There is a clear correlation between COVID-19 vaccination rates and political affiliation in Oregon counties, and experts say it’s about more than just politics — it’s also about where and how people live, how they feel about authority and whether they believe they have a voice in how government decisions get made in this state with deep partisan divides.

University of Oregon political science professor emerita Priscilla Southwell says that while vaccines are not inherently political, they have become so in much of the United States. In Oregon, areas where a majority of people are registered Republicans report lower vaccination rates. But Southwell says another, and perhaps more influential, type of demographic split is at play.

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“That’s just the difference between rural and urban counties in Oregon and that phenomenon growing,” Southwell said. “People who live in rural areas, in general, tend to vote for the Republican Party.”

An unvaccinated patient fights COVID-19 in the St. Charles Health System in Central Oregon. Rural counties in Oregon have seen a surge in cases from the delta variant of the virus, which has predominantly hospitalized unvaccinated people.

An unvaccinated patient fights COVID-19 in the St. Charles Health System in Central Oregon. Rural counties in Oregon have seen a surge in cases from the delta variant of the virus, which has predominantly hospitalized unvaccinated people.

Video still / St. Charles Health System

Southwell says rural areas, by definition, are more sparsely populated and have more people in blue collar jobs. She says there are a number of reasons rural areas tend to have a higher percentage of Republican voters. People in rural areas have historically taken on a more libertarian view of government, but when forced to vote in a two-party system, they will tend to side with Republican candidates and legislature.

“The Libertarian Party, which barely exists anymore, does have an appeal to both left wing and right,” Southwell said. “A lot of it is just a hands-off approach to government and authorities in particular, so that kind of feeling is much more predominant in Eastern and rural Oregon in general.”

Additionally, Southwell said people in rural areas tend to oppose gun control laws proposed by Democratic lawmakers. Others, she says, disapprove of high taxes, and they tend to have religious beliefs that align more closely with the Republican Party.

Southwell said if you already align a political party or political figurehead because of how they lean on certain issues, it’s easy for people to adopt the standpoint they have on other issues as well.

“Obviously there are opinion leaders and pundits, and whether they’re giving false information or not, they are discouraging people from getting the vaccine,” Southwell said. “And if you align with that particular spokesperson or that particular political leader, usually on the right, then you’re going to sort of fall in.”

And Southwell said this is happening in Oregon, where some Republican lawmakers have kept their vaccination status a secret. Eight out of the 10 counties with the highest vaccination rates voted for Joe Biden in the 2020 presidential election and the 10 counties with the lowest vaccination rates all voted for Donald Trump.

“It’s a kind of a distrust and an alienation from political elites which has now trickled over to medical elites,” Southwell said.

Alsea School District Superintendent Marc Thielman reads over the language of a federal disability anti-discrimination law in his office on the rural school campus in Alsea, Ore. Thielman says parents who oppose Oregon Gov. Kate Brown's statewide school mask policy can use a part of the law to get an accommodation that would allow their children to opt out of the mandate. (AP Photo/Gillian Flaccus)

Alsea School District Superintendent Marc Thielman reads over the language of a federal disability anti-discrimination law in his office on the rural school campus in Alsea, Ore. Thielman says parents who oppose Oregon Gov. Kate Brown's statewide school mask policy can use a part of the law to get an accommodation that would allow their children to opt out of the mandate. (AP Photo/Gillian Flaccus)

Gillian Flaccus / AP

Public health agencies in these rural areas are left with the particularly challenging task of trying to encourage vaccinations against COVID.

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Robert Duehmig, interim director of the Oregon Office of Rural Health, said that as far as he’s aware, all Oregon public health agencies are united in supporting the vaccine, regardless of the political tilt in individual counties.

“I think that at a time when our country is pretty divided on so many issues, and the pandemic itself, the vaccine just got lumped into that discussion and those challenges,” Duehmig said. “So it’s the politicization of it. The divisiveness of where we are in our political discussions today certainly have created a challenge on making sure that the right information gets out there.”

Public health challenges in rural Oregon

As vaccines became more available last winter, Duehmig said rural health agencies found success with administering doses at local doctor’s offices, pharmacies and clinics versus the mass vaccination sites utilized in urban areas.

“They were getting information that they needed directly from the providers they trusted, which is their own provider,” Duehmig said. “And I think that was extremely helpful.”

Duehmig said in rural areas, distrust of authority is common. In response, rural health agencies have been focusing on education about vaccines, rather than trying to mandate them.

“It’s about the vaccine and what it does versus ‘you must do this or you shouldn’t do that’,” he said. “I think what we’ve seen is that there’s been a slow but steady increase in many of these communities as people have been more confident in the vaccines.”

Still, rural, Republican-leaning counties are well behind urban, Democratic ones as far as vaccine rates. Southwell said while this isn’t unique to Oregon, it’s fairly unique to the United States. She said in other Westernized nations, vaccination rates and political affiliation are unrelated.

Related: COVID-19 deaths are much higher in Washington’s Republican counties, analysis shows

“So this is something that has been cultivated, frankly, I think particularly by Republican leaders in the United States,” Southwell said. “Because it is not a phenomenon among other Conservative governments, at least in Western Europe.”

Oregon’s unique political makeup adds to the tension: The state has several heavily populated Democratic counties, and many sparsely populated Republican counties, creating a dynamic in which a large portion of the state — at least geographically speaking — is left with less power in state government.

“It looks very strange that you have about six or seven very blue counties, and yet they control the state legislature and they control the governor’s office,” Southwell said. “There’s a great deal of resentment in the sense that a lot of these conservative Republicans in eastern Oregon, feel as if they’re outnumbered, which they are.”

As the number of vaccinations being administered dwindles throughout the state, health agencies are still battling misinformation about the COVID-19 vaccines.

“The bottom line is that the science of this doesn’t change,” Duehmig said. “The vaccines work, and they keep the infection rates down, and if you do happen to get a breakthrough case, you are very less likely to end up in a hospital. Those are points that don’t change and I think they just need to continue to be shared. And as we move farther and farther through this pandemic, we just hope that those messages will continue.”

Duehmig said while stats on vaccination rates can offer a quantitative picture of public health efforts, the reason why people do or don’t get vaccinated is much more complicated.

“This isn’t going to be the last time we’re going to have a big challenge like this,” Duehmig said. “And there’s not been a lot of research done into the pandemic as far as people’s attitudes, there’s been a lot of polling, but that’s very different from really good research.”

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