Covid-19 vaccination rates are 'abysmal' overall in the United States, and even lower in rural areas

In January 2021, four in 10 U.S. adults (41%) polled said that when a Food and Drug Administration-approved vaccine for Covid-19 was available for free, they would get it as soon as possible.

Fast forward to fall 2023, and times have changed. As Katelyn Jetelina writes in her newsletter, Your Local Epidemiologist: "Data is starting to roll in on Covid-19 vaccine inequities this fall. And it's not pretty. . . . Access. Cost. Outreach. Education. All of these changed once the federal emergency ended in May. Vaccines are no longer purchased or distributed by the government, and funding ran out to support vaccine campaigns. This means the U.S., once again, faces the pre-pandemic privatized and fragmented healthcare and public health systems. And one could argue an even worse system, given the loss of trust. Unfortunately, our communities continue to feel it disproportionately."

Even in 2021, Americans did not universally accept Covid-19 vaccines, with some Americans adopting a "wait and see" approach and "rural residents among the most resistant to getting vaccinated," KFF Health News reported. According to Jetelina, rural Covid-19 vaccination rates have not improved. She cites a Centers for Disease Control and Prevention analysis from last week that "found adults in rural areas were less likely to have gotten a Covid-19 vaccine (10%) vs. those in urban (15%) or suburban (14%) areas."

YLY graph, from CDC data

When compared to other countries, U.S. Covid-19 vaccination rates are strikingly poor. Jetelina writes, "U.S. rates of Covid-19 vaccination this fall are, overall, abysmal. This is especially apparent when we compare it to counterparts like the United Kingdom, where 68% of people over 65 years old are vaccinated (compared to 31% in the U.S.).

Jetelina adds that disparities also fall along race and ethnicity lines, "Communities of color continue to have much lower rates of vaccination." Jetelina states that gaps matter and impact national health for two primary reasons.

1. Those who are more likely to lack access to healthcare are even more likely to be infected and get seriously ill once again.
2. The commercialization of vaccines has only amplified gaps in access and uptake. This is cause for concern about our national vaccine system during non-emergency times.

What's the bottom line? "When the nation's health is at stake, we need public health to ensure our resources are fairly distributed and get to those who need it most," Jetelina writes. "The 'marketplace' doesn't do this naturally. In fact, it works against many of our communities. These inequities will continue unless we make big, systemic changes. One would hope that a pandemic would jumpstart these changes, but it seems we are quickly falling back to our pre-pandemic ways."