Wide gulfs exist in COVID-19 vaccination rates across southwest Ohio — the rates in some communities are more than three times higher than others, a Dayton Daily News investigation found — exposing many long-term disparities and undermining efforts to end the pandemic.
Area hospital officials say nearly nine out of 10 of those hospitalized in intensive care units for COVID-19 in the most recent surge and 84% of those who died were unvaccinated. Local health experts say they are working hard to increase vaccination rates in remote and underserved areas, but are stymied by challenges including misinformation and mistrust.
Our investigation found:
- Statewide, 60% of eligible Ohioans are fully vaccinated. But ZIP codes within our region range from below 30% to 79% vaccinated.
- Overall, vaccination trends tend to correlate with other factors related to health outcomes, such as poverty and education.
- The vaccination rate for white residents is higher than for Black residents in area counties and across Ohio, while Black Ohioans who get COVID-19 disproportionately end up hospitalized. In Montgomery County, 56% of white residents are vaccinated, while 45% of Black residents have gotten the shot.
- Rural counties with the lowest vaccination rates have seen the most deaths per 100,000 residents; meanwhile the counties with the highest vaccination rates have seen the lowest deaths per capita.
Dr. Terri Moncrief, a Dayton-area allergy doctor, said she constantly runs into vaccine concerns. She sees both rural and minority patients at particular risk from COVID-19 because of issues like asthma and obesity.
“Early on, it was more of the vaccine was rushed and there was not enough research that had been done on the vaccine. There were some concerns about conspiracy theories very early on,” she said “But now what I’m hearing more of is people have a false sense of their risk being lower than it likely truly is.”
The vaccination map follows the same patterns as other maps of health outcomes — with lower socio-economic areas facing disproportionate risk.
For example, none of the 10 ZIP codes with the highest poverty levels had vaccination rates above 50%. Most of the 10 ZIP codes with the lowest poverty levels were at least 60% vaccinated.
Likewise educational attainment correlates with vaccination rates. Most of the ZIP codes with the highest percentages of college graduates have vaccination rates over 70%. Most of those with the lowest percentage of college grads have rates under 45%.
“(The numbers) are a little disheartening,” said Montgomery County Health Commissioner Jennifer Wentzel. “We want to have our vaccination numbers more than what the state average is of course, and getting vaccines in the community is very important. That’s why we’ve had very deliberate efforts over the past year to make that happen.”
Tale of two ZIP codes
Two ZIP codes tie for least vaccinated in Montgomery County at 41% of the eligible population vaccinated: 45345, which is New Lebanon and some surrounding area, and 45417 in West Dayton.
Both New Lebanon and West Dayton have higher levels of poverty and lower levels of educational attainment, according to census data.
In the New Lebanon ZIP code, 18% of the population is below the national poverty line and of adults 25 years and older, 10% have no high school diploma or equivalent (9% have a Bachelor’s degree or higher). In the West Dayton ZIP code, 35% live below the poverty line and 22% of people 25 and older have no high school diploma (10% have a Bachelor’s degree or higher).
While the ZIP codes touch and share some characteristics, some stark differences exist. New Lebanon is majority white and residents describe the community as rural. West Dayton is majority Black and more urban. The majority of all Dayton voters (about 70%) voted for Joe Biden, while over 70% of New Lebanon voted for Donald Trump in the 2020 presidential election.
New Lebanon Mayor Ray Arriola doesn’t know why his community is less vaccinated than other parts of the county. Arriola said he does not believe COVID-19 is a serious threat to New Lebanon and he has not been vaccinated, nor is he considering getting the shot.
“My opinion is just that the citizens, maybe they’re doing their research and seeing what the side effects are from the vaccines,” he said. “I’ve been doing my own research, and I’ve seen what’s been going on around the country and even the world with the side effects.”
The U.S. Centers for Disease Control and Prevention monitors side effects from vaccines and makes data publicly available. The CDC now recommends getting the Pfizer or Moderna shots over the Johnson & Johnson vaccine because of 57 cases of blood clots after 18 million administered doses of J&J. The risk of contracting COVID-19, by contrast, is much higher.
Danielle Parker, a 23-year-old Miami University student from New Lebanon, said she thinks her community is less vaccinated because of lack of education and a perception that there aren’t common gathering places to spread the virus.
“We really only have a McDonald’s,” she said. “So a lot of people don’t see a reason to get vaccinated because there’s not like a bowling alley here a lot of people go to or a movie theater a lot of people go to, so no one’s really gathering. There’s not a huge reason to get it for people around here.”
