RALEIGH, N.C. (WNCN) — North Carolina ranks 38th nationally when it comes to the overall percentage of adults who have received at least one dose of the COVID-19 vaccine, according to data from the Centers for Disease Control and Prevention.

Because vaccination rates are relatively high for the oldest people in virtually every state, that low ranking appears to reflect the reluctance of younger and middle-aged adults — those between 18 and 64 years old — to get inoculated.

North Carolina is one of 43 states where at least 75 percent of those 65 and older have gotten at least one shot, CDC data show. People in that age group were prioritized early in the vaccination rollout.

“We actually did a good job as a state, I think, to roll vaccine out in the over 65s, so I would carve them out as a separate group,” said Dr. Cameron Wolfe, an infectious disease specialist at Duke University’s medical school. “Older adults have actually done a fabulous job. So that deserves credit where it is.”

What that means is the variance is coming from among those adults younger than that.

Less than 43 percent of North Carolinians between the ages of 18 and 64 have received their first dose, putting the state 36th in that measure. Nine of the bottom 15 states are located in the Southeast, including the bottom three of Louisiana (33.1 percent), Alabama (32.8 percent) and Mississippi (31.7 percent).

Three Northeastern states — Massachusetts, Connecticut and New Hampshire — are at the top of that list, all better than 60 percent.

A closer look at North Carolina’s counties reveals some trouble spots.

There are 13 counties where fewer than 10 percent of people between 18 and 24 years old have had their first dose. In Onslow County, that rate is just 3.5 percent. 

Among those between 25 and 49 years old, more than a third of counties — in all, 35 — have not yet gotten that rate to 20 percent, and once again Onslow County ranks last at 11.4 percent.

And in nine counties, fewer than 30 percent of those between ages 50 and 64 have received their first shot.

Hoke County is the only county in the CBS 17 viewing area to appear on all three of those lists. That county’s health director, Helene Edwards, did not return an email from CBS 17 News asking for an interview.

There are many explanations for the state’s low overall ranking, from hesitancy among minorities, to concerns over side effects either now or in the future, to political leanings, with surveys showing Republicans less likely to get the vaccine than Democrats.

“COVID is not a bloody political issue. It is a health issue,” Wolfe said. “And so how that has become a vaccine hesitancy debate is mind-numbing to me. And yet we fall foul of that in North Carolina quite significantly. … My God, don’t let politics get in the way of this.”

Wolfe has another theory: North Carolina’s handling of the pandemic has gone relatively well compared to other states.

“It’s not necessarily in your face as much as it was daily if you’re living in New York, or still, if you’re in Michigan,” he said. “And so that sort of that recognition of how bad COVID can be is, if it’s not in front of you, every day, you don’t see it, you don’t feel it, you don’t feel the motivation to get vaccinated.”

CBS 17’s Joedy McCreary has been tracking COVID-19 figures since March 2020, compiling data from federal, state, and local sources to deliver a clear snapshot of what the coronavirus situation looks like now and what it could look like in the future.