Racial Disparities in Access to Potential COVID‐19 Vaccine Administration Facilities across US States: A Geographic Information Systems Analysis

Abstract

Research ObjectiveA major challenge in the design of vaccine distribution and administration plans is ensuring equitable access to COVID‐19 vaccines among racial minority populations, who have been disproportionately affected by the pandemic.We calculated driving distance to the closest potential COVID‐19 vaccine administration facility for a representative sample of the US population and estimated whether race was associated with access to healthcare facilities that may serve as COVID‐19 vaccine administration locations.Study DesignWe mapped community pharmacies providing immunization services as of October 1, 2020, federally qualified health centers, rural health clinics, and hospital outpatient departments. For a 1% sample of a US synthetic population, we computed driving distance to the closest facility using ArcGIS Network Analyst and a national transportation dataset. For each state, we calculated the proportion of population with ≥10 miles distance to the closest facility and the odds ratio of having a distance≥10 miles to the closest facility for Black compared to White residents.Population Studied1% sample of the 2010 U.S. Synthetic Population developed by RTI International (n = 2,982,544).Principal FindingsThe mean (median) number of potential COVID‐19 vaccine administration facilities per state was 988 (1335) and ranged from 201 in WY to 6577 in CA. In 21 states, more than 5% of the population had a driving distance ≥10 miles to the closest facility. In ND, SD, MT, WY, NE, and KS, over 10% of the population had a driving distance ≥10 miles.In 17 states, Black residents were more likely to live ≥10 miles to the closest facility than White residents. Among these 17 states showing statistically significant disparities, there were 8 states where Black residents were at least 5 times more likely to have a driving distance ≥10 miles than White residents, including AK, CT, DE, MA, NJ, RI, UT, and DC. Additionally, in CA, NV, and SC, Black patients were 2 to 5 times more likely to have a driving distance ≥10 miles to the closest facility.ConclusionsThere exists large state‐level variation in racial disparities in access to potential COVID‐19 vaccine administration facilities. While states with a greater proportion of the overall population ≥ 10 miles to the closest facility were concentrated in the Midwest, states with significant racial disparities, mostly placed along the coasts, tend to be more populous with highly diverse racial composition.Implications for Policy or PracticeEnsuring an equitable COVID‐19 vaccine administration among the U.S. population is the current public health priority. Our analyses can guide public health officials in the identification of areas that necessitate additional infrastructure for a equitable vaccine distribution. This is of upmost importance to prevent the historical disparities in access to health care from further magnifying disparities in COVID‐19 related outcomes.Primary Funding SourceWest Health Policy Center.