As much as I distrust Wikipedia, I grabbed this about Columbiana County, Ohio within which East Palestine sits:
"Unlike most counties in Northeast Ohio, Columbiana County has been predominantly Republican throughout most of its history. In only eight elections from 1856 to the present has a Democratic Party candidate won the county, the most recent being Bill Clinton in 1996. Despite this, the county was a swing county in the latter half of the 20th century, voting for the national winner in all but two elections from 1952 to 2004. However, it has trended strongly Republican in recent elections, with the party's candidates garnering increasing amounts of the vote in each presidential election from 2000 on. This trend was most apparent in 2016 when Donald Trump posted the best showing by a Republican in the county since Herbert Hoover in 1928 with a 41.4 point margin of victory over Hillary Clinton."
Probably because the vax was getting too many of their own