide rate of 29.2% (which does include unallocated vaccinations) is the fourth lowest in the nation, just ahead of Utah (29.0%), Alabama (27.5%) and Mississippi (25.8%).

The table at the bottom of the post provides a sortable list of vaccination rates and raw numbers for rural, urban, and unallocated vaccinations.

The Daily Yonder has calculated rural and urban vaccination rates back to April 24, as national data became available. One trend is that the gap between the rural and urban rates of vaccination is growing. The week of April 24, the rural rate was 2.5 percentage points lower than the urban rate. Last week, the rate had climbed to 6.1 percentage points.

Public health officials point to a number of factors explaining the vaccination gap. These include less access to healthcare because of fewer medical facilities per capita, transportation issues such as lack of public transit, higher poverty rates (which tend to predict lack of healthcare access), and greater vaccine hesitancy.

*Unallocated vaccinations. The Daily Yonder analyzed the rural and urban vaccination rates using county-level data provided by the CDC. A small and varying percentage of vaccinations in every state are not allocated to specific counties and therefore cannot be part of the rural/urban analysis, though they are included in the statewide vaccination rate. The greater the proportion of vaccinations that are not allocated to specific counties, the likelier the statistical chance that the reported rural and urban rates are lower than the actual numbers of vaccinations in those localities.

For example, in West Virginia, 32.8% of the population has completed vaccinations. The state’s total vaccinations of about 588,000 includes about 272,000 that are not allocated to specific counties. These unallocated vaccinations (which comprise nearly half of the state’s total) are not included in the rural and urban analysis.

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