Vaccination Costs Are Relatively High for Older Ages, But the Lag in Southern Counties, Counties with Higher Poor Conditions and Countries Voted for Trump

Older adults in the United States hit infected with coronavirus disease, which contains the majority of COVID-19 hospitalization and death. Since the approval of COVID-19 vaccines beginning in December 2020, there has been significant progress in vaccinating older people, who are among the first groups prioritized for vaccines. after health care workers and residents and staff of long-term care facilities. As of May 12, the Centers for Disease Control and Prevention (CDC) reported that 84.0% of adults 65 and older had received at least their first dose and 71.9% were fully vaccinated.

While there is evidence that vaccinations already have a major impact on mortality rates and cost of hospitalization for older adults, especially long-term care population, vaccination equity issues still remains a problem and there are challenges in reaching the specific population for vaccination. Rates of fully vaccinated elderly people vary by state, from 57.6% in Utah to 87.0% in Vermont (as of May 12, according to national CDC data), but state -level standards may obscure even more county-level changes. The County-level analysis provides an even more prominent look at the characteristics associated with variations in immunization rates among older adults across the country.

This analysis examined differences in vaccination rates for older adults by county characteristics, consistent with data from the CDC to May 11, 2021 that included 77% in all counties (2,415 ) in the US. (See Data and Methods for more details).

Primary Extraction

The average COVID-19 vaccination rate in the population is 68.9% for adults age 65 and older, but is much more varied and lower than the county average.

  • With a higher proportion of the elderly living in poverty (58.8%)
  • Ranks higher in the Social Vulnerability Index (60.1%)
  • Located in the South (60.7%)
  • With a higher share of adults voting for Trump (63.3%) (Figure 1)


The average vaccination rate for adults 65 and older was 68.9% among the data -reporting subjects, weighed in the population age 65 and older (Figure 2).

Vaccination rates are significantly different from the 2,415 data reported by the counties. In the high end (the top 10% of data reporting counties), at least 79.4% of adults 65 and older were fully vaccinated, and in the lower end (the bottom 10% in counties), no more than 48.6% of the elderly are fully vaccinated However, rates are likely to be higher in all counties, including those in the high and low deciles, as vaccination rates continue to change. o.

Southern provinces have lower rates of immunization of the elderly than provinces in other regions, similar to those found from others. Analysis of KFF showing that vaccination rates are generally lower in Southern states (Figure 1; Table 1) The average vaccination rate for older adults in the Southern provinces was 60.7%, lower than the average vaccination rate for older adults in the Northeastern provinces (70.1% ), Midwest (66.6%), and West (64.4%). Southern provinces represent a disproportionate share of counties with low average vaccination rates: Southern provinces accounted for 34.0% of the data reporting counties, but 42.9% of all counties with a vaccination rate below the weighted average of 68.9%. In contrast, Northeheast counties represent 8.4% of the total data reporting counties, while only 5.4% of counties in this region have vaccination rates below the weighted average for the elderly.

The vaccination rate for adults aged 65 and over is lower in counties where a high proportion of adults 65 and over live in poverty compared to counties where a small proportion of the elderly live. adults living in poverty. Vaccination rates among adults 65 and older are more than 10 percentage points lower in counties where a higher proportion of people 65 and older live in poverty (58.8%) than in counties. where a lower proportion of older adults live in poverty (69.0%).

Counties that rank high in Social Vulnerability Index (SVI) show the same trend in counties with a large proportion of older adults living in poverty. This finding is not surprising given poverty is one of 15 demographic measures used to calculate SVI, along with other measures including race / ethnicity, disability, and lack of car access. . (SVI criteria are for the total population of a county and are not limited to adults 65 and older). Counties that rank high in the index (i.e., those with more vulnerabilities) have a lower average immunization rate for adults 65 and older than counties that rank lower in it. index (60.1% vs. 67.7%).

Consistent with “Wait and see” vaccination method more common among Republicans than Democratic voters, regardless of age, vaccination rates for older adults are lower in counties where the majority of voters voted for Donald Trump than in counties where the majority voted for Joe Biden in the 2020 election. In counties where Trump got the most votes, the average vaccination rate for adults 65 and older was more than 7 percentage points lower than in counties that voted for Biden (63.3% compared with 70.8%).


While significant progress has been made in the last four months of vaccination of older U.S. adults against COVID-19, drilling up to the county level has shown significant changes in the vaccination rate. These findings suggest that more work needs to be done to increase vaccination rates for certain segments of the population, including older adults in the Southern provinces, in higher areas. poverty, and in counties voting for Trump. The fact that Southern provinces are left to vaccinate older adults is consistent with a much higher poverty rate for older adults in the South than other regions of the country. These outcomes may also indicate that some older adults may face barriers that make it more difficult to access vaccinations, such as lack of transportation, lack of internet access, and health conditions that make travel to vaccinated areas, etc.. With 71.9% of elderly people in all U.S. states today fully vaccinated, this analysis however suggests that the push for vaccination in the elderly is not over. Increasing vaccination rates among older people – especially those living in high -poverty areas and the South – may require more and more focused efforts to further remove barriers.

This analysis obtained data from multiple sources. Our main consequence of interest, county vaccination rate, is collected from Centers for Disease Control and Prevention (CDC) COVID-19 Integrated County View. CDC data completes vaccination rates for the general population and population over age 65. Data are not reported for Hawaii, New Mexico, Texas, and the smallest counties of Alaska and California. . In addition, we excluded data for counties where less than 80% of vaccination records include residential counties, excluding data for Colorado, Georgia, Vermont, Virginia, and West Virginia. The analysis included data for 2,415 counties, 77% of the total counties (3,142) in the U.S.

The average county-weighted vaccination rate for the general population is slightly lower than national estimates due to missing data from several states and counties as mentioned above.

We classified the states by the region used 2010 U.S. Census Bureau Regions and Sections classification.

Data to categorize counties by the demographic characteristics of residents were obtained from Census Bureau’s 2019 American Community Survey 5-Year Estimate by county. We used ACS data to categorize the counties as residents ’poverty. Specifically, we calculated the share of the population of the county that’s age 65 and up in a family with low incomes.

The County Social Vulnerability Index (SVI) from the CDC Agency for Toxic Substances and Disease Registration. SVI shows the vulnerability of a community in line with specific social conditions (i.e. socioeconomic status, household composition, language, etc.) that can affect the community in the event of a disaster.

The results of the 2020 Presidential Election are taken from a GitHub repository gathered data from media sources including The Guardian,, Fox News, Politico, and the New York Times. Alaska was excluded from this analysis component because available data was only at the district level and could not be circulated across counties.

To classify the counties, we interpreted the continuous steps into outcome categories, using the group definitions below:

  • For continuous measures of poverty rate, SVI, and medical risk conditions, we classified counties under 25 percent of the total distribution of counties for each measure. “low,” counties above 75 percent as “high,” and all other counties as “medium.” For specific breaks for each variable, see Table 1.

Given the ongoing concerns related to equitable access to the COVID-19 vaccine, examining differences in racial / ethnic vaccination rates at the county level could add to the current national and state -level data. However, the results of our analysis lack face stability compared to data analyzed at the individual level which showed that people of Hispanic ethnicity were vaccinated at a much lower price than White people, which leads us to the conclusion that there are confusing factors driving the consequences in accordance with the composition of the racial and ethnic level in the province. Therefore, we did not include comparisons of vaccination rates based on racial and ethnic composition of the province.

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