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The rate of vaccinations in rural America grew by about a third of a percentage point last week, among the slowest rates of growth since Covid-19 vaccines became broadly available in spring 2021.

About 172,000 rural Americans completed their Covid-19 vaccination regimen last week, according to a Daily Yonder analysis. That’s roughly on par with the rate of new vaccinations in the weeks leading up to Thanksgiving. Currently 46.8% of the rural population, or 21.5 million people, have completed a Covid-19 vaccination.

In metropolitan counties, the vaccination rate grew by about 0.7 percentage points to 59.5% of the metropolitan population. That’s 27% higher than the rural rate.

Rural America’s lower vaccination rate is the primary cause of its disproportionately high number of Covid-19 deaths, according to Carrie Henning-Smith, deputy director of the University of Minnesota Rural Health Research Center. Rural residents are currently dying of Covid-19 at more than twice the rate of metropolitan residents. The gap between rural and urban death rates has gotten worse with each successive wave of the pandemic, the Daily Yonder has reported.

Biggest Gains

  • For the second week in a row, West Virginia had the largest percentage-point increase in rural vaccinations. The state’s vaccination rate jumped 27 points last week because of clerical adjustments. This week’s rural vaccination increase in West Virginia was 2.1 percentage points. The state’s adjustments and new vaccinations have moved it from 46th in rural vaccinations to 18th.
  • North Dakota had the second highest increase in rural vaccination rates, with an increase of 1.3 percentage points. The state ranks just behind West Virginia for its cumulative rural vaccination rate, which is 52%.
  • Massachusetts and Arizona were next in the weekly percentage-point increase in rural vaccinations.
  • Hawaii, Vermont, Utah, Maine, New Hampshire, Montana, and New Mexico all increased their rural vaccination rates by at least 0.8 percentage points.
  • The states with the best rural vaccination rates remain unchanged for the past several weeks. Massachusetts is first at 77%; Connecticut second at 72%; and Arizona third with 70%.
  • Maine, Hawaii, and New Hampshire all had rural vaccination rates of over 60% of total population.

Lowest Gains and Overall Rates

  • On the other end of the list, Texas, Michigan, and Virginia had the lowest growth in rural vaccination rates. But Virginia’s low performance was due to record-keeping changes.
  • Deep South states figure prominently for having the lowest rates of rural vaccination. Georgia has less than a quarter of its rural residents vaccinated, although a large number of vaccinations without geographic information could be part of the reason. Missouri, Alabama, and Louisiana all have rural vaccination rates under 40% of total population.

Best Performing Rural Counties

  • The rural counties with the highest vaccination rates are Vera Cruz County, Arizona, 98% of total population; Bristol Bay, Alaska, 97%; and Dukes and Nantucket counties (both islands with small year-round populations), Massachusetts, 95% each.
  • Other nonmetropolitan (rural) counties with more than 80% of their total population completely vaccinated are San Juan County, Colorado; Apache County, Arizona; Presidio County, Texas; Summit County, Utah; Big Horn County, Montana; Hamilton County, New York; Los Alamos County, New Mexico; and Summit County, Colorado.

Data Notes

This week’s Daily Yonder analysis of rural vaccinations covers Friday, December 10, through Thursday, December 16, 2021. Data comes from the Centers for Disease Control and Prevention and from the state health departments of Hawaii, Massachusetts, and Texas.

Rural is defined as nonmetropolitan, mean counties that are not included in Metropolitan Statistical Areas, according to the federal Office of Management and Budget (2013).