ALBANY COUNTY — The rural areas of Albany County have lower rates of vaccination against COVID-19 than the suburban and urban areas.

County leaders made a call to action on Monday for places with the lowest vaccination rates — Berne and East Berne, Westerlo, Ravena, South Bethlehem, and some Albany neighborhoods.

All but the Albany neighborhoods are rural.

When Albany County Executive Daniel McCoy presented data on Monday, he focused on racial disparities. Both the county and the state have focused on equity in vaccination since before doses were available.

But something beside race is going on in the rural areas of the county, which are predominantly white.

The ZIP code (12046) with the lowest rate of all is in rural Coeymans Hollow — at 19.1 percent of its population having first-dose vaccinations. That is under half of the state’s rate. Only 1.45 percent of Coeyman Hollow’s population is non-white.

Berne (12023) has 36 percent of its residents with one shot and has a non-white population of just 2.2 percent. This compares to a high of 69 percent in suburban Slingerlands (12159) with a much larger non-white population.

The New York Times recently looked at data for nearly every county in the United States and found “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 Donald J. Trump in 2020.”

Half of Berne’s 12 election districts went for Trump. In Knox, 10 of 11 election districts favored Trump. In Rensselaerville, seven of 12 election districts favored Trump. And in Westerlo, 11 of 12 districts went for Trump.

People in the rural Helderberg Hilltowns have had a false sense of security with the pandemic, says Jill Martin, a nurse practitioner who owns and runs Hilltown Healthcare, located in Berne.

“We tend to socially distance as a norm,” Martin said. “Even our houses are situated far apart.” And many Hilltowners work independently — say, as farmers — and don’t regularly go to crowded venues like theaters or restaurants, she noted.

“It gives a false sense of security that we don’t have the virus,” Martin said.

She believes the public is largely unaware of the “extremely high numbers” of COVID-19 cases that the Hilltowns suffered in November, December, and January.

Her staff had to come up with a policy, leaving test kits outside for patients to pick up and then treating them through phone calls unless their symptoms worsened and they had to be hospitalized.

Before the post-holiday surge, it was typical that, out of 10 COVID tests given by Hilltown Healthcare in a day, zero would be positive. Starting in November, “at least half” would come back positive, Martin said, calling it “unbelievable.”

Most of her patients recovered, she said, but a few were hospitalized and “did not make it through.”

Once vaccine doses became available, many residents did not want to travel off the Hill to get shots, she said.

Martin contacted the county’s health department, which sent 100 doses to each Hilltown, she said. “We got 400 people vaccinated within a couple of days,” she reported.

On April 20, she worked with Berne-Knox-Westerlo, vaccinating students 16 and older who were accompanied by their parents.

Her staff called every one of their patients who were 65 or older to offer vaccination to each. Only “a small percentage” were not interested, she said.

Martin is now offering free vaccination to any resident; they need not be her patients. They can simply call her office at 518-872-0009 to schedule an appointment and be willing to wait 15 minutes to be sure there is no bad reaction.

“To be honest,” Martin said, “not many primary-care providers are giving vaccinations.”

She thinks this is largely because of the amount of paperwork involved. “Most I spoke with said it’s not feasible with their staff and time,” said Martin.

“A lot of patients feel safer, more comfortable in a primary-care office,” said Martin.

Her office was originally given doses of Johnson & Johnson vaccine, which requires one shot instead of two like Pfizer and Moderna. “Sometimes people don’t come in for a second vaccine,” said Martin.

Since there was a pause on administering Johnson & Johnson while a rare blood-clotting disorder was investigated, Martin’s office has now been given Pfizer, which is the only one of the three vaccines that is authorized for 16- and 17-year-olds.

When Martin has asked Hilltowners why they don’t want a vaccination, she said, she is frequently told they are concerned because it was developed so quickly and “hasn’t been around long enough.”

She went on, “They’re not trusting the science for the long-term side effects.”

Martin tells them how the science in developing the vaccines is based on years of knowledge from other vaccines.

“A few were worried they’d catch COVID,” she said, explaining how this is not possible.

A lot of Hilltowners work from home and stay isolated so don’t believe it is necessary, she said.

Martin said, then, the point is to get vaccinated for the good of society.

“We want our life back to normal,” she said. “I got vaccinated to protect my patients, to protect my parents. … The sooner everybody gets vaccinated, the sooner we have normalcy.”

Equity

In January, Governor Andrew Cuomo said he himself would not get vaccinated for COVID-19 until the vaccine is available to people in his same age group in Black, Hispanic, and poor communities in New York State.

“I understand the cynicism and skepticism; it is not without cause,” Cuomo said in recorded remarks to the Abyssinian Baptist Church in New York City. “The Tuskegee experiment is a terrible stain on the soul of this nation.”

He was referencing a study by the Centers of Disease Control and Prevention and the United States Public Health Service, from 1932 to 1972, in which African-American men were told they were getting free health care when, in fact, they were being used — without being told — as part of a study on untreated syphilis.

Since the start of the pandemic, Albany County has focused on underserved Black and brown communities in Albany, offering walk-up COVID-19 testing in neighborhoods where residents may not be able to drive to the state’s testing site at the uptown University at Albany campus.

On Monday, McCoy focused on the race differential when he used a handful of county ZIP codes to illustrate those places with the highest and lowest rates of vaccination against COVID-19.

“Many of the ZIP codes doing the worst are also the highest percentage of non-white residents,” he said.

He made his point by listing the two ZIP codes, both wealthy areas, with the highest rates:

— Slingerlands (12159) where 69 percent have gotten at least a first dose and where 16.3 percent of the population is non-white; and

— Loudonville (12211) where 66.5 percent have received a first dose and where 16.3 percent of the population is non-white.

McCoy contrasted this with two ZIP codes, in poorer areas of Albany, where rates are the lowest:

— Albany’s West Hill (12206) where just 27 percent have gotten a first dose and where 67 percent of the population is non-white; and

— Albany’s South End (12202) where 31 percent have gotten a first dose and where 72 percent of the population is non-white.

“We still need to get buy-in from the community,” said McCoy. “So I’m pleading with everyone .... We need your help.”

Albany County Health Commissioner Elizabeth Whalen said of vaccination, “We have tried to do this with an equity lens, looking at our high-risk ZIP codes.”

Now that supply of the vaccine has outstripped demand, she said, the county would “double down” with additional strategies, focusing on education and having community health workers answer questions.

“We know there are still people sitting on the fence with questions and concerns,” she said.She explained how variants of viruses emerge and said, “As COVID evolves and changes ... the more likely it could mutate .... If we can vaccinate up to 70 percent of the population, we can stop the spread ... stoop the chances for mutation.”

Whalen urged residents who have been vaccinated to “share with those that you know that may have questions or concerns your reason for vaccinating.”