Abstract
BACKGROUND: The COVID-19 pandemic resulted in the rapid development and distribution of vaccines as a critical strategy to control the spread of the virus. This paper explores COVID-19 vaccine uptake in the state of Ohio, with a particular focus on the difference between metro and non-metro residents. METHOD: Survey data collected as part of the IMPACT-Ohio Project were used for this study. From August 2021 to February 2023, 3,806 individuals who resided in 12 Ohio counties (six metro and six non-metro counties) responded to the survey. Chi-square tests compared the relationships between various demographic, socio-economic and clinical characteristics among metro and non-metro region respondents. Binary logistic regression modeled the probability of receipt of COVID-19 vaccine and compared those Ohioans who lived in metro (RUCC codes 1-3) vs non-metro (RUCC codes 4-9) counties with adjustment of various covariates. RESULTS: Participants residing in metro counties were almost two times more likely to receive the COVID-19 vaccine compared to those living in non-metro counties adjusting for demographic, socioeconomic and clinical characteristics (aOR: 1.89, 95% CI: 1.38-2.58, P < 0.0001). Lower COVID-19 vaccine uptake was associated with younger age (less than 65 years old), lower education level, having no health insurance or public insurance and being food insecure. CONCLUSION: This study provides a comprehensive understanding of the barriers and determinants associated with vaccine uptake which can inform future interventions and public health policies aimed at improving vaccination rates in Ohio.