Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–April 10, 2021

Details

• Personal Author:
  Murthy, Bhavini Patel ; Sterrett, Natalie ; Weller, Daniel ; Zell, Elizabeth ; Reynolds, Laura ; Toblin, Robin L. ; Murthy, Neil ; Kriss, Jennifer ; Rose, Charles ; Cadwell, Betsy ; Wang, Alice ; Ritchey, Matthew D. ; Gibbs-Scharf, Lynn ; Qualters, Judith R. ; Shaw, Lauren ; Brookmeyer, Kathryn A. ; Clayton, Heather ; Eke, Paul ; Adams, Laura ; Zajac, Julie ; Patel, Anita ; Fox, Kimberley ; Williams, Charnetta ; Stokley, Shannon ; Flores, Stephen ; Barbour, Kamil E. ; Harris, LaTreace Q.
• Corporate Authors:
  National Center for Immunization and Respiratory Diseases (U.S.)Immunization Services Division. ; CDC COVID-19 Response Team. ; Stat-Epi Associates, Inc.
• Description:
  What is already known about this topic? Residents of rural communities are at increased risk for severe COVID-19–associated morbidity and Mortality. In September 2020, COVID-19 incidence (cases per 100,000 population) in rural counties surpassed that in urban counties.
  
  What is added by this report? COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%); disparities persisted among age groups and by sex.
  
  What are the implications for public health practice? Disparities in COVID-19 vaccination access and coverage between urban and rural communities can hinder progress toward ending the pandemic. Public health practitioners should collaborate with health care providers, pharmacies, employers, faith leaders, and other community partners to identify and address barriers to COVID-19 vaccination in rural areas.
  
  Approximately 60 million persons in the United States live in rural counties, representing almost one fifth (19.3%) of the population.* In September 2020, COVID-19 incidence (cases per 100,000 population) in rural counties surpassed that in urban counties (1). Rural communities often have a higher proportion of residents who lack health insurance, live with comorbidities or disabilities, are aged ≥65 years, and have limited access to health care facilities with intensive care capabilities, which places these residents at increased risk for COVID-19–associated morbidity and Mortality (2,3). To better understand COVID-19 vaccination disparities across the urban-rural continuum, CDC analyzed county-level vaccine administration data among adults aged ≥18 years who received their first dose of either the Pfizer-BioNTech or Moderna Covid-19 Vaccine, or a single dose of the Janssen COVID-19 vaccine (Johnson & Johnson) during December 14, 2020–April 10, 2021 in 50 U.S. jurisdictions (49 states and the District of Columbia [DC]). Adult COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%) overall and among adults aged 18–64 years (29.1% rural, 37.7% urban), those aged ≥65 years (67.6% rural, 76.1% urban), women (41.7% rural, 48.4% urban), and men (35.3% rural, 41.9% urban). Vaccination coverage varied among jurisdictions: 36 jurisdictions had higher coverage in urban counties, five had higher coverage in rural counties, and five had similar coverage (i.e., within 1%) in urban and rural counties; in four jurisdictions with no rural counties, the urban-rural comparison could not be assessed. A larger proportion of persons in the most rural counties (14.6%) traveled for vaccination to nonadjacent counties (i.e., farther from their county of residence) compared with persons in the most urban counties (10.3%). As availability of COVID-19 vaccines expands, public health practitioners should continue collaborating with health care providers, pharmacies, employers, faith leaders, and other community partners to identify and address barriers to COVID-19 vaccination in rural areas (2).
  
  Suggested citation for this article: Murthy BP, Sterrett N, Weller D, et al. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–April 10, 2021. MMWR Morb Mortal Wkly Rep. ePub: 18 May 2021.
  
  mm7020e3.htm?s_cid=mm7020e3_x
  
  mm7020e3-H.pdf
  
  
• Subjects:
  CoronaVirus Infections/Prevention & Control COVID-19 Vaccines COVID-19/Prevention & Control Health Status Disparities Rural Population Urban Population Vaccination Vaccines/supply & Distribution
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2021; v. 70 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Name as Subject:
  Moderna Covid-19 Vaccine ; Pfizer-BioNTech COVID-19 Vaccine
• Place as Subject:
  United States
• Pages in Document:
  7 pdf pages
• Volume:
  70
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:071361e078f39496a9ff43c87dd2d9c077966c974fb1f214b367ea7ab3bd484b240be5c2a73115927f459c8a3a66c066ad82da337ae20a2af1ae72ee3403ae70
• Download URL:
  https://stacks.cdc.gov/view/cdc/106329/cdc_106329_DS1.pdf
• File Type:
  [PDF - 206.51 KB ]