When it comes to getting a COVID-19 vaccination, a significant number of South Dakota residents are taking a hard pass.

According to a report from 24/7 Wall St, the latest numbers from the U.S. Census Bureau show that more than 18 percent of adults surveyed in the Mount Rushmore State (116,670 people) say they will either probably or definitely not agree to receive the vaccination.

That's well above the national average of 10 percent, which translates to nearly 27 million Americans.

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South Dakota's refusal rate trails only Wyoming, where 25 percent of residents are going unvaccinated.

Seven other states have refusal rates of 15 percent or higher:

  • Montana: 18%
  • North Dakota: 17.8%
  • Louisiana: 16.4%
  • Oklahoma: 16.4%
  • Alabama: 15.5%
  • Missouri: 15.5%
  • Michigan: 15.1%

Vermont (4.2%) and Maryland (4.7%) are the only states where fewer than five percent of the population is refusing to get their shots.

Despite the high percentage of resistance to getting the vaccine, South Dakota's COVID death rate is not among the worst in the country. 13 other states have lost a higher number of people (per 100,000) to the virus:

STATES WITH HIGHEST COVID DEATH RATE (Per 100,000 people)

  • Mississippi – 339
  • Alabama – 322
  • New Jersey – 314
  • Louisiana – 313
  • Arizona – 297
  • New York – 287
  • Arkansas – 280
  • Georgia - 279
  • Florida – 279
  • Oklahoma – 277
  • Massachusetts – 276
  • Rhode Island – 272
  • South Carolina – 271

According to the latest numbers from the South Dakota Department of Health, slightly more than 58 percent of state residents are fully vaccinated.

Since the beginning of the pandemic, there have been 136,709 confirmed COVID cases in South Dakota, with 2,277 deaths.

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Vaccinations for COVID-19 began being administered in the U.S. on Dec. 14, 2020. The quick rollout came a little more than a year after the virus was first identified in November 2019. The impressive speed with which vaccines were developed has also left a lot of people with a lot of questions. The questions range from the practical—how will I get vaccinated?—to the scientific—how do these vaccines even work?

Keep reading to discover answers to 25 common COVID-19 vaccine questions.

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