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COVID-19 vaccination coverage higher in urban U.S. counties — except in Arizona

A new CDC study of COVID-19 vaccination rates shows the nationwide gap between urban and rural areas more than doubled in the past year, with urban counties beating rural counties everywhere — except in Arizona

First-dose vaccination coverage was less than 59% in rural counties nationwide versus 75% in urban counties, with the largest gaps among children and adolescents.

Similar patterns held true for second doses and boosters.

But not in Arizona, which had higher rural rates than urban.

When asked to explain the unusual result, the CDC replied that it had "considered several hypotheses, but there is not enough evidence at this time to determine why vaccine coverage was higher in Arizona's rural counties compared to urban counties. Further research is needed to better understand these findings."

But Dr. Dan Derksen, who directs University of Arizona's Center for Rural Health, was not surprised Arizona's rural counties did well, despite the state's failure to curtail preventable deaths.

"Once the vaccines became available, we actually did pretty well as a state as far as getting those eligible to be vaccinated vaccinated in our rural communities," he said.

Derksen cited cross-border collaborations, efforts by the Navajo Nation and county successes in bringing vaccinations to rural laborers.

"They were very creative about ways to get vaccinations out to the harder-to-reach populations," he said. 

But Derksen was quick to add that the work of educating and making vaccines available to all Arizonans is not finished.

"How do we get people to their trusted health providers to make sure that they get the education information they need so they can make prudent decisions for themselves and for their family members about being vaccinated and being protected going forward?" 

Nicholas Gerbis was a senior field correspondent for KJZZ from 2016 to 2024.