Montgomery County’s reported 99.9% COVID vaccination rate highlights continuing disparities in Maryland, experts say

Leading all other Maryland jurisdictions as well as much of the nation, Montgomery County landed near the top of federal health officials’ list of the most vaccinated counties Monday, with 99.9% of its eligible population at least partially vaccinated.

That would mean nearly all Montgomery County residents over age 12 have gotten at least one dose of vaccine, a feat so rare and improbable absent a state or federal mandate that data experts and public health professionals already have called it into question.


“It’s kind of hard to believe, approaching 100% of the eligible population vaccinated,” said Josh Michaud, an epidemiologist and the associate director for global health policy at the Kaiser Family Foundation. “As with any large-scale data collection effort, it’s an imperfect system, and you can’t read too much into the specific numbers here.”

But the figures from the U.S. Centers for Disease Control and Prevention still highlight an ugly truth about the pandemic: Areas with higher median incomes, with higher levels of education and closer to urban centers, like Montgomery County, are far outpacing the more rural areas on the Eastern Shore and Western Maryland, which have vaccination rates as low as 55% of all eligible people.


“Our community really embraced the science,” said James Bridgers, Montgomery County’s acting health officer. “They stepped up and got the shots because they understood that vaccines are the best way to protect themselves, their families and their communities, and return to some semblance of normalcy.”

Bridgers said he’s comfortable with the 99.9% figure but acknowledged that there could be discrepancies in how vaccine numbers are collected.

For example, state data shows how many people have been vaccinated within Maryland, while federal data reflects how many residents of a given state or county have been immunized. And some of the nuances of the vaccination campaign may not be represented in the data at all, such as the percentage of people who received first doses but failed to show up for a second.

Much attention has been paid to the racial and ethnic disparities that have guided much of the public health crisis’ impact. But geographic ones exist, too, even in relatively highly vaccinated states like Maryland.

Montgomery and Howard counties, two of the most affluent in Maryland, lead in the percentage of eligible people at least partially immunized against COVID-19, according to the CDC. Behind Howard’s 94.2% come Anne Arundel (86.9%), Frederick (84.8%), Prince George’s (83.4%), Talbot (82.2%), Carroll (80.6%), Baltimore (80.1%) and Harford (78.6%) counties. Baltimore City stands at 72.7%.

On the opposite end of the spectrum are Allegany at 60.6% and Garrett and Somerset counties, both of which have less than 60% of their eligible population at least partially vaccinated, according to state and federal data.

Michaud said it’s possible that Montgomery County’s rate is not far off from what has been reported. It is likely the highest in Maryland, he said, for fairly well-established reasons.

“We know from polling at the national level, certain groups are reluctant or refuse to get vaccinated and the groups most commonly refusing are rural groups, white men and conservative people,” Michaud said. “Those groups aren’t evenly distributed around Maryland — they are in places with lower vaccination rates.”


Those persisting gaps may be preventing the coronavirus pandemic from coming to an end. While sickness, death and hospitalizations have trended downward across the country following a midsummer surge fueled by the more contagious delta variant, Maryland alone added more than 700 new cases to the state’s running infection tally Monday, and 14 fatalities associated with COVID-19.

“The way out of this pandemic, at this point, is getting every single person in our state, our country and in our world vaccinated,” said Dr. Maura Rossman, health officer at the Howard County Health Department, which reports having over 90% of its eligible residents at least partially vaccinated against the coronavirus.

About 95% of the United States is classified as having “high” or “substantial” rates of community transmission, according to the latest CDC figures. That includes every county in Maryland, including Montgomery and Howard.

Rossman said Howard County’s problems haven’t ended simply because its own residents have high levels of vaccine coverage. Viruses don’t recognize borders, and with every person left unvaccinated, COVID-19 has a chance to mutate and become more lethal and contagious, she said.

Even fully vaccinated people can contract and spread COVID-19, though their infections are much more likely to be mild than those in unvaccinated individuals and represent a small percentage of the new cases. Unvaccinated people account for an overwhelming majority of the new infections and hospital beds occupied in Maryland and around the country.

Those ineligible to be vaccinated, such as children, also have made up higher proportions of illnesses and hospitalizations as the public health crisis has progressed. Thousands of school-aged kids have been quarantined since the academic term began about six weeks ago, forcing them and their parents into isolation, though the problem has not been as pronounced in Maryland as elsewhere.


Rossman attributed Howard County’s success to its demographics: Residents tend to be well educated, skew to the political left and have easy access to health care. But she also cited the health department’s relatively high levels of resources and the local government’s support of its mission.

Funding and cooperation, she said, are critical means to getting people vaccinated.

“There’s alignment with the science,” she said. ”And, our public information officers are pushing out information every day, seven days a week. And, it’s traditional science, rather than misinformation or disinformation.”

Rossman also acknowledged that about 18% of those 12 to 18 years old in Howard County remained unvaccinated, and that the addition of more young kids and booster shots into the mix likely will complicate the picture.

Nationwide, more than 66% of the country has received at least one dose of vaccine, according to the CDC. That equates to more than 200 million people. In Maryland, roughly 72% of the population has been at least partially immunized, totaling about 4 million of 6 million people, state data shows.

Gov. Larry Hogan sliced the data a bit differently Monday in touting that about 85% of adults in the state had been partially vaccinated, outpacing the national total of close to 80%.

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Concerns about the delta variant have helped persuade some of those on the fence about getting inoculated to roll up their sleeves. But other factors, such as a person’s occupation, also may be driving vaccination decisions, said Beth Blauer, executive director of the Centers for Civic Impact at the Johns Hopkins University, who has been working on a COVID-19 data project aimed at offering policymakers useful information to stem infections and address inequities.

Blauer said many residents of highly vaccinated jurisdictions tend to be “deep believers” in immunizations because they work in the health field, as medical professionals, researchers at the federal institutions located nearby and elsewhere.

Also, she said the leadership in the highly vaccinated counties put forth more strict measures, including masking, distancing rules and vaccinations, as imperative to the long-term health of the economy.

The same is true, she said, for places such as Baltimore City, where the health department has been aggressive in outreach, education and countermeasures, as well as testing and vaccination. But, she said, the city’s residents are different demographically from Montgomery County’s, explaining why the city’s vaccination rate is lower than that county’s but still higher than in the rural counties.

Blauer will continue collecting COVID-19 data from around the country, an effort made more difficult by some states that have wound down reporting on such data. The information remains essential to decision-makers, who need to know where infections are occurring so they can be addressed with appropriate measures, she said.

There is doubt, Blauer said, that the numbers coming out of any county are fully accurate. But the infrastructure to count and identify cases and vaccinations will be essential for the next pandemic.


“It’s so needed,” she said. “There is value in having day-to-day information on highly dangerous infections in our community. We see leaders across the United States deciding they are going to think of this as temporary infrastructure and data doesn’t need to be reported. How can we respond effectively?”