What Accounts for Differing Vaccination Rates?

Jan Plotczyk • August 3, 2021
 
We would not expect every Eastern Shore county to have identical covid-19 vaccination rates, and they don’t — but what accounts for the differences that range from 43% to 65% vaccinated? We’ll look to politics, social vulnerability, and race/ethnicity for answers.

Vaccination Rate Differences and Politics

It’s been pretty well documented that there’s a correlation between covid-19 vaccination levels and 2020 presidential election voting patterns. Numbers show that, overall, states and counties that voted for Biden have higher vaccination rates than states and counties that voted for Trump.

Numerous polls (KFF, Monmouth, Washington Post-ABC News, and others) have consistently found that Republicans are much more likely to say that they definitely do not want to get vaccinated and Democrats are much more likely to report having been vaccinated.

Data show that the top 22 states (including D.C.) with the highest adult vaccination rates all went for Joe Biden in the 2020 presidential election. Maryland is number six on that list, as of July 28. Trump won 17 of the 18 states with the lowest adult vaccination rates. Almost all U.S. counties below 20 percent vaccination rates lean Republican, and almost all above 65 percent lean Democratic.

Do the nine counties of the Eastern Shore follow this pattern? Let’s look at the data for percent of total population that has gotten at least one shot, as of July 27. Because these are rates of total population, they are much lower than rates calculated with only adults.


The two counties that went for Biden — Talbot and Kent — have the highest (65.9%) and third highest (61.5%) vaccination rates in this group. Worcester County is the outlier — it went for Trump by 17 points, but has the second highest vaccination rate (63.1%). Wicomico County was close in the election; it went for Trump by only 1.9 points, but has the second lowest vaccination rate (47.3%) in this group.

 

For comparison, Maryland’s vaccination rate is 59.6%. In the U.S. it is 56.9%.

 

Overall, the pattern mostly holds true for the Eastern Shore counties, although it is not the case that vaccination rate is proportional to support of either candidate.

 

In the past few weeks, some GOP lawmakers and conservative media figures have changed course and are now encouraging hesitant people to get vaccinated. The current sudden rise of cases, hospitalizations, and deaths due to the extremely contagious and virulent delta variant is overwhelmingly in states and counties that have lower vaccination rates. CDC Director Rochelle Walensky called it a “pandemic of the unvaccinated.”

 

Vaccination Rates and Social Vulnerability Index

 

It is clear that vaccination rates for counties do not depend solely on partisanship. For an insight into what some of those other factors could be, let’s take a look at vaccination rates and the Social Vulnerability Index.

 

The Social Vulnerability Index was created by the Centers for Disease Control and Prevention more than 20 years ago to help emergency response planners and public health officials identify and map communities that will most likely need support before, during, and after a hazardous event. The coronavirus pandemic is one such hazardous event.

 

The index assesses four themes in each community — socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. Scores are used to determine the degree to which these factors would influence the ability of local officials to react effectively to disasters and disease outbreaks.

 

Scores are generated at the overall county level and for each theme. They are ranked on a scale of 0 to 1, with 1 being the most vulnerable.

 

Social Vulnerability Index Themes Defined:


We would expect to see that counties with higher social vulnerability scores would have lower vaccination rates, due to difficulties in reaching populations of elderly residents, people with limited English proficiency, those without transportation, etc.

 


Queen Anne's County has a Social Vulnerability Index of 0.00 in the chart above — the lowest vulnerability score. We see that the four counties with the lowest social vulnerability scores — Talbot, Worcester, Kent, and Queen Anne’s — have the four highest vaccination rates in the group. The five counties with the highest vulnerability scores have the lowest vaccination rates in the group.

 

Vaccination Rate Disparity by Race/Ethnicity

 

Finally, what role does race/ethnicity play in vaccination rates? Unfortunately, there are no public data on vaccination status by race/ethnicity at the county level, so we’ll have to look at Maryland as a whole.

