The Washington PostDemocracy Dies in Darkness

Red America has seen the highest rates of cases and deaths, and the lowest rate of vaccinations

President Biden delivers remarks on the authorization of coronavirus vaccines for children ages 5 to 11 on Nov. 3. (Evelyn Hockstein/Reuters)

It’s worth putting a fine point on a subject I raised earlier Monday: It is red America, Donald Trump-voting America, that has seen the worst effects of the pandemic. With divergent vaccination rates, with the unvaccinated population that’s most at risk being made up of Republicans at three times the rate of Democrats, that gap is poised to grow.

If we break down monthly case and death figures by county vote in 2020, we see that Trump counties have been hardest hit by the pandemic on a per capita basis since last year. If we throw in vaccination rates, we see that it is those same counties that have been the slowest to get vaccinated. As of April of this year, the most red and most blue counties in the country began to diverge on vaccination rates. As of writing, data compiled by The Washington Post suggests that the counties that voted most strongly for President Biden are fully vaccinated at a rate 40 percent higher than the rate in the counties that voted most strongly for Trump.

Those are cumulative. If we look at how the monthly total of cases and deaths has compared to vaccination rates over time, the picture is different. Since June, the number of cases in the most-blue counties has grown more slowly than the number of cases in the most-red ones. The gap on deaths is even wider — even as the vaccination rates have moved in the inverse relationship.

Here is the month-by-month relationship between vaccination rates and either cases or deaths.

Notice the shifts since July. The red arrows below, marking the most-red counties, point more to the right: Their case and death rates increased along with vaccination rates. In the most-blue counties, the arrows from July to November point more up than to the right, meaning that vaccination rates rose much more than case or death rates.

If we look just at the increases in per capita totals during three periods — before vaccines, during the early rollout and since that point — we see that a relatively even increase in cases and deaths has become lopsided along a partisan axis. That axis, of course, correlates with vaccine uptake.

There is no guarantee that this pattern will hold. Winter is almost upon us and, last year, the Northeast got hammered. The Sun Belt was hit hard during this summer’s fourth wave, spurred by the delta variant, and may be less likely to see a surge this winter. It’s also possible that the omicron variant spurs a fifth surge of the virus that slams more-blue counties pushed indoors for the winter months.

All of the data, though, suggest that vaccination plays an important role in preventing infection, illness and death. According to data from the Centers for Disease Control and Prevention, the unvaccinated are at far more risk of those worst-case outcomes — which might help explain why more-vaccinated blue counties saw slower growth in deaths during the fourth wave than cases. Hence Biden’s call Monday to get vaccinated with the new variant looming.

But the problem, as always, is that the people who disproportionately need to be convinced to get vaccinated are also those least likely to follow Biden’s lead.