Parker was required to get the vaccine for school but says that she would have gotten it anyway. She thinks if people heard from other community members who got the shot, they might be convinced to get it.
Her family, whom she describes as old-fashioned, haven’t gotten the shot. Parker thinks getting the message out that the vaccine protects your community might help.
“It’s to protect the older people, your family or the people around you. And just I guess pulling people’s heartstrings works a little better than just being like, ‘You know, it’s for your own safety’. A lot of people are like ‘Oh, I’ll just hide out in my house. It’ll be fine,’ ” she said.
As part of LaShanda Jones’ job working the front desk at Samaritan Health Center in the 45417 West Dayton ZIP code, she asks patients if they’ve gotten the coronavirus vaccine. If they haven’t, then she often asks them why.
“And the first thing they say is it was made too quick, the government is trying to inject a chip into us and track us and why get the shot if you still can get COVID,” she said. “Some just don’t trust the government. I mean, that’s really what it boils down to.”
Jones said people don’t like being told they have to get the shot.
“I’ll use my daughter as an example. She wasn’t going to get it at first because they were paying people to get it. So she thought that was like a conspiracy,” she said.
Jones, her daughter (who works in health care) and much of their family did eventually get the shot. Jones said she believes in science and in God.
Ashley Odon, a 33-year-old mother of three who works at Smith’s Carry-Out in Westwood and lives in the same
ZIP code, doesn’t get any vaccines for her or her kids.
Odon doesn’t have any sources she trusts for information on vaccines.
“(I trust) no one, really. I looked into it myself when Johnson & Johnson was having that big debate about whether it was good or not,” she said. “I just Googled it.”
Most vaccinated communities
In ZIP codes 45419 (Oakwood/Kettering) and 45458 (Centerville/Washington Twp.), 79% of the eligible population is completely vaccinated against COVID-19.
Both Oakwood and Centerville/Washington Twp. have high levels of educational attainment and low levels of poverty. In the 45419 ZIP code, 54% of residents have a bachelor’s degree or higher and 7.5% live below the poverty line. In the 45458 ZIP code, 55% have a bachelor’s degree or higher and 6% live below the poverty line.
Sitting in the Centerville Library, Peter Jones said he believes the vaccines are safe and effective, based primarily on advice from medical professionals he knows personally.
He said he believes that area has a higher vaccination rate because Centerville has a sense of community that leads people to work together to support businesses and keep their neighbors safe.
“That spirit of community is very evident, very real,” he said.
Library patron Eddie Conduff said he had concerns and held off getting vaccinated until this January.
“A friend of mine got really ill, and my wife and I went and got our shots,” he said.
The racial divide
Statewide, 42% of eligible Black residents are vaccinated compared to 53% of white residents and the disparity plays out locally.
“We are becoming instruments of our own destruction because of messaging,” said the Rev. Benjamin Speare-Hardy of St. Margaret’s Episcopal Church in Trotwood, a majority Black congregation in a majority Black town.
Speare-Hardy and other area pastors have worked with Public Health-Dayton & Montgomery County to increase vaccination rates in the community, offering vaccines at church and doing a podcast. But he said the young population is particularly hesitant.
Prominent, respected members of the community should continue being vocal about why they are vaccinated and encourage others to do so, Speare-Hardy said.
“We have to lead by example,” he said. “We have to keep preaching and fighting against the hesitancy.”
Fabrice Juin, project manager for the Dayton & Montgomery County Local Office of Minority Health, said discrepancies in health issues between ZIP codes is not a new phenomenon.
“When you consider the different struggles that people go through, for most, COVID-19 is not the No. 1 crisis that they’re going through in life in terms of making sure they can make ends meet,” he said.
At this point, Juin doesn’t believe many access issues exist for residents who want the shot. Coronavirus vaccines are widely available at pharmacies and the health department has held clinics in underserved areas. Juin said a plethora of misinformation about vaccines online continues to influence people.
“Our new focus involves normalizing vaccination. Not making it the hot topic that it has been so far, but presenting it as something that over 60% of Ohioans and close to half of Montgomery County’s Black and African American population is taking advantage of,” he said. “We know it’s going to take some time to get there, but we remain committed to not leaving anyone behind, as we pull ourselves out of this as a community.”
Howard Rucker, a 40-year-old phlebotomist at Miami Valley Hospital who is Black and lives in the 45417 ZIP code, said he was initially unsure about getting the shot. But after witnessing so many unvaccinated people die from COVID because they didn’t get the shot, he said it was common sense.
Rucker said people in his community are scared and lack definitive information about coronavirus vaccines. He agrees that hearing from other people who are vaccinated might convince people.