 

The Kaiser Family Foundation looked at vaccinations by race/ethnicity for the 40 states that reported those data. They found that across all these states, the percent of White people who have received at least one covid-19 vaccine dose (48%) was roughly 1.3 times higher than the rate for Black people (36%) and 1.2 times higher than the rate for Hispanic people (41%) as of July 19.

 

Maryland has done a bit better. Higher percentages of each group have been vaccinated compared with the 40-state composite, but disparities still exist. The percent of White people who have received at least one dose as of July 19 is 61%. This is 1.2 times higher than the rate for Black people (51%) and 1.1 times higher than the rate for Hispanic people (54%).

 


Black people account for 30% of Maryland’s population, but only 26% of total vaccinations; 37% of covid deaths were among Black people. Covid-19 cases were not reported by race/ethnicity in Maryland.

 

Hispanic people account for 11% of Maryland’s population, but only 10% of total vaccinations; 9% of covid deaths were among Hispanic people.

 

White people account for 55% of Maryland’s population and 56% of total vaccinations; 50% of covid deaths were among Whites.




The share of vaccinated Black and Hispanic people has been growing recently relative to White people.

 

Recent surveys reveal that the population of unvaccinated can actually be subset into two groups: those who are adamant in their refusal of the vaccine (the “definitely nots” — 45% of unvaccinated), and those who are open to being persuaded (the “wait and sees” — 35% of unvaccinated). The former group is overwhelmingly White, Republican, and younger, and represents 15% of Americans; the latter group includes many younger people, Black and Hispanic Americans, and Democrats.

 

Among the “definitely nots, ” 83% believe that the seriousness of covid-19 is exaggerated, and 88% are not worried about getting sick from covid. Among the “wait and sees,” 78% believe the vaccines are not as safe as they are said to be, 44% say they would be more likely to get vaccinated if the vaccines gained FDA approval (rather than provisional approval), and 46% state they would be more likely to get vaccinated if they could do it at their own doctor’s office.

 

There didn’t look like there was much hope of vaccinating our way out of this pandemic voluntarily. But people may be changing their minds — vaccinations have recently risen in areas hard hit by the delta variant. And lately, some private companies, some local and state governments, and the federal government have decided to require that employees either be vaccinated or wear masks and social distance and get tested weekly or more often. A few private companies are making vaccination a condition of employment. And some businesses (restaurants and theaters, for example) are requiring their patrons be vaccinated. This may be the way out of the mess we’re in.

 

 

Sources:

The Red/Blue Divide in COVID-19 Vaccination Rates is Growing. Jennifer Kates, Jennifer Tolbert, Kendal Orgera, Kaiser Family Foundation.

https://www.kff.org/policy-watch/the-red-blue-divide-in-covid-19-vaccination-rates-is-growing/

 

KFF Covid-19 Vaccine Monitor.

https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid-19-vaccine-monitor-dashboard/

 

Monmouth University Poll.

https://www.monmouth.edu/polling-institute/documents/monmouthpoll_us_062321.pdf/

 

A Third of White Conservatives Refuse to get Vaccinated. Philip Bump, Washington Post.

https://www.washingtonpost.com/politics/2021/07/06/third-white-conservatives-refuse-get-vaccine-refusal-shown-both-polling-real-world/

 

States ranked by percentage of population fully vaccinated: July 28. Katie Adams, Becker’s Hospital Review.

https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-population-vaccinated-march-15.html

 

The 4 main fault lines that divide the vaccinated from the unvaccinated. Umair Irfan, Vox

https://www.vox.com/22587443/covid-19-vaccine-refusal-hesitancy-variant-delta-cases-rate

 

2020 U.S. County Level Presidential Results. Tony McGovern.

https://github.com/tonmcg/US_County_Level_Election_Results_08-20/blob/master/2020_US_County_Level_Presidential_Results.csv

 

