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Outlier counties have higher COVID vaccination rates than states | Health news from the healthiest communities

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While a majority of U.S. residents are now fully vaccinated against COVID-19, the differences between states are significant. At the end of December, the proportion of people fully vaccinated ranged from 46% in Idaho at 77% in Vermont.

However, even within the lagging states, there are still some communities that stand out. These are the outliers – counties with significantly higher vaccination rates than their state. In Jefferson County, Mississippi, for example, 65% of residents were fully immunized, compared to 48% in the state, according to The data Centers for Disease Control and Prevention. This is despite the fact that Jefferson is one of the poorest counties in the entire United States, with a median household income of around $ 25,000 and significant health problems due to the high rates. of Diabetes and arterial hypertension.

“We have our struggles. We’re the last in a lot of things, ”says Crystal Cook, medical director of the Jefferson Comprehensive Health Center, a local community health network. “But with COVID-19, I’m proud to say we’re the first in something, especially something good.”

Sometimes a county’s demographic or political characteristics can contribute to it having a significantly different vaccination rate than the state as a whole. But there may also be a deeper explanation for the success of vaccination. In interviews with public health officials working in various outlier counties, a few commonalities emerge, indicating lessons about how other communities can increase their own immunization rates as well. Leaders say they thwarted misinformation through education, avoided shame and judgment, and used trusted local messengers to spread the word about immunization.

Jefferson County has also been successful in bringing people vaccines, instead of the other way around. Workers at the Cook Health Center toured the county in a mobile unit the size of a motorhome and equipped with a waiting room, laboratory, refrigerator and a freezer for storing heat-sensitive vaccines. Health workers have set up vaccination sites with the local school district, correctional facility and in front of social housing, allowing people without access to transport to walk directly.

“People know us. They know our services very well. We have earned the trust of the community, ”says Cook.

Cook says workers encountered significant vaccine misinformation, but responded without “shaming vaccines” to anyone. Some people, she said, believed in a myth about vaccines containing microchips. Cook, however, explained how the syringe worked, showing how the needle was retractable. This demonstration was enough to allay people’s fears.

“Education was the biggest tool, and being patient, being there, meeting people where they are,” says Cook.

Some places that now have high vaccination rates are also among those particularly affected by COVID-19.

“We were listed as worst city in the United States with the highest infection rate per capita, ”explains Richard Chamberlain, director of health for the city of Laredo, Texas.

Webb County – home to Laredo, a border town where about 95% of the county’s population live – peaked at an average of more than 400 new COVID-19 cases and eight deaths per day in January 2021, according to the non-partisan data center Facts about the United States. Today, 80% of the county’s residents are fully immunized, compared to 57% of Texans overall.

Laredo officials have deployed a bilingual blitz of communications efforts – using social media, print and television – to spread vaccine information and answer people’s questions. The city’s Emergency Operations Center broadcast live question-and-answer sessions three times a week.

“The message was continuous, it flowed. … ‘Vaccines are safe, vaccines are effective, and there is no cost,’ ”says Chamberlain.

Laredo officials also worked closely with the mayor of the sister city Nuevo Laredo, Mexico, to help immunize approximately 20,000 people who live across the southern United States border. The reflection: epidemics in one city would inevitably affect the other.

“We absolutely believe in regional immunity… we know we really are one Laredo,” Chamberlain says. Notably, vaccination rates have also been high in the Mexican states opposite Webb County. Nuevo León, for example, had given 91% of its adult population at least one dose as of Dec. 1, according to government data Quoted by the Mexico Institute of the American think tank Wilson Center. Tamaulipas, home to Nuevo Laredo, recorded an 86% dose vaccination rate. (Beatings given to Mexican residents do not count towards Laredo’s vaccination rate.)

The success in Webb County is part of a larger trend in border communities. Of the top 50 outliers in the United States – where counties have the largest positive difference between their immunization rate and the state’s overall rate – six are on the U.S.-Mexico border. These include places like Cameron County, Texas, which has a complete vaccination rate of 72%.

“I’m super proud of the border.… The border is very different from the rest of the state. We feel responsible, we have that weight on us to protect the rest of the state,” said Esmeralda Guajardo, administrator of Cameron’s health. Departmental public health.

Immunization rates along the border may be somewhat inflated as they are based on demographics from the US Census Bureau. Office historically had difficulties Accurately collect demographic data on Latinos and immigrants without legal documents. However, Guajardo still believes vaccination rates in her region are high, as she says increases in the vaccination rate have consistently followed a decrease in the case rate in the region.

“I think it skewed our numbers, but not that much. And that’s why: if you look at our vaccination rates versus our number of cases, you’ll see it’s pretty consistent, ”says Guajardo.

Eight more of the top 50 outliers in the United States are counties where at least one-third of the population is Native American. Including Big Horn County in Montana, which is home to part of the Crow Indian Reservation, and Apache County, Arizona, which is home to part of the Navajo Nation. They are respectively 83% and 89% fully vaccinated.

COVID-19 has devastated the Navajo Nation, resulting in more 1,200 deaths by March 2021. “The success of achieving high vaccination rates is unfortunately the result of our disproportionate rates of infection, serious illness and death,” said Dr Kevin Gaines, Acting Chief Medical Officer of the Navajo Area Indian Health Service.

But public encouragement from the political and spiritual leaders of the Navajo Nation also played a role, according to Gaines. He knows some traditional indigenous healers who announced that they had received vaccines and encouraged others to do the same.

“The leadership of the Navajo Nation since the President has been very public and open in also advocating for precautions and measures to prevent the spread of COVID,” notes Gaines.

Harley Jones, senior manager of the Project HOPE medical awareness program, helped coordinate efforts to send medical volunteers to tribal areas. Jones attributes the high vaccination rates in places like Apache County in part to a culture that values ​​community health over individualism: “There was a belief there in the collective responsibility of each person to care for themselves. get vaccinated ”.

“Getting the vaccine was not just how you protected yourself,” Jones says, “but more importantly, how you protected the community and the culture.”

Below are the top 50 counties with the greatest positive difference between local vaccination rate and state rate:

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