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The rate of new Covid-19 vaccinations in rural counties fell slightly last week, the fourth consecutive week that the pace of new vaccinations has declined.

Rural counties reported that 159,000 additional residents completed their vaccination regimen last week. That’s down about 4% from two weeks ago.

The pace of newly completed vaccinations in metropolitan counties fell by 20%, from about 1.6 million two weeks ago to 1.2 million last week.

As of November 11, 44.8% of the entire rural population was completely vaccinated for Covid-19. That’s about 20% lower than the metropolitan vaccination rate of 57.0% of the population. (See graph above.)

  • Tennessee made the biggest one-week improvement in rural vaccinations, as measured by the percentage point increase in the rural vaccination rate. The state reported an additional 11,000 rural residents finished their vaccinations, raising the state’s rural vaccination rate by 0.7% percentage points. But the state ranks 41st in the U.S. for cumulative rural vaccinations. Just under 40% of rural residents are completely vaccinated in Tennessee – about 10 points lower than the metropolitan rate.
  • South Dakota had the second-highest percentage-point increase in rural vaccinations last week. The state vaccinated an additional 2,800 rural residents, increasing the rural rate by 0.6 percentage points. South Dakota has vaccinated 49.4% of its rural population and ranks 20th nationally in cumulative rural vaccinations.
  • Utah, California, and North Carolina rounded out the top-five states with the highest percentage-point increase in rural vaccination rates last week.

  • West Virginia had the lowest rate of increase in rural vaccinations last week. The state completed only 234 additional rural vaccinations last week, bringing its rural rate to 22.6% of population. The actual rate is likely a bit higher, because about two-thirds of the vaccinations completed in the state have not been assigned to a specific county and therefore not reflected in the rural and metropolitan analysis. Statewide, about 41% of West Virginia residents have been completely vaccinated against Covid-19.
  • Other states with very low improvement in their rural vaccination rates last week were Indiana, Georgia, Michigan, and Mississippi.
  • Just five states accounted for nearly a third of all new rural vaccinations last week. They were North Carolina (12,000 new rural vaccinations completed), Tennessee (11,000), Texas (9,300), Ohio (7,400), and Kentucky (6,700).
  • Massachusetts remained well ahead of the rest of the U.S. in percent of rural population vaccinated. The state is one of only four that has a higher metropolitan rate than rural rate (73.5% vs. 67.0%). The other three states with rural rates higher than their metropolitan rates are Arizona, New Hampshire, and Alaska.
  • Other states that buck rural vaccination trend are Maine and Vermont. The states have the largest percentage of rural population in the U.S. and are near the top of the heap in their statewide vaccination rates. Read more in a related story.
  • About half of the nation's 1,976 rural counties completed more vaccinations last week than they did two weeks ago.
  • Rural counties with the highest percentage-point increase in their rural vaccination rates clustered in the West. States west of the Mississippi that had counties in the top 20 for rural vaccination rate increases were South Dakota, Nebraska, Montana, Colorado, North Dakota, Montana, Texas, Wyoming, Arkansas, and Utah. Tennessee and North Carolina were the only states east of the Mississippi with counties in the top 20.

This week’s vaccination report covers Friday, November 5, through Thursday, November 11. Data come from the Centers for Disease Control and Prevention community profile reports. Data for Hawaii, Massachusetts, and Texas come from those states’ departments of health.

The article defines rural as nonmetropolitan, or counties that are not part of a Metropolitan Statistical Area, as defined by the Office of Management and Budget in 2013. More information on rural definitions.