Reaching Rural and Remote Workers with COVID-19 Vaccinations

Rural and remote workers encounter distinct challenges to vaccination, but state, tribal, local, and territorial health departments can help.

  • While there are many definitions of “rural,” most counties in the United States are completely or mostly rural. In addition, up to 1 in 5 people in the United States lives in a rural area. The most rural areas are often referred to as frontier and remote.
  • Rural workers play a key role in a variety of industries, including agriculture, ranching, fishing, and manufacturing.
  • People living in rural areas may also work in remote areas and either live on-site or commute long distances. Examples of remote workers include miners, loggers, wildland firefighters, and oil and gas extraction staff.
  • Distance from healthcare resources and issues related to weather and transportation are additional challenges in many rural areas.

Vaccination Strategies

State, tribal, local, and territorial health departments should consider employing multiple strategies to offer and administer COVID-19 vaccines to all rural and remote workers.

  • Offer workplace vaccination clinics for work sites that bring large numbers of workers together at the same time. For example, a factory or meat processing plant in a rural area with a hundred or more employees may be a good candidate for a workplace vaccination clinic. These vaccination clinics could also potentially be opened to others in the community, such as workers’ family members.
  • Offer mobile vaccination clinics for smaller work sites with fewer workers who work alone or in a small group. This approach may allow for short stops at several work sites in a remote area.
  • Partner with local pharmacies, through either the Federal Retail Pharmacy Program or agreements with independently owned pharmacies. Ensure vaccination sites are open during a variety of hours, including evenings and weekends, to accommodate different work schedules and shifts.
  • Partner with local Cooperative Extension Systemexternal icon field offices for assistance with reaching agricultural operations and planning vaccination for their workers.
  • Encourage employers of remote workers to provide transportation vouchers or allow workers to use company vehicles to drive to their vaccination appointment.
  • Encourage employers to allow employees to get vaccinated during work hours or take paid leave to get vaccinated at a community site. This may require educating employers that the cost of a long commute for vaccinating a group of workers may be worth it in the long term to help keep the business operational.
  • Partner with volunteer fire departments to boost access to community COVID-19 vaccination clinics. Volunteer fire departments offer a centralized location within many communities and people (volunteers) to facilitate vaccine distribution. The National Highway Traffic Safety Administration’s Office of Emergency Medical Services (EMS) has developed guidanceexternal icon describing how health departments may use EMS clinicians, including those who are members of a volunteer fire department, as vaccinators. Health departments can determine if their state allows EMS clinicians (and at what level of training) to administer vaccinations through the National Association of State EMS Officialsexternal icon.
  • Engage with North America’s Building Trade Unions , which are offering all training centers and union halls for national vaccine distributionexternal icon.

Communication Strategies

Often the best way for health departments to reach rural and remote workers is through trusted sources where they routinely go for information in their home community or area where they work, rather than trying to make direct contact. This is especially true for workers who travel long distances and cross through multiple counties or states. Trusted sources vary among worker populations, but may include:

  • Physicians, nurses, nurse practitioners, physician assistants, and pharmacists
  • Community and faith leaders
  • Employers
  • Unions for represented workforces
  • Cooperative Extension System field agents for agricultural employers and workers
  • Health insurance providers

Some people may have concerns about COVID-19 vaccines and may take a “wait and see” approach. Messages that may resonate include some of the following benefits of vaccination:

  • Returning to normal daily life and helping to end the pandemic
  • Keeping family members safe and healthy
  • Improving the worker’s ability to stay healthy at work, or return to work

In addition, encouragement and positive examples from coworkers and other people they know who have been vaccinated (including peer leaders and supervisors) can be important in building vaccine confidence. For more communication strategies and resources for vaccinating workers, please visit the Essential Workers COVID-19 Vaccination Toolkit.

Special Considerations for Wildland Firefighters

Wildland firefighters are particularly affected by the challenges their remote location causes in getting vaccinated. Ideally vaccinate this group, including personnel not directly on the fire line (e.g., aviation, camp crews), before fire season. Encourage them to get fully vaccinated as soon as possible and before reporting for duty. If they have not been vaccinated already, their annual pre-placement physical is an opportune time for vaccination. Once they are on active duty, they live and work in close quarters in fire camps and typically have limited access to medical facilities. Because of their isolated work and remote locations, it may be operationally infeasible or quite difficult to vaccinate them during wildland fire response.

Page last reviewed: May 17, 2021