COVID-19 Integrated County View. CDC, July 27, 2021

https://covid.cdc.gov/covid-data-tracker/#county-view

 

Covid-19 Vaccine Equity

https://covid.cdc.gov/covid-data-tracker/#vaccination-equity

 

At A Glance: CDC/ATSDR Social Vulnerability Index.

https://www.atsdr.cdc.gov/placeandhealth/svi/at-a-glance_svi.html

 

CDC/ATSDR SVI Data and Documentation Download.

https://www.atsdr.cdc.gov/placeandhealth/svi/data_documentation_download.html

 

Latest Data on COVID-19 Vaccinations by Race/Ethnicity.

Nambi Ndugga, Olivia Pham, Latoya Hill, Samantha Artiga, Noah Parker, Kaiser Family Foundation.

https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

 

KFF COVID-19 Vaccine Monitor: Profile Of The Unvaccinated. Grace Sparks, Ashley Kirzinger, Mollyann Brodie, Kaiser Family Foundation.

https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-profile-of-the-unvaccinated/

 

AP Poll Finds 45% of Unvaccinated Americans say they will definitely not get a shot. Boston Globe, July 23.

https://www.bostonglobe.com/2021/07/23/nation/associated-press-poll-finds-45-unvaccinated-americans-say-they-will-definitely-not-get-shot/


As Delta surges, poll data suggests that unvaccinated America’s opposition to the shots is declining, IPSOS.

https://www.ipsos.com/en-us/news-polls/axios-ipsos-coronavirus-index

 

 

Jan Plotczyk spent 25 years as a survey and education statistician with the federal government, at the Census Bureau and the National Center for Education Statistics. She retired to Rock Hall.

 

Common Sense for the Eastern Shore

Health of His Constituents is Apparently Not a Priority for Rep. Dr. Andy Harris

By Jan Plotczyk • October 8, 2025
The Republican Congress and President Trump are causing a health care crisis and Democrats are trying to fix it. Passed in July, the GOP budget reconciliation bill is drastically cutting health insurance programs to pay for tax cuts for billionaires. Rep. Andrew P. Harris (R-MD01) voted for the budget reconciliation bill. He voted, knowing that his vote would mean that health care costs would rise for 25,000 of his constituents in Maryland’s First Congressional District:

Judge Denies Trump Administration’s Attempt to Stall Maryland Offshore Wind Case Amid Federal Shutdown

By CSES Staff • October 8, 2025
 Efforts by the Trump administration to delay a critical court case over Maryland’s offshore wind project have failed, marking another setback in the president’s campaign to block renewable energy development along the East Coast. On Oct. 2, U.S. District Court Judge Stephanie Gallagher denied a motion filed by the Department of Justice to pause an ongoing lawsuit involving US Wind’s proposed 114-turbine wind farm off Ocean City. The administration had argued that the federal government’s shutdown prevents its attorneys from continuing the case. The judge’s swift rejection ensures that the litigation and progress on one of Maryland’s most significant clean energy projects will continue. Initially filed by Ocean City officials and a small group of residents nearly a year ago, the suit challenges the federal approval of US Wind’s project, which would deliver enough clean electricity to power more than 700,000 homes. Under the Biden administration, the federal government had defended the project in partnership with US Wind. That stance was reversed after Trump took office earlier this year and installed officials hostile to offshore wind. In September, the Trump administration filed a separate motion seeking to vacate federal approval for the Maryland project altogether, a move widely condemned by environmental advocates, labor groups, and business leaders who see offshore wind as a cornerstone of Maryland’s energy and economic future. US Wind responded forcefully to the shutdown motion, warning the court that the administration’s attempts to delay proceedings could allow it to undermine the project’s approval behind the scenes quietly. The company argued that halting the case would create “existential risks” for the future of Maryland’s offshore wind industry. Judge Gallagher agreed that the case should move forward, setting the next status hearing for Oct. 7. The Trump administration’s repeated efforts to obstruct offshore wind development come as Maryland and other states have invested heavily in building the infrastructure, workforce, and port facilities needed to anchor the growing clean energy industry. Maryland Gov. Wes Moore has championed the sector as a key driver for well-paying jobs and long-term economic resilience for the Eastern Shore. Supporters of US Wind point out that the project will bring over $1 billion in investment to Maryland, generate thousands of construction and maintenance jobs, and help deliver cleaner, more affordable energy to homes and businesses across the region. “Offshore wind isn’t just about turbines, it’s about jobs, innovation, and independence,” one clean energy advocate said after the ruling. “Every delay costs working Marylanders opportunity, and this decision ensures progress continues.” While the broader lawsuit over the project’s approval is ongoing, the latest ruling represents a clear win for those fighting to keep Maryland’s offshore wind future on track — and a blow to Trump’s attempt to turn back the clock on clean energy.

