I agree that #2 is what’s actually happening. Instead of trying to reach less educated rural people, medical professionals are reinforcing blue tribe solidarity by attacking them. A lot of blue tribe behavior these days is based on that—antagonism toward less educated whites is a key force keeping the coalition together—but now it’s killing people.
If (by hypothesis) the insecure-obstinate anti-vaxxers can't be convinced no matter what, then it's not the blue-tribe attacks on them that are killing people, it's the anti-vaxxers' pig-headedness.
And if blue-tribe attacks on anti-vaxxers help to increase blue-tribe and independents' vaccination rates, then net-net the attacks are a good thing from an overall-vax-rate perspective, because (again, by hypothesis) the blue-tribe attacks won't decrease the anti-vaxxers' vaccination rates, which are already at or near zero, and nothing will increase those rates.
EDIT: There's also a question of patience (an exhaustible resource) and cost-effectiveness: when dealing with a toddler screaming for candy in the grocery store, at some point you stop trying to reason with them and just physically remove them from the store. Likewise with anti-vaxxers: At some point the rest of us are going to lose patience and stop being willing to incur costs in terms of dollars, unavailability of ICU beds for other patients, and needless deaths and long-haul illnesses. Personally, I'd be OK with putting voluntary anti-vaxxers under house arrest, akin to being locked up for contempt of court: The key to your cell is in your own hands.
EDIT 2: You persist in labeling the blue-tribe attacks as being on less-educated and rural people. From where I sit, the attacks are on pig-headed voluntary anti-vaxxers — some of whom are well-educated city-dwellers such as the commenters on Fox News (some of them doubtless being vaccinated themselves).
