Exploring the gap: rural and urban disparities in COVID-19 vaccination uptake among U.S. adults
Abstract
Background: Though urban-rural disparities in coverage rates of COVID-19 vaccine have been documented in previous studies, little is known on how vaccination uptake trend has evolved over time across urban and rural areas. This study, using individual level data, aimed to assess the differences in monthly progression of vaccination uptake among U.S. adults by urban and rural areas.
Methods: We used data from the COVID Vaccination module of the 2022 Behavioral Risk Factor Surveillance System survey. Our sample comprised of 135,969 adults aged 18+ years, living in 29 U.S. states. We estimated Kaplan-Meier survivor functions for the event of being vaccinated by urban and rural residence for the period of 25 months starting from December 2020. We also assessed monthly survival probabilities by urban and rural areas for education and income sub-groups.
Results: We found a gradual divergence of COVID-19 vaccination uptake in favor of adults living in urban areas, which was robust across different age groups, educational attainment, and household income levels. The urban-rural gap became apparent following the expansion of COVID-19 vaccination eligibility in March 2021 and further widened over the course of time. In April 2021, 65.95% urban adults and 82.76% rural adults were unvaccinated. In December 2022, 44.36% urban adults and 70.76% rural adults remained unvaccinated suggesting widening of the gap.
Conclusions: Notable and persistent differences in monthly progression of COVID-19 vaccination uptake were observed across urban and rural areas in the US. These results call for further investigation to identify the root causes of disparity and to strategize equitable vaccination policies.
Keywords: COVID-19, vaccination, rural populations, socioeconomic disparities in health
Keywords
COVID-19, vaccination, rural populations, socioeconomic disparities in health
Exploring the gap: rural and urban disparities in COVID-19 vaccination uptake among U.S. adults
Background: Though urban-rural disparities in coverage rates of COVID-19 vaccine have been documented in previous studies, little is known on how vaccination uptake trend has evolved over time across urban and rural areas. This study, using individual level data, aimed to assess the differences in monthly progression of vaccination uptake among U.S. adults by urban and rural areas.
Methods: We used data from the COVID Vaccination module of the 2022 Behavioral Risk Factor Surveillance System survey. Our sample comprised of 135,969 adults aged 18+ years, living in 29 U.S. states. We estimated Kaplan-Meier survivor functions for the event of being vaccinated by urban and rural residence for the period of 25 months starting from December 2020. We also assessed monthly survival probabilities by urban and rural areas for education and income sub-groups.
Results: We found a gradual divergence of COVID-19 vaccination uptake in favor of adults living in urban areas, which was robust across different age groups, educational attainment, and household income levels. The urban-rural gap became apparent following the expansion of COVID-19 vaccination eligibility in March 2021 and further widened over the course of time. In April 2021, 65.95% urban adults and 82.76% rural adults were unvaccinated. In December 2022, 44.36% urban adults and 70.76% rural adults remained unvaccinated suggesting widening of the gap.
Conclusions: Notable and persistent differences in monthly progression of COVID-19 vaccination uptake were observed across urban and rural areas in the US. These results call for further investigation to identify the root causes of disparity and to strategize equitable vaccination policies.
Keywords: COVID-19, vaccination, rural populations, socioeconomic disparities in health
