Hesitancy Narrative Hampers Vaccine Uptake in Rural USA
Up until now, residents in rural US counties have had higher vaccination rates against COVID-19 than their urban counterparts. If this statistic surprises you, you’re not alone.
The narrative that rural Americans are too mistrustful to vaccinate against COVID-19 has undermined the reality shown in the early data. Rather than encouraging vaccination or even accurately reporting on current rates, this narrative has created a false impression in rural areas that their friends and neighbors are not getting vaccinated and do not trust the vaccine. This in turn has created a toe-hold for disinformation to take root and increased vaccine mistrust which threatens to stall further vaccination and put rural communities at risk for future virus surges.
Fortunately, there is still time to learn from the past to overcome the effects of misinformation and get rural residents back on track towards vaccinating at rates in line with early data.
The Effects of the Vaccine Hesitancy Narrative
At the beginning of the year, early data indicating that Black Americans were not being vaccinated at rates equal to their overall share of the population sparked a rampant narrative of Black vaccine hesitancy in the media. Months later, statistics proved that lack of eligibility, not hesitancy, was the major reason for the comparatively lower vaccination rates. The truth was, when measured against eligible populations, Black communities were getting shots equal to or above expected levels.
These false narratives, many of which made it to mainstream media at local and national levels, hid the real barrier preventing Black (and Hispanic) Americans from being vaccinated at rates equal to their share of the population: access. It also robbed Black and Hispanic Americans of the credit they deserved for overcoming the institutional and technical barriers that made it harder for them to access the vaccine. But perhaps worst of all, by constantly telling Black and Hispanic Americans that their communities did not trust the vaccine and repeating all the reasons they might not, the media contributed to BIPOC hesitancy in groups where distrust in the community remained.
With many looking to neighbors and peers for guidance on what to trust during uncertain times, this narrative effectively reinforces vaccine mistrust instead of alleviating it.
Though access is not the main problem for rural communities — most residents report knowing where to get a vaccine and believe they could get an appointment if they tried — the current narrative being told to rural Americans is that their communities are the new problem and that their neighbors don’t trust the vaccine. With many looking to neighbors and peers for guidance on what to trust during uncertain times, this narrative effectively reinforces vaccine mistrust instead of alleviating it.
Hesitancy is real and opposition to the vaccine is growing in rural areas because residents are not receiving information from leaders they trust. According to the Kaiser study, rural residents are now 20% more likely to report voluntarily forgoing the vaccine, while 9% of respondents expressed having difficulty accessing it.
To overcome misinformation and correct the false narratives we must start engaging and informing residents through honest information and trustworthy voices.
To start, the media should focus on a more truthful and complete narrative about vaccination in rural communities that highlights the adoption and successes as well as the dangers from remaining hesitancy in the minority of residents; and public health campaigns need to model themselves after success stories.
Addressing Misinformation — Examples From Success Stories
Black faith leaders have already pointed the way to one key way to address hesitancy in rural areas. A lack of effective engagement with faith communities on the part of public health campaigns has resulted in many vaccine-opposed Americans (especially in rural areas) saying they will not be vaccinating because COVID vaccines are not compatible with their pro-life values. This is an issue in both white and black communities, but Black clergy have been able to dispel this misinformation by explaining that fetal stem cells were not used in the vaccine. Now their communities are seeing full vaccination rates, well above the national average.
Much more can be done to reach faith communities and address specific concerns by pro-life Americans around how the vaccines were developed, especially after both the Southern Baptists and Catholic Church have said that vaccines are pro-life.
We can also look to the Native American community. Many Native American reservations took control of the vaccine distribution, working with tribal leaders and social networks to administer vaccines, address vaccine hesitancy, and offer solutions to the barriers rural communities face. Many of these same reservations went from having one of the worst death rates (336 deaths per 100,000) to having some of the highest vaccination rates, some well beyond even top-level urban areas.
In order to build vaccine trust, we need to stop admiring the problem and instead integrate trusted community leaders — who know their communities and are trusted by them — to help build trust by delivering better information so that people can make the decision that is in the best interest for their — and their neighbors’ — health. This is the only way we will be able to protect entire communities and the nation from a resurgence of COVID-19 infections.
