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The biggest barrier to getting more rural residents vaccinated against Covid-19 is the overwhelming amount of information – and disinformation – swirling through communication channels, according to a poll of rural residents.

The best way to overcome that barrier is to focus on sharing accurate information through the people and institutions that people trust the most, primarily healthcare professionals, according to a report commissioned by the National Rural Health Association.

“A lot of (the barrier was) trying to decipher what was fact, and what was not,”  said Amy Elizondo, one of the report’s authors, in an interview with the Daily Yonder. “It’s who do you believe and who do you trust? That obviously varied across the board with the population as well. Some of the most trusted sources were healthcare providers, and certainly the people that were vaccinated tended to trust the government and government organizations a bit more.”

The study found that 61% of rural residents report being either partially or fully vaccinated, including 47% of rural parents and 48% of rural teens. A majority of the vaccinated adults, 62%, also reported getting their booster shot. The Daily Yonder’s analysis of Centers for Disease Control and Prevention data shows that just over half of all rural residents are completely vaccinated. 

Only half of the parents (46%) said they had at least partially vaccinated their children. Of those whose children are unvaccinated, 15% said they are hesitant to get them vaccinated. Another 8% said they plan on vaccinating them in the future. More than a quarter (28%) said they didn’t plan on vaccinating their children.

The study found that healthcare providers were the biggest source of information and the most trusted compared to other outlets such as social media. More than three quarters of the rural adults surveyed (77%) said they saw their healthcare provider as a trusted source of information. Only 10% said they trusted Twitter, and 17% said they trusted Facebook. Healthcare providers were also more than twice as trusted as media outlets, with 35% of rural adults viewing CBS and NBC as trusted sources, and only 30% and 31% trusting Fox and CNN respectively.

The top reasons to get the vaccine, the survey found, were the health of the respondent or the health of those around them. Nearly a third of the vaccinated rural adults said the recommendation of their health care provider was the key motivator to get the vaccine.

Understanding the data in the poll is crucial in persuading more rural residents to get vaccinated, Elizondo said.

“We hope to do a follow-up survey in a couple of months to see where we are again, but certainly, I think with the new variants that have come up, the more people you have in the gray area or on the fence, the more likely you are to get back to (seeing) an uptick again. I think the overall message that the survey shows though is that with all those that are unvaccinated, it’s still crucial to reaffirm and continue that messaging around those initial first shots.”

New Covid-19 infections have increased each week for the past month, according to a Daily Yonder analysis. Cases have doubled in the last four weeks. But those numbers may be artificially low, former U.S. Food and Drug Administration Commissioner Scott Gotlieb, M.D. told CBS New. The availability of home tests may mean as many as six of every seven infections are going unreported, he said. 

The omicron subvariant BA.2 accounts for more than 85% of the new cases, according to the federal Department of Health and Human Services.

Those increased infection rates mean getting rural residents fully vaccinated and boostered is as important as ever, Elizondo said, especially as Congress considers further Covid-19 funding.

“Since rural America remains more vulnerable and unvaccinated, it would still be very critical for vaccines to be provided without cost and accessible,” she said. “Early on, the thing was getting it to these remote areas and to these underserved populations, as quickly as possible. We saw the virus move from the urban areas to rural areas pretty fast, and I think that (vaccination) is going to remain critical.”

Getting more rural residents vaccinated will take a continued effort by health care providers on multiple fronts to hammer home the message.

“I think what this survey tells us is again… let’s get back to the basics of where we started with or let’s protect our communities together,” she said. “But we also need to help people continue to (sift through) all the information by having those one-on-one conversations… The one-on-one conversation is more effective than a large group where people may not feel comfortable about raising questions or sharing personal fears and such.”

But it’s also important, she said, to do that in a non-threatening way.

“We’ve heard stories too in the past where people were afraid to get vaccinated in their community, because they didn’t want people to know they were getting vaccinated,” she said.

Some survey respondents – adult and teen – said they felt pressured to either get or not get the vaccine. About one third of adults (31% of liberals and 33% of conservatives) said they received pressure about the vaccine, mostly to get it. Half of the rural teens surveyed (50%) said they felt pressure over the vaccine, with 15% of those feeling pressured reporting they felt pushed to reject it.

The study conducted online interviews with more than 2,500 adults and teens living in non-urban Zip codes. The full study had a margin of error of plus or minus 2 percentage points, with results from the teen sample having a margin of error of plus or minus 7 percentage points. 

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