Nurses Sharon Daley, left, and Maureen Giffen fill syringes with the Moderna COVID-19 vaccine in a makeshift clinic in the kitchen of a community center, Friday, March 19, 2021, on Great Cranberry Island. Credit: Robert F. Bukaty / AP

Hesitancy about the COVID-19 vaccine has remained low in Maine while appointments have remained in high demand, bucking a trend toward unfilled slots and low uptake seen in other rural states.

More than 600,000 Mainers have received at least one vaccine dose, accounting for about 54 percent of the eligible adult population. All Mainers aged 16 and older became eligible for the vaccine last week.

Maine ranks 11th-lowest in vaccine hesitancy among U.S. states, according to survey data analyzed by the U.S. Department of Health and Human Services, with 12.3 percent of the adult population considered hesitant and 7.8 percent strongly hesitant. Other New England states rank better, with Massachusetts, Vermont and Connecticut occupying the top three spots, all with less than 10 percent of their populations hesitant and less than 4 percent strongly hesitant.

Hesitancy rates varied widely by state, going as high as 30.7 percent in Wyoming. Among the 10 most rural states in the U.S., only Vermont has a lower hesitancy rate than Maine, the data show. In a handful of rural states, the percentage of adults deemed vaccine hesitant is more than double that in Maine.

There is relatively little distinction between Maine’s more rural and urban counties, the federal survey found, with hesitancy ranging from just shy of 11 percent in Cumberland County to 14 percent in Aroostook and Washington counties.

Hesitancy is likely relatively low because more people are getting sick, demonstrating the immediate threat to the public, Robert Horsburgh, an epidemiology professor at Boston University, said. There are still people who are more skeptical of the virus’ dangers, but he said that may change as people continue to get sick.

“It’s not like measles, where there’s hesitancy because it’s rare and we haven’t seen it in a while,” he said. “With COVID-19, there’s more of a chance that you know someone who has gotten it.”

Rural hesitancy, Horsburgh said, could be caused by two things: a perception that residents are less at risk or a lack of access to vaccines, causing people to not get the vaccine as soon as they are eligible. Those reasons may change as the pandemic continues and doses become more available, he said.

“If someone can’t spend an hour to drive to Bangor to get vaccinated because of work, that doesn’t mean they didn’t want the vaccine,” he said. “It just means they made the calculation to make money rather than getting the vaccine.”

Maine has seen significant geographic disparities in county-level vaccination rates, though the state has tried to expand access in rural parts of the state in recent weeks. As of Friday, about 43 percent of adults in Somerset County had received at least one vaccine dose compared to 62 percent in Cumberland County.

Some critics raised concerns about vaccine hesitancy among Mainers in their 50s when the state announced it would extend vaccine eligibility to all adults due to unfilled appointments only a week after eligibility extended to that group. Still, as of Friday — three weeks after eligibility was extended to them — 57 percent of Mainers in their 50s had already received a vaccine. Survey data has not shown a higher hesitancy rate among that age group compared to the state’s general population.