CDC report highlights disparities in COVID vaccination rates in urban and rural counties

The latest data from the Centers for Disease Control and Prevention (CDC) shows a nearly 7% difference in COVID-19 vaccination rates between rural and urban counties. Between December 2020 and April 2021, about 45.7% of individuals in urban counties received a vaccine compared to 38.9% in rural counties.

The urban-rural disparities were also evident when comparing age groups. Among adults aged 18-64 years, vaccination rates were 29.1% in rural counties and 37.7% in urban. For those over 65 years old, vaccination rates jumped to 67.6% in rural counties and 76.1% in urban. Vaccine coverage rates for women in urban counties (48.4%) and rural counties (41.7%) were both higher than rates among men (35.3% rural, 41.9% urban).

The CDC notes, however, that vaccine coverage was not calculated by race and ethnicity because that information was missing for 40% of the data they used.



The urban-rural vaccine disparity varied among jurisdictions. Florida, for example, saw a 13.3% greater vaccination rate in urban counties. Massachusetts had a 10.9% difference and Missouri saw a 10.3% difference.

In some states, such as Connecticut, Maryland, and Michigan, the difference in vaccination rates was less than 1%. In others, like Arizona and New Hampshire, rural counties saw higher levels of vaccinations.

The lower rates of COVID vaccination among rural counties is particularly concerning, says the CDC, because rural communities are at increased risk for severe COVID-associated morbidity and mortality. Rural communities are often older, have higher uninsured rates, and have more limited access to health care facilities.

“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.”

The CDC reasons that challenges related to vaccine access, distribution, and vaccine hesitancy may have a hand in the lower vaccination rates in rural areas.

According to the Kaiser Family Foundation’s COVID-19 Vaccine Monitor, about 55% of those in rural settings say they have either already gotten a COVID vaccine or plan to get one as soon as possible. This number jumps to 67% among suburban populations and 64% in urban populations. Seventeen percent of rural residents reported that they will “definitely not” get a vaccine, compared to 14% of the suburban population and 9% of the urban population.


Image: Kaiser Family Foundation


Despite the CDC not being able to evaluate urban-rural vaccine disparities based on race and ethnicity, the U.S. Dept. of Health and Human Services (HHS) announced on Wednesday that community health centers have administered over 10 million COVID vaccine doses – with 61% going to racial and ethnic minorities.

HHS Secretary Xavier Becerra says the vaccination work at community health centers is critical in making sure that hard-hit and underserved communities are able to get vaccinated.