LOUISVILLE, Ky. — As the weather cools and holidays arrive, COVID-19 cases in Kentucky are creeping back up, but vaccination rates in some counties remain alarmingly low, health officials told Spectrum News 1.

“Get vaccinated,” Gov. Andy Beshear said Monday in a press conference where he outlined an increase in cases and hospitalizations across the state. "Everybody at your Thanksgiving dinner should be vaccinated, as long as they're over five."

The reversal of October’s dramatic decrease in COVID cases, which followed a delta variant-fueled summer surge, is a concern to public health officials everywhere, but those who live and work in places with the state’s lowest vaccination rates are particularly on edge. 

“It’s concerning and we’re trying so hard to make this vaccine available,” said Lewis County Health Director Anita Bertram.

Lewis County, on the Kentucky-Ohio border, has a 39% vaccination rate. It has also seen cases begin to increase over the month of November. After seeing more than 200 active cases a day in Sept., the number dropped all the way down to 17 earlier this month. But last week, the number of active cases once again climbed above 60.

Bertram said the primary concern she’s heard from the vaccine hesitant is about long-term side effects of the vaccine. She encourages people with those concerns to speak to trusted health professionals, and to avoid Facebook.

There are currently 16 counties in Kentucky with vaccination rates below 40% and one under 30%. They range from Ballard and Hickman counties in far eastern Kentucky, to Lewis and Elliott Counties in eastern Kentucky. The list includes tiny counties (Robertson, population 2,108) and one of the state’s largest (Warren, population 132,896). Statewide, the vaccination rate is 59%, with leading counties surpassing 70%.

Only 38% of Owen County is vaccinated and a health official said COVID cases are ticking up there. To combat vaccine hesitancy, the Three Rivers District Health Department, which has jurisdiction over Owen and three other counties, is publishing testimonials from “vaccine champions” in newspapers and on social media.

In one recently-posted testimonial, Gallatin County Fiscal Court Treasurer Lesa Bullard said she was vaccinated after losing a family member, and nearly losing another, to COVID-19.

“What we're finding is that the population that is not getting vaccinated are often the younger ones who are less concerned about their health,” said Cloie Rager, spokesperson for the Christian County Health Department. The western Kentucky county ranks 119th among Kentucky’s 120 counties in vaccination rate, with only 34% of its 70,461 people vaccinated.

The trend she identified is not isolated to her area either. Only half of the state's 18 to 24-year-olds are vaccinated. And 58% of those between 25 and 39 are vaccinated. 

Rager said the health department is trying to reach the unvaccinated through advertising. “We're on TV. We're on the radio. We're on the internet. We're on mailboxes. We’re on pizza boxes. We're doing countywide mail outs,” she said.

The county also partnered with the city of Hopkinsville to offer a $100 payment to anyone who received a shot. Though they had the ability to pay the incentive to 1,000 people, only 250 showed up. “Even with the best incentives and the best marketing, it just seems like there's a disconnect with the population who are not getting vaccinated,” she said. “We're kind of at a loss”