Publication date: Sep 18, 2025
To examine whether medical training among local health department (LHD) executives influenced COVID-19 vaccination uptake and case growth rates in US counties. Cross-sectional study using county-level data from January 2020 to June 2022. US counties with available data on LHD leadership, vaccination uptake, and COVID-19 case growth. Counties led by medically trained (MD or nursing degree), public health-trained only, or non-medically trained LHD executives. The final sample includes 1466 counties, excluding Alaska, Hawaii, Texas, and Virginia due to data limitations. COVID-19 vaccination uptake and case growth rates, adjusted for demographic, political, and health system factors. Counties led by medically trained LHD executives had a 2. 5 percentage points higher vaccination uptake on average following the April 19, 2021, vaccine eligibility expansion (all P values
| Concepts | Keywords |
|---|---|
| Alaska | COVID-19 |
| Hispanic | local health departments |
| Pandemic | medical background |
| Vaccination | public health leadership |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | IDO | role |