A shorter version of this column has been published by Axios.

Getting shots into arms in rural Americans, most of whom see getting the vaccine as a personal choice and not a social responsibility to protect others, is a problem that will require tailored outreach and messaging. It underscores that a cookie cutter approach to vaccine hesitancy campaigns will not work.

Even as coronavirus surges in rural America rural residents are more vaccine hesitant than their suburban or urban counterparts and just as hesitant as Black Americans are, a group which has been singled out for their vaccine hesitancy.

+ 35% of rural Americans say they either will not or probably will not get it. That compares with 26% of urban Americans who say the same thing and is the same overall level of hesitancy we see for Blacks.

People living in rural America are no less likely than people in urban or suburban areas to know someone who has tested positive or died from coronavirus, they have other reasons for their hesitancy.

+ They are less worried than their urban counterparts that someone in their family will get sick from the virus.

+ And more rural Americans say the pandemic is exaggerated compared to people in the suburbs and the cities.

This isn’t just because rural residents are more likely to be Republicans and support President Trump.  Analysis shows that their hesitancy and lack of worry about COVID-19 extends beyond their partisanship.

Strikingly, 62% of rural residents see getting vaccinated as a personal choice compared with 36% who see it as part of their responsibility to protect the health of others in the community. Its just the opposite for people in urban areas.

The data suggest that addressing hesitancy in rural America will require convincing rural Americans about the seriousness of the pandemic and then reaching them with an almost second amendment-like appeal: that the vaccine is a way to protect you, your family and your way of life. As neighbors who are not vaccine resistant are vaccinated some of the hesitancy we see in rural America may fade away.

But it will require very targeted digital messaging to reach these more conservative vaccine resistant rural populations who hear regularly from conservative media that COVID-19 mitigation strategies are a way to take away they personal liberties and deny them their way to make a living. This would include targeted ad buys on Fox, Newsmax, OANN and other information channels they trust.