Should We Pin Our Hopes on Mid-Cycle Redistricting in MD-01?

By Jan Plotczyk • October 8, 2025
Maryland has eight congressional districts, and the seats for all but District 01 are filled by Democrats. As we well know, the First District representative is a Republican — Andrew P. Harris. Here’s what Maryland’s congressional district map is now.

Megan Outten Kicks Off Wicomico County Council District 7 Campaign with Packed Crowd and Strong Early Momentum

By CSES Staff • October 8, 2025
With standing room only at Salisbury’s Historic Poplar Hill Mansion, and blending policy, community service, and grassroots energy, Megan Outten launched her campaign for Wicomico County Council District 7 before almost 100 supporters on Oct. 4. The event drew community residents, labor leaders, and local officials, many of whom also helped to pack nearly 300 care kits for Wicomico residents in need. The community service effort doubled as a campaign statement about what Outten calls “choosing connection over convenience.” District 7 is one of Wicomico’s newly drawn single-member districts, with a Democratic advantage of 7.7%. Outten recalled her family’s history of service in Fruitland and Salisbury. “Service isn’t just politics in my family,” she said. “It’s how you belong to a place. It’s how you prove you care.” She pointed to the county’s landfill crisis, water and septic system failures, and school underfunding as examples of leadership that reacts rather than plans. “This is what happens when leaders only react after things break,” she said. “It costs us more. It hurts families. It robs our kids of the future they deserve.” Outten was joined by several local leaders who offered strong endorsements and reflections on her record. AFSCME Local 3 Eastern Shore representative Jack Hughes praised her leadership on the Salisbury City Council, crediting her with helping pass the Eastern Shore’s first municipal labor code, a significant win for city workers and first responders. Councilman Josh Hastings, who represents the district and is running for the Maryland House of Delegates in District 38B, said Outten would be “crucial in carrying forward the progress we’ve made” on clean water, schools, and infrastructure planning. Whitney Snowden-Olanrewaju from Blending Cultures, a non-profit organization that promotes diversity and equality, spoke about Outten’s record of community inclusion and bridge-building across diverse groups. Outten’s campaign is expected to roll out additional endorsements in the coming weeks. In her speech, she outlined a platform focused on fully funding schools, investing in infrastructure before it fails, and ensuring that county government works for everyone. “This campaign is not mine,” she told the crowd. “It’s ours. I am not standing above you. I am standing with you. And together, we will put Wicomico families first.” With enthusiasm, endorsements, and her message that’s focused on service and accountability, Outten’s kickoff reinforced that District 7 is already shaping up to have a strong favorite in 2026.

