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BOISE (Idaho Statesman) — Idaho residents living in affluent neighborhoods are more likely to be vaccinated against COVID-19 compared to residents in poorer neighborhoods, according to state data.
Data provided by the Idaho Department of Health and Welfare showed total populations of those who received the COVID-19 vaccine through May 24 and the ZIP codes they provided with their addresses. An analysis by the Idaho Statesman compared those vaccination rates to the U.S. Census Bureau’s American Community Survey demographics and found that in those neighborhoods with higher median household incomes, there were higher vaccination rates.
College graduates are also more likely to get the vaccine, according to the data.
The analysis has some caveats. A comparison to 2019 American Community Survey data is imperfect, since current vaccination rates could be impacted by recent changes in population or ZIP code boundaries. P.O. boxes and ZIP codes with populations of fewer than 500 were excluded.
But public health experts said the analysis generally aligned with similar findings. Dr. Christine Hahn, state epidemiologist, said she had found a link to wealth in her own county-level analysis.
Dr. Ted Epperly, a family doctor and former Central District Health board member, said state officials have made their best efforts to vaccinate hard-to-reach communities and campaign for more residents to protect themselves and others.
“This isn’t a problem of trying,” Epperly told the Statesman. “This is more of a problem of the audience not listening. That’s the important message there.”
The decision to get the COVID-19 vaccine comes down to news sources and to whom the communities are listening, Epperly and Hahn said.
Hahn said she believes households with higher incomes might have a greater trust in government and traditional scientific sources. Hahn used the example of Dr. Anthony Fauci, who was known to her as a credible scientist in the National Institutes of Health long before most of the public knew his name.
“Scientists work very hard to defeat that bias and come out with what they think is the truth,” Hahn told the Statesman. “I tend to have trust in most of them that that’s what they’re doing. I think that not everyone looks at the world that way. … There’s a divide there as far as trust in the source.”
HOUSEHOLD INCOME TIED TO WORK FLEXIBILITY, HEALTH EXPERTS SAY
Amy Gamett, director of clinical services at Eastern Idaho Public Health, agreed that it’s less about the vaccine being accessible and more about people’s choices.
Gamett said the public health district has tried all kinds of ways to improve vaccination rates among harder-to-reach populations.
The district has provided walk-in Spanish-speaking clinics. It has started a call center, where people who aren’t ready to book vaccine appointments call with specific concerns. It conducted a phone bank in the early stages, when older people may have struggled with booking online appointments. And a postcard campaign will be underway in the next one or two weeks.
The district is trying to partner with other groups or institutions to bring vaccines to underserved communities at food banks or a housing coalition that provides resources to homeless communities. But the district has been getting much fewer requests for workplace clinics or homebound services, Gamett said.
Gamett said she keeps reminding her staff that the time when they would have 1,000 people attend a vaccination clinic is over and that they should recognize the small victories.
“We have to be OK when it’s 23,” Gamett told the Statesman. “We have to celebrate those wins as well. We’re in a different place than we were in March or April.”
Data collected by the state also showed relatively low vaccination rates among Hispanic populations. But it’s unclear how wide of a gap there may be due to incomplete information. The state did not collect race and ethnicity data from many of those who received the vaccine.
Christine Myron, spokesperson for Central District Health, said by email that the trends show “what is unfortunately too common of a reality we see around health outcomes.” In an emailed statement, she acknowledged that a variety of socioeconomic factors influence someone’s ability and willingness to get vaccinated. Someone in a higher-wage job, for example, is more likely to work at a place that offers paid time off, she said.
Myron said the district has engaged with refugee community members, young people, Spanish speakers, rural community members “and everyone in between who has not yet received the vaccine.”
“These efforts will be ongoing, and are not likely to move the needle quickly,” Myron said via email. “But we believe that continued efforts over time can improve COVID-19 vaccine rates among those who are not yet vaccinated, regardless of their socioeconomic status.”
WHAT MAKES IDAHO RESIDENTS GET THE COVID-19 VACCINE?
Bert Baumgaertner, associate professor at the University of Idaho, studied vaccination attitudes that predate COVID-19. His study was published in October 2020 and was prompted by measles cases that spiked in 2018.
But the study had similar conclusions: The willingness to get vaccinated was linked to someone’s income, age and ideology.
An increase in wealth can sometimes mean a more flexible job, Baumgaertner said.
“Convenience is also a very real concern,” Baumgaertner said. “If it takes someone a much longer drive to go somewhere to get vaccinated, they’re less likely to do so than someone who is just a few blocks from, say, a Walgreens, where they can go get vaccinated.”
In an Idaho survey of adults who haven’t been vaccinated against COVID-19, conducted in early June, 64% of those who planned to get the vaccine said they needed time off work.
Among those who said they “definitely” would not get vaccinated, the vast majority said it was because they didn’t trust science. Those who said they “probably” would not get the vaccine were waiting to see how the vaccinations were going.
When the Johnson & Johnson COVID-19 vaccine was linked to blood clots, despite their rarity, that news also set the state back, Hahn said. State officials had initially planned to use the single-dose vaccine for harder-to-reach communities. Hahn said the vaccine helped until it was put on pause.
The Centers for Disease Control and Prevention and Food and Drug Administration confirmed 38 cases of the blood-clot syndrome, out of more than 12.3 million people who received the dose. Injections resumed after a brief pause.
“There was a loss of faith in the vaccine in some communities that this wasn’t safe,” Hahn said.
ZIP CODES, VACCINES AND RESIDENTS’ AGES
Elderly residents at high risk of COVID-19 have high vaccination rates in Idaho. Some affluent ZIP codes had high rates of older people; 83616 in Northwest Boise, for example, had a median age of about 48 and a vaccination rate of over 57%. About 30% were 60 or older.
But other areas — such as 83716 in Boise, with a 67% vaccination rate and a median household income of over $96,000 — did not have high rates of older residents.
A ZIP code in North Idaho, 83822, had a median age older than 57 but a vaccination rate of 11%. About 41% were 60 or older.
State officials tout their successes in getting Idaho’s older residents vaccinated. As of this week, about 80% of those 75-84 have gotten vaccinated against COVID-19, according to the state. Getting younger populations vaccinated, however, has gone more slowly than Idaho’s public health experts were expecting.
Idaho’s vaccination rate for those 12 and older was 47.6% through Wednesday. The national average was 63.4%.
Hahn said that with the amount of misinformation being circulated around the vaccines, public health experts must ensure that providers are given clear, accurate information about the risks and benefits involved in the vaccine for every age group.
“We need to continue to work hard with our providers to make sure they have the confidence and ability to either provide the vaccine or strongly recommend it for the patients that they feel should get it,” Hahn said. “We need to have clear language for parents. I think CDC’s working on that and we’re trying to make sure providers have that as soon as it’s available.”
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