COVID-19 vaccine hesitancy in a small rural southern state: Results of a weighted random sample survey.

Objective: COVID-19 remains a significant health threat to the United States (U.S.) and the world even after the development of effective vaccines. Throughout the pandemic, rural areas have been more hesitant to be vaccinated for COVID-19 than more urban counterparts. The purpose of this study was to assess predictors of vaccine hesitancy in a small, largely rural, southern state using a multivariate model that would allow an assessment of independent predictors of COVID-19 vaccine hesitancy. Methods: Cross-sectional survey research was conducted using data collected from a weighted random sample of 1500 individuals residing in Arkansas, U.S. Data were collected using random digit dialing of landline and cell phone numbers between July 12 and July 30, 2021. Participants were asked about their hesitancy to be vaccinated for COVID-19. Data were analyzed using bivariate odds ratios and cumulative logit model. Results: Results found 47 % of the sample were hesitant to be vaccinated. Bivariate analysis found vaccine hesitancy to be related to age, race/ethnicity, rural residence, education, employment, and having had COVID-19. Multivariate analysis showed sex, age, rural residence, and history of having had COVID-19 were associated with hesitancy. A history of vaccination/trust in vaccines remained strongly negatively associated with hesitancy. Conclusion: Findings suggest population diversity may account for vaccine hesitancy across jurisdictions, suggesting public health messages be tailored to a local audience. The strongest finding suggests vaccinations should be emphasized in general to build habits of being vaccinated.