Combination of the two. If you go to very rural areas, you'll find people who don't trust the medical establishment as much (not to the point that they won't go to the dr., but if they have already have covid, they won't get vaccinated, and some who are young and healthy won't either. And then a small minority of people who should have more sense won't).
I think county health care and local health plans generally have an initiative to get as many vaccinated as possible and they'll come up with creative ideas (not sure what the fed. reimbursement is for giving vaccines, as there may also be profit motive).
Generally here, though, most are going to get the vaccine - expectation from the outset has been 70% but I think after seeing a 90%+ uptake among front line workers and nursing home residents, it's expected to end up at 80%+, and some of the remaining cohort will have had covid, so some level of immunity will be closer to 90% and that should be enough to shove covid off into the penalty box.
I may come off as a contrary crank, but it seemed like a clear case to me and I got pfizerized as soon as it was available (back in feb and early march? two shots were only 3 weeks apart that I recall). My dad would be in the category of folks who voted for trump and had bumper stickers with trump stuff (and my mother has a car in the same driveway next to it with hillary and biden stuff all over it - terrible . both of them!), but he also got vaccinated right away, as did my mother. I think that's more typical here - that even folks politically opposed to it recognize how effective it is and bite their tongue.