Community Rallies After Theft of Car Containing Hundreds of Care Kits for Wicomico Residents in Need

By CSES Staff • October 8, 2025
An act of inhumanity in Salisbury has sparked an outpouring of compassion. Early on Oct. 5, community organizer Jared Schablein’s car was stolen from his backyard. Inside the vehicle were hundreds of care kits assembled just days earlier during Megan Outten’s Wicomico County Council District 7 campaign kickoff event. Packed by volunteers at Salisbury’s Poplar Hill Mansion, the kits contained feminine hygiene products, socks, and toiletries meant for Wicomico County residents facing housing insecurity. “Those kits were meant for neighbors in need,” said Schablein. “If nothing else, I hope whoever took them returns them. Getting those care kits to the folks who need them matters more to me than anything else.” Schablein and Outten have turned the theft into action, launching a new effort called the “Care Kits Comeback Drive.” The event, scheduled for Oct. 12 at 2pm at Poplar Hill Mansion, aims to replace every lost kit, and more. Volunteers are asked to bring or donate items such as sanitary wipes, socks, toothpaste, period products, and underwear. Donations will support the Wicomico County Library, Help and Outreach Point of Entry, and other local service organizations. In announcing the new drive, Schablein emphasized the deeper meaning behind the effort: “When acts of inhumanity happen, the best response is acts of humanity. We’re showing that Salisbury’s compassion can’t be stolen.” Despite the setback, organizers say community support has been overwhelming. Donations began arriving within hours of the announcement, and several local groups have offered to distribute supplies once the new kits are complete. The theft is still under investigation by the Salisbury Police Department. As one volunteer put it at the last event, “Community isn’t guaranteed, it’s built.” This Sunday, Salisbury will build it again.

Momentum Builds to Save Connelly Mill Park: Community Leaders and State Officials Unite Around Vision for Wicomico’s “Central Park”

By CSES Staff • October 8, 2025
What began as a grassroots campaign to preserve a parcel of local land has become one of the most inspiring community movements on the Eastern Shore. Led by residents James and Mikele Dahlen and Holly Campbell, alongside dozens of volunteers, the Save Connelly Mill Park effort reached a significant milestone last week as Maryland Secretary of Natural Resources Josh Kurtz toured the site with local and state officials to explore opportunities for partnership and permanent protection. On Sept. 23, citizens gathered at Connelly Mill Park with a delegation of state and county leaders, including Sen. Mary Beth Carozza, Del. Barry Beauchamp, County Council President John Cannon, Vice President Jeff Merritt, Councilman James Winn, and local municipal representatives from Delmar and Salisbury. The tour marked the strongest signal to date that the state may play an active role in turning the park’s long-promised vision into reality. Advocates for Save Connelly Mill Park presented Kurtz with a booklet outlining the site’s environmental, historical, and economic importance. The presentation highlighted Connelly Mill’s potential to become a keystone of Wicomico’s park system — protecting the Paleochannel aquifer, preserving wildlife habitats, and providing much-needed green space for recreation and community gathering. Located just five miles from Salisbury, the 234-acre property has rolling forest, wetlands, and unique topography that advocates say could one day make it the “Central Park of Wicomico County.” “The natural beauty of Connelly Mill spoke for itself,” said one organizer after the event. “What we have here is not just land, it’s a promise to future generations.” Adding to the momentum, the community’s advocacy materials were presented directly to Maryland Gov. Wes Moore the next day at the Tawes Crab and Clam Bake in Crisfield, where he was briefed on the citizens’ efforts and growing local support. The proposed park would provide walking trails, open space for families, and educational opportunities while safeguarding vital water resources and promoting mental, physical, and social well-being for county residents. For many, the movement to save Connelly Mill has come to represent more than just one park. It’s about accountability, long-term planning, and ensuring public commitments to community spaces are kept. “We’re not out of the woods yet,” the group shared in a recent update. “But the spotlight is on Connelly Mill, and the momentum is growing.” As the state evaluates whether to designate Connelly Mill as a Partnership Park, supporters say they will continue to meet with officials and rally community engagement to ensure this once-forgotten project finally fulfills its promise. If realized, Connelly Mill would not only protect vital natural resources — it would stand as testament to what determined citizens can build when they refuse to give up.
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