What color is the state of your health?

It has become almost cliché to talk about America’s divisiveness. We have so-called “blue states,” “red states” and some “purple or swing states.” Colors are now used to describe our unhinged politics, economic divisions and frayed social fabric reflective of educational gaps, income disparity, racial and religious tension and a fractious culture. Into that chasm comes a new line of division: vaccination politics. 

According to national data, the U.S. vaccine map looks a lot like a map of how states vote in presidential elections, with most blue states vaccinating at levels well above the national average and GOP states bringing up the rear. 

The New York Times examined survey and vaccine administration data for nearly every U.S. county and found that both willingness to receive a vaccine and actual vaccination rates to date were lower, on average, in counties where a majority of residents voted to re-elect former President Trump in 2020. 

The top 21 states for vaccination rates all went for President Biden in the 2020 presidential election. Iowa – with 47 percent of its population receiving at least one shot – is the highest ranking state on the list, at No. 22, that voted for Trump. 

The state with the lowest vaccination rate, Mississippi, at 32 percent, is deeply red, as are the other four states that round out the bottom five: Louisiana, Alabama, Wyoming and Idaho. A poll by The Associated Press-NORC Center for Public Affairs Research in late March found that 36 percent of Republicans said they will probably or definitely not get vaccinated, compared with 12 percent of Democrats. Similarly, a third of rural Americans said they were leaning against getting shots, while fewer than a fourth of people living in cities and suburbs shared that hesitancy. 

The emerging pattern: Americans in blue states that lean Democratic appear to be getting vaccinated at more robust rates than those in red Republican states.

Like most things, not everything is black or white. There are also some intriguing anomalies in the data with Pennsylvania, Georgia, and Arizona reflecting some mixed data, defying easy classification. Like many swing states, Michigan, for example, is more toward the middle of the pack when it comes to vaccinations.

But more important than the data itself is the question: What does it mean to add vaccination division into an already fractured nation?

1. Health Disparity

In addition to raw political tension, the vaccination gap reflects a dangerous set of health disparities in America that must be addressed if we want to be prosperous. The stress and strain of the COVID epidemic laid bare the fundamental problems with the U.S. health care system and the inequalities in care depending on county and city. If, as predicted, America fails to reach herd immunity with roughly 80 percent of the nation vaccinated, we will continue to have COVID cases and new outbreaks without time to address the old problems. It is not enough to just let those who don’t want a vaccine skate by without responsibility for an entire health care system that pays a price each time someone becomes ill.

2. Media Madness

Misinformation, disinformation and a lack of information about vaccines have created chaos — some intended, some not. We have more opinion than fact in a “news” industry that is still wrestling with the proliferation of media outlets and the lack of editorial constraint. The decline of traditional journalism has left us unmoored in a world awash with information, technology and data but lacking in context and quality content. Into that mess it is possible to spin a vaccine tale anyway you like.

3. Culture

At its most fundamental level, the vaccination divide becomes reflective of a divide between individuals in ways that question our personal and national identity. Whether you get a shot in the arm might depend on whether you live in a rural area, a suburban setting or an inner city. It might depend on where you pray and if you pray. It might depend on where you went to college or if you went to college. 

All of these factors add up to what we define as our “culture” — our norms, values, traditions and shared or unshared understanding of what it means to be an American. We cannot begin to resolve difficult issues like immigration if we cannot even agree on who we are and what kind of country we want to be. Confusion is the breeding ground out of which hatred, discrimination, conflict and violence emerge. We can’t let politics eclipse and poison even our most basic desire to live peacefully.

The pandemic is coming to an end. But all of us remain plagued by its uneven ending, and all of us will reap what we sow from this past year. Can we learn any lessons from being isolated? Can there be any joy from being together? 

The only real solution is to heal our divisions and, at this moment of fragility and awakening, to let the voices of reason rise up.

Tara D. Sonenshine served as U.S. under-secretary of state for public diplomacy and public affairs. Follow her on Twitter @TSonenshine.