On June 20, anti-vaccination activists protest the proof of vaccination requirement to get into the Foo Fighters show as Madison Square Garden reopens with the first full capacity concert since March 2020 .

Opinion: What the Media Gets Wrong About Red-State Vaccine Hesitancy

Many poor, rural Whites have legitimate reasons to distrust the health care system — and real barriers to access.


In May, the late-night show “Jimmy Kimmel Live!” aired a public service announcement that told viewers to “grow the f*ck up” and take the Covid-19 vaccine. In the clip, a Trump-supporting White woman is belittled for spreading misinformation about vaccination risks via Facebook. Viewers are mocked for listening to her over the advice of health care workers who “are smarter than we are.”

The tone of this PSA is consistent with a broader trend in mainstream media coverage of vaccination rates. Narratives about politically conservative White populations commonly assert that belief in misinformation and conspiracy theories have led these groups to underestimate risk. Articles portray these populations as being anti-science while highlighting absurd examples, such as an individual motivated to reject the vaccine simply for the purpose of trolling the political left. This narrative reveals a remarkable lack of curiosity and empathy regarding the complexity underneath these beliefs. By contrast, articles about unvaccinated minority populations have rightly focused on underlying causes of hesitancy, exploring legitimate grievances such as historical and contemporary racism. Explanations beyond hesitancy are often mentioned, including economic factors, structural barriers, immigration status, and lack of health insurance.

Even essays that strive for nuance often reinforce a moral dichotomy between unvaccinated White conservatives and minorities. A May report from the prominent health analytics firm Surgo Ventures, discussed in a New York Times op-ed, contrasts “Covid Skeptics” (a group Surgo previously labelled “Conspiracy Believers”) with “System Distrusters.” Covid Skeptics hail from states like Arkansas and Alabama — conservative strongholds — and believe theories such as “microchips are implanted with the Covid vaccine.”

On the other hand, System Distrusters come from progressive bastions like Washington, D.C., and Maryland and believe members of their race aren’t treated fairly by the health care system. The op-ed emphasizes that this underserved second group must be reached as a matter of equity. Another New York Times opinion piece notes that “For Republicans, [hesitancy] is connected to a general skepticism of government and science. For Black and Hispanic Americans, it appears to stem from the country’s legacy of providing substandard medical treatment, and sometimes doing outright harm, to minorities.” Although the piece goes on to cite class as a common factor, it nevertheless defines Republicans by the superficial expression of their hesitancy, while Blacks and Hispanics are defined by the underlying source of that hesitancy.

In truth, fringe theories around vaccines have long existed across the political and racial spectrum. The pre-Covid anti-vaccination movement defied polarization, with deep roots in liberal circles. Among the 12 people the Center for Countering Digital Hate and Anti-Vax Watch flagged as most responsible for anti-vaccine online content are members of a range of political and racial backgrounds, including Robert F. Kennedy Jr., Rizza Islam, and Dr. Rashid Buttar. Louis Farrakhan — the head of the Nation of Islam — advised Black people not to take Covid-19 vaccines because of links to Bill Gates and governmental sterilization plans.

This narrative reveals a remarkable lack of curiosity and empathy regarding the complexity underneath these beliefs.

Yet, rarely is vaccine hesitancy in minority communities attributed to popular belief in these conspiracy theories and misinformation. Rather than dwelling on these most extreme (often non-representative) examples, journalists take the extra step of looking at context such as the “distrust and social alienation” that foments openness to conspiratorial views. This approach makes sense given that individuals often embrace conspiracy theories because of pre-existing distrust of vaccines or medical systems, not the other way around.

If we take this same nuanced approach with unvaccinated conservative White people — and scratch the surface beneath the conspiracy theory and anti-science explanation even a little — we find that their underlying characteristics are similar to those of unvaccinated minority groups.

Even the label “conservative Whites” is misleading. Class is far more predictive of vaccine hesitancy than either politics or race — with working class White people being twice as likely to be hesitant as White college graduates. Poor White people expressing hesitancy typically have strong religious beliefs, face disproportionate economic and access barriers to vaccination, and have legitimate reasons to mistrust the medical system. Historically, the same sterilization programs that the Nation of Islam members evoke also purposefully targeted poor White people. When Justice Oliver Wendell Holmes, Jr. wrote “Three generations of imbeciles are enough” in a Supreme Court ruling upholding Virginia’s involuntary sterilization law, he was describing a poor White woman with no mental impairment.

More recently, the opioid epidemic ravaged suburban and rural Whites. As detailed in Sam Quinones’ “Dreamland,” the opioid epidemic was caused by the entire health care system pushing painkillers like OxyContin. Mass prescription of opiates has been cited as the core cause of rising mortality among poor Whites, relative to other demographics. Arkansas — the state with the most “Covid Skeptics,” according to the Surgo Ventures report — is second in the nation in dispensing opioids. Other states such as Alabama and Louisiana also significantly exceed the national average on both lists.

Poor White people expressing hesitancy typically have strong religious beliefs, face disproportionate economic and access barriers to vaccination, and have legitimate reasons to mistrust the medical system.

Vaccine hesitant conservatives are also disproportionately rural. This creates unique access problems, including shortages of health care workers to administer the vaccines and long driving distances to vaccination sites.

My point isn’t that we should weigh political and racial grievances, or declare that one group’s low vaccination rates are most justified than another’s. (Mortality data alone suggest that ethnic and racial minorities still have the most objective reasons for distrusting the medical system). Rather, my point is that the suspicions felt in Black and Brown communities likely aren’t all that different from the suspicions felt by White people. In each case, focusing on outlandish vaccine conspiracy theories glosses over genuine underlying concerns. In each case, vaccine hesitant Americans are being asked to take a drug developed at unprecedented speed under unfathomable pressure using novel techniques based on short-term studies.

Taking such a vaccine requires trust in the medical system and in society more broadly. Most unvaccinated groups have been let down by both, and a connection can easily be traced between vaccine hesitancy and those failures. That dynamic deserves to be approached with empathy, not ridicule. Unfortunately, the mainstream media seems to be treating some groups as worthy of humanizing contextualization, while implying that the others are motivated by rank buffoonery.

Timothy DeLizza is a writer living in Baltimore, Maryland. He was awarded the 2020 Barry Lopez Nonfiction Prize for his essay “Legally Speaking, Rats Aren’t Even Animals.”