“Proof. Something that I do when people ask me did I get the vaccine, I keep my vaccination card with me and I show them,” he said.
Survey: Why people forgo jab
Respondents to a Dayton Daily News survey asking people why they haven’t gotten vaccinated don’t believe the vaccine is safe or effective. Many believe the media and government are underplaying the dangers of the vaccines and overplaying the risk of COVID-19. Many also point out that people who are vaccinated are getting COVID.
These sentiments were shared by many people coming and going from the BMV in downtown Franklin, where fewer than half of eligible residents are vaccinated.
“You don’t know what the side effects are going to be. It could be years before you know the side effects,” said Mark Jewett.
Jewett said his doctor encourages the vaccine, but he is still worried about it. Like most people interviewed in Franklin and who responded to the survey, he has zero trust in the government. Many people said they trust no one but themselves.
Patricia Scott said she was concerned about things she read online and heard from people about the vaccine. But she ended up getting it because her doctor said she should because of other health issues.
“Once my heart doctor and my primary care signed off that I could get it, I really didn’t have a choice,” she said.
The rural divide
Craig Carafa is the owner and pharmacist at Saint Paris Pharmacy, which serves two of the lowest vaccinated ZIP codes in rural Champaign County where the rates are 33% and 38%.
“It’s heartbreaking for me, as both a pharmacist and a member of the community,” he said of the resistance he hears to the vaccine.
“The amount of people recently we’ve done some vaccinations for is because they know someone who unfortunately has passed away from it,” he said.
He said he talks to people about the science showing the vaccines are safe and effective. He respects his customers’ freedom to choose if they want it or not, but worries about those who are vulnerable and refuse.
“All I can do is offer the opportunity and go to your house to do it, and we will,” he said.
Of the 17 ZIP codes with vaccination rates under 40%, 14 are in rural Darke and Preble counties.
Darke County Health Commissioner Terrence Holman said they offer several vaccine locations and try to address misinformation. They plan to start posting educational billboards and offering clinics in Bradford and Union City, where $100 cash cards will be offered.
“We are a very rural, conservative county. People don’t feel as at risk due to being so spread out,” he said.
Adjusted for population, however, Preble and Darke counties have the highest numbers of deaths from COVID-19 in the region per 100,000 residents, according to a Dayton Daily News analysis of Ohio Department of Health data.
Who to trust
Politics plays a muddying role as well. People interviewed often invoke their dislike and mistrust of President Joe Biden.
Warren and Butler counties, however, which are staunchly conservative and voted for Trump by a nearly 2-to-1 margin in 2020, have the highest countywide vaccination rates. They also have the lowest number of COVID-19 deaths per 100,000 population.
Trump himself received vaccines and booster shots, and he has expressed frustration with people not giving his administration enough credit for developing the vaccines.
Butler County Sheriff Richard K. Jones, a 2016 Trump delegate and vocal conservative, said he took heat recently for releasing a video urging people to take precautions to protect themselves against COVID-19.
Jones said three of his employees have died from COVID. And in the first month of this year, the 70 cases among his staff are almost as much as the 80 cases each of the previous full years.
Jones said he was vaccinated last year after his antibodies from having COVID previously started declining. He said anti-vaccine people he knows are smart, hard-working people with good reasons not to trust the government and understandably not wanting to be told what to do.
“Here’s what I tell them: It’s your choice. I got my shots. It’s up to you,” he said. “I don’t get my medical advice from any politician, I get my medical advice from my doctor.”
Why Miami County isn’t in this story
The Miami County Health Department was unable to release data for this story because it could not get permission to do so from the Ohio Hospital Association. The Ohio Department of Health likewise would not release vaccination percentages by eligible population by ZIP code statewide.
The Ohio Department of Health on a daily basis reports ZIP-code level COVID-19 vaccination numbers to the Ohio Hospital Association. The hospital association analyzes those numbers and makes vaccination rates by ZIP code available to hospitals and local health departments. But OHA says the system it uses is proprietary, and state officials are not allowed to release this information to the public.
For this story, the Dayton Daily News used Ohio public records law to obtain the data from eight area county health departments. This data shows local disparities in protection against COVID-19 not reflected in countywide numbers released by the Ohio Department of Health.
ABOUT THE PATH FORWARD
Our team of investigative reporters digs into what you identified as pressing issues facing our community. The Path Forward project seeks solutions to these problems by asking how the community can overcome the COVID-19 crisis and prevent another one. Follow our work at DaytonDailyNews.com/path-forward.