Marked Inequalities in COVID-19 Vaccination by Racial/Ethnic, Socioeconomic, Geographic, and Health Characteristics, United States, January 6 – February 15, 2021

Abstract

Background: The COVID-19 pandemic has had a substantial adverse impact on the health and wellbeing of populations in the United States (US) and globally. Since the availability of COVID-19 vaccines in December 2020, efforts have been underway to vaccinate priority populations who are at increased risks of COVID-19 infections, morbidity, and mortality, but rigorous and analytical national data on vaccination rates are lacking. Using the latest nationally representative data, we examine disparities in COVID-19 vaccination among US adults aged 18 years and older by a wide range of social determinants. Methods: Using three consecutive rounds of the US Census Bureau’s Household Pulse Survey from January 6 to February 15, 2021 (N=224,458), disparities in vaccination rates by race/ethnicity, socioeconomic status, health insurance, health status, and metropolitan area were modeled by multivariate logistic regression. Results: An estimated 33.6 million or 13.6% of US adults received COVID-19 vaccination. Vaccination rates varied 5-fold across the age range, from a low of 5.8% for adults aged 18-24 to 19.1% for those aged 65-74, and 29.0% for those aged ≥75 years. Males, non-Hispanic Blacks, Hispanics, divorced/separated and single individuals, those with lower education and household income levels, renters, not-employed individuals, the uninsured, and individuals with higher depression levels reported significantly lower rates of vaccination. Controlling for covariates, non-Hispanic Blacks had 11% lower odds and Asians had 50% higher odds of receiving vaccination than non-Hispanic Whites. Adults with less than a high school education had 64% lower adjusted odds of receiving vaccination than those with a Master’s degree. Adults with an annual income of <$25,000 had 33% lower adjusted odds of vaccination than those with a ≥$200,000. Vaccination rates ranged from 10.7% in Riverside-San Bernardino, California to 16.1% in Houston, Texas. Conclusion and Implications for Translation: Ethnic minorities, socioeconomically-disadvantaged individuals, uninsured adults, and those with serious depression reported significantly lower vaccination rates. Equitable vaccination coverage is critical to reducing inequities in COVID-19 health outcomes. Copyright © 2021 Singh. et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.