To examine COVID-19 vaccination barriers in the US, this study drew on publicly available county-level data (n = 3130) to investigate the impact of vaccine hesitancy on the relationship between county-level social/structural barriers and vaccine coverage. A hierarchical regression was performed to establish the relationship between the COVID-19 Vaccine Coverage Index (CVAC) and vaccine coverage, assess the moderating effect of vaccine hesitancy on this relationship, and explore the influence of ethno-racial composition on vaccine coverage. A significant, negative relationship (r2 = 0.11, f2 = 0.12) between CVAC and vaccine coverage by county was established (step 1). When vaccine hesitancy was introduced as a moderator (step 2), the model significantly explained additional variance in vaccine coverage (r2 = 0.21, f2 = 0.27). Simple slopes analysis indicated a significant interaction effect, whereby the CVAC–vaccine coverage relationship was stronger in low hesitancy counties as compared with high hesitancy counties. Counties with low social/structural barriers (CVAC) but high hesitancy were projected to have 14% lower vaccine coverage. When county-level ethno-racial composition was introduced (step 3), higher proportions of white residents in a county predicted decreased vaccination rates (p < 0.05). Findings indicate that CVAC should be paired with vaccine hesitancy measures to better predict vaccine uptake. Moreover, counties with higher proportions of white residents led to decreases in vaccine uptake, suggesting that future intervention strategies should also target whites to reach herd immunity. We conclude that public health leaders and practitioners should address both social/structural and psychological barriers to vaccination to maximize vaccine coverage, with a particular focus on vaccine hesitancy in communities with minimal social/structural barriers.

A low heart rate variability (HRV) is indicative of autonomic inflexibility, which has important implications for physical and psychological health. This study investigates autonomic functioning and its relationship to state anxiety in the context of music intervention. A within-subjects, quasi-experimental design was used with undergraduates, a population frequently impacted by state anxiety. Participants pre-selected music that they identified as the most “relaxing” before being administered the State-Trait Anxiety Inventory (STAI). Baseline physiological indices were then collected using an EKG, followed by administration of the selected music and an additional collection of physiological indices. After the full duration of music intervention was administered, participants took the STAI once more. Results indicated that even short durations of music listening may serve to reduce anxiety in the undergraduate student, as was evidenced by the significant increase in physiological indices and decrease in self-reported anxiety levels. However, while changes in HRV and anxiety may trend together, results indicated no statistical association between these parameters. KEYWORDS: Heart Rate Variability; Anxiety; Music Intervention; Autonomic Tone; Vagal Control; Autonomic Flexibility; College Students; State Anxiety

BackgroundResearch shows that lower heart rate variability (HRV) is associated with multiple health risks, including early mortality, congestive heart failure and mental illness. Research on the relationship between HRV and anxiety has been inconclusive but should be studied, as HRV may be a noninvasive indicator of overall mental health. Music has been used as an inexpensive intervention method to significantly lower self‐reported anxiety in multiple populations.ObjectiveTo determine the strength of the possible relationship between anxiety and HRV with music intervention.Subjects and MethodsA within‐subjects experimental design was used with undergraduate students (n=32). Self‐reported anxiety used STAI, followed by the collection of seven minutes of baseline EKG data. Seven minutes of pre‐selected, “relaxing” music was played (intervention) while physiological indices were again collected. The STAI was re‐administered.ResultsAfter music intervention, significant reduction in anxiety (p<0.001) and heart rate was demonstrated (p<0.01), with a significant increase in RR (p<0.01), SDRR (p<0.01), and pRR50 (p<0.01). No correlation was found between the change in anxiety and physiological indices (p=0.737).ConclusionsUndergraduate students may benefit from music intervention, as music significantly improved self‐reported anxiety and physiological anxiety, as measured by STAI score and HRV, respectively. However, these improvements seemed to occur independently, thus decreasing the strength of the proposed relationship between HRV and anxiety in the literature. Elon University IRB #17‐083.Support or Funding InformationResearch supported by Elon University Undergraduate Research Program (URP) and Elon College Fellows (ECF) program.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.