UK gets $3.7 million to figure out why Ky. Appalachian counties have low Covid-19 vaccination rates, and how to get them up

State Dept. for Public Health map, adapted by Kentucky Health News; for a larger version, click on it.

By Christopher Carney
University of Kentucky

Researchers from three colleges at the University of Kentucky and the state Department for Public Health are leading a five-year, $3.7 million project to study Appalachian Kentucky residents' hesitancy to get vaccinated against Covid-19.

The project is called Kentuckians Vaccinating Appalachian Communities, or K-VAC. It plans a personalized, community-engaged approach and involves researchers from UK's College of Public Health, the College of Medicine and the College of Communication and Information and is funded by the National Institutes of Health.

Rural Appalachian Kentucky communities are particularly vulnerable to Covid-19 suffering and death. More than half of Kentucky residents have received at least one dose of a coronavirus vaccine, many Kentucky counties have had much lower uptake.

Marc T. Kiviniemi and Kathryn M. Cardarelli, of the public-health college's Department of Health, Behavior & Society, are the co-principal investigators and researchers on the project. They are spearheading the multilevel approach that addresses the individual, relational and structural variables potentially contributing to vaccine hesitancy in this region of Kentucky.

Kathryn M. Cardarelli and Marc T. Kiviniemi (UK photo) 

“We are studying ways of simultaneously addressing the willingness to be vaccinated, and vaccine accessibility, and then seeing if addressing those problems increases the portion of the population that has received a vaccine," Cardarelli said.

Kiviniemi said, “This region is rural, with many communities geographically isolated and with challenges with access to health care. In addition to low socioeconomic status, and elevated levels of chronic disease, this population is placed at significant risk of complications and mortality due to Covid-19 infection. K-VAC’s vaccination interventions must use individually tailored, strong community partnerships and strategies to build trust with this community.”

Cardarelli added, “We understand that there are different attitudes and feelings about vaccinations. This collaborative, community-based research aims to build better, trustworthy communications to help populations make more informed, actionable decisions while addressing the structural barriers such as physical location, transit time, community features, access to health care, among others.”

The co-investigators include the public-health college's Angela Carman, Anna Hoover and Emily Slade; the College of Medicine's Dr. Kevin Pearce and Jamie Sturgill; the College of Communication and Information's Diane Francis, Emily Messerli of the state health department's Immunization Branch; and Center of Excellence in Rural Health Director Fran Feltner. The center, based in Hazard, will provide facilities for the project.

To ensure that the project’s approach is responsive to the communities’ cultural, social, historical and economic contexts, K-VAC will be guided by a Community Advisory Board that includes members of the Kentucky River Health Consortium, which includes more than 50 organizations within K-VAC’s target population, including human-services organizations, health coalitions, law-enforcement agencies and managed-care organizations that administer Medicaid in Kentucky.

“Vaccination is a critical strategy for reducing the Covid-19 overall burden and health disparities, yet vaccine intentions and uptake are unacceptably low in our partner communities in Appalachian Kentucky,” Cardarelli said. “Nationally, individuals with lower education, lower household income and those living in rural areas are more likely to express Covid-19 vaccine hesitancy. I am excited to be a part of this project, in collaboration with our project and community partners, to improve the lives of this population.”