The Association of COVID-19 Infection and Vaccination Rates in Florida

Objective: This study investigates the association of COVID-19 infection and vaccination rates with 2020 presidential election voting preference in Florida counties and the moderating role of age, race, ethnicity, and other community characteristics. Methods: Florida county COVID-19 infection and vaccination counts through September 2021 were supplemented with socioeconomic characteristics and 2020 presidential election results. Poisson regression measured the association of infection and vaccination rates with county political preferences, race, ethnicity, and other county demographic and economic characteristics. For models of April through September 2021 infection rates, the same county characteristics were assessed alongside county vaccination levels. Results: Each 1% increase in county full vaccination rates was associated with 82.47 fewer infections per 100 000 during the span of April to September 2021. Vaccination rate was the largest and most statistically significant determinant of vaccine era infections. Each 1% increase in the county share of votes for the 2020 Republican presidential candidate was associated with 109.7 more COVID-19 infections per 100 000 through March 2021 and a 0.546% decrease in county vaccination rates through September 2021. Conclusions: At the county level, COVID-19 vaccination rates are associated with infection rates, with a higher county population proportion of fully vaccinated associated with fewer infections per 100 000. County political preference in the 2020 presidential election is significantly associated with county-level COVID-19 infection and vaccination rates.