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Study led by Ohio University professor offers clues to address vaccine resistance in Appalachian Ohio

By: David Forster
Posted on: Thursday, February 24, 2022

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ATHENS, Ohio (WOUB) — Southeast Ohio as a region has the lowest COVID-19 vaccination rates in the state.

Zelalem Haile saw this coming. He has some insights into why the rates are so low and what might be done to improve them.

Haile is an associate professor of epidemiology at Ohio University, and he led a study early last year on COVID-19 vaccine acceptance in Ohio.

The study involved a representative sample of Ohio adults, who were surveyed in January 2021, just before the start of the vaccine rollout in the state.

What Haile and his fellow researchers found then was that about 59 percent of Ohio’s population was open to getting a COVID-19 vaccination.

Now, just over a year later, 66 percent of the adult population in Ohio is fully vaccinated. But vaccination rates vary significantly by region, which Haile expected based on the study published this month in the journal BMC Public Health.

“We found lower rates overall in acceptance in Appalachian Ohio and … this finding actually mimics the current state of the current level of vaccination proportions in Appalachian Ohio,” Haile said.

For most counties in southeast Ohio, the percentage of fully vaccinated adults is in the 40s, and it’s in the 30s for Lawrence and Vinton counties.

Haile’s study found that vaccine acceptance appears to vary with certain characteristics, and significant among these are education level and trust in government.

Many counties in southeast Ohio rank in the bottom third when it comes to the percentage of the population with education beyond high school.

And many studies have documented low levels of trust in government and other social institutions in the southern Appalachian region.

Haile said these and other variables that appear to influence vaccine acceptance suggest a tailored approach is needed for vaccination campaigns.

“Each subgroup have unique needs and we have to acknowledge those unique needs and come up with plans that address those unique needs instead of having a TV ad that says let’s pull up our sleeves and get vaccinated,” he said.

And it’s important not just to have the right message, Haile said, but to have the right people delivering that message.

“Individuals who are trusted in the community,” he said. “They have similar shared beliefs. They have the same characteristics. They come from within the community. And they are heard within that community.”

Haile said that raising vaccination rates in southeast Ohio is particularly important because this region has among the highest rates of underlying health conditions that contribute to more serious or deadly cases of COVID-19. 

“So we need special efforts in this region to ensure that they’ll be vaccine compliance,” he said. “Otherwise the longer this pandemic lingers in this subregion the worse the prognosis for the overall health of the Appalachian region will be.”