Rural communities are experiencing a faster transmission rate of COVID-19 compared to urban or suburban communities. However, they face unique challenges exacerbated by the COVID-19 public health emergency, including fewer health care facilities and hospital beds, limited telehealth access, and fewer medical workers.[1] Individuals in rural communities also tend to experience an increased risk of severe COVID-19 symptoms or death due to older age or chronic disease.¹ Nonetheless, individuals in rural communities are among the most vaccine hesitant population and are less likely to say they will receive a COVID-19 vaccine than those living in suburban or urban communities.¹

CMS recently spoke with health plans that shared the following promising practices for addressing barriers to vaccine access in rural communities:

• Conduct outreach to members in rural areas. Health plans are conducting outreach to members in rural areas to educate them on vaccine availability and access, as some members may not know where to find vaccine information or how to schedule a vaccine appointment. Several health plans have prioritized members at the highest risk, including those with limited access to vaccines and those most vulnerable to COVID-19, to determine members in need of outreach. Health plans are also reaching more members by contacting them during non-business hours and on weekends. Additionally, health plans provide language translations as needed, help members schedule appointments, and coordinate with the member’s caregivers as necessary to get them to the vaccine appointment.
• Address technology barriers. Individuals in rural communities may not have access to a computer or internet. To address this, health plans are scheduling appointments for members who cannot schedule appointments themselves. Health plans are also working with resource centers to make Wi-Fi hotspots available to schedule vaccine appointments and with state and local agencies to create stations at libraries reserved for scheduling vaccine appointments.
• Provide transportation access. Many individuals in rural communities face challenges obtaining transportation to receive the COVID-19 vaccine.² Health plans are providing members with transportation to vaccine appointments at health clinics or vaccination hubs. Depending on a member’s plan, they may cover transportation as a non-emergency medical transportation benefit. Health plans have also leveraged partnerships with home health care organizations to identify members who have difficulty leaving their homes and to provide in-home vaccines. In addition, health plans have partnered with ride-share services to provide transportation to vaccine appointments for individuals in at-risk or underserved communities, including rural areas.
• Dispel vaccine myths and share facts. Individuals in rural communities are more likely to be hesitant to receive the COVID-19 vaccine. Health plans are reaching out to individuals who have not received the COVID-19 vaccine to ask how the members feel about the vaccine, answer members’ questions, and provide education about the benefits​ of the COVID-19 vaccine. Health plans have also developed community-relevant messages from trusted leaders using local channels and sources to share what the COVID-19 vaccine is, why it is helpful, and to compare vaccine myths to facts. Sharing the seriousness of the COVID-19 public health emergency and stressing that the COVID-19 vaccine can protect an individual, their family, and their way of life are shown to be effective messages for individuals in rural communities.³

[1] Altman, D. (2021). The challenge of vaccine hesitancy in rural America. Kaiser Family Foundation. Retrieved from https://www.kff.org/coronavirus-covid-19/perspective/the-challenge-of-vaccine-hesitancy-in-rural-america/.

[2] Cooper, R., Levisohn, A., & Rosenthal, J. (2021). States identify and address covid-19 vaccine disparities through targeted rollout and outreach. National Academy for State Health Policy. Retrieved from https://www.nashp.org/states-identify-and-address-covid-19-vaccine-disparities-through-targeted-rollout-and-outreach/.

[3] Kirzinger, A., Munana, C., & Brodie, M. (2021). Vaccine hesitancy in rural America. Kaiser Family Foundation. Retrieved from https://www.kff.org/coronavirus-covid-19/poll-finding/vaccine-hesitancy-in-rural-america/.