Last week’s post on Diphtheria Pertussis and Tetanus (DPT) vaccine coverage in the Alleghenies showed a large cluster of 722 zip codes with a low coverage of 82.2%. Looking more closely at those zip codes reveals that all of them are located in West Virginia. West Virginia is almost completely covered by either the Allegheny Mountains or the Allegheny Plateau. If West Virginia is excluded from the above graph it looks like the graph below.
The plot above shows better DPT vaccine coverage in the Alleghenies than outside except for a few zip codes in Virginia and New York. Maryland zip codes have the best coverage at 91.6%. All of the Pennsylvania zip codes are at 90.2% coverage. This post discusses DTP vaccine coverage and mortality in the Alleghenies. A median value is the value that appears in the middle if the values are ranked from highest to lowest.
The graph above from the last post shows the elevated mortality rates in the Alleghenies with many West Virginia zip codes with mortality rates above 1,000 deaths per 100,000. If we exclude West Virginia, mortality is still higher in the Alleghenies.
Above we see that there are many zip codes in the border area of Virginia with West Virginia that also have elevated mortality rates as well as many Virginia zip codes. Below is a box plot that looks at mortality rates by state and the Alleghenies.
The above plot shows elevated median mortality rates for the Allegheny regions for each state (above 750 deaths/100,000). For the non-Allegheny regions each state has a median zip code at or below 750 deaths/100,000. Low DPT coverage may not fully explain the high mortality rates in West Virginia. The conditions that lead to the higher rates in the Alleghenies may be exasperated in West Virginia. West Virginia is completely covered by the Alleghenies.
According to the CDC, only 2 measles cases are in West Virginia so far this year. By comparison, PA has 767 cases with 4 deaths so far. If the outbreak goes unchecked it is a matter of time it spreads to other states.