Abstract
Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress. Racial disparities in vaccination persist despite the increased availability of vaccines. We ask what factors are associated with such disparities. We combine data from state, federal, and other sources to estimate the relationship between social determinants of health and racial disparities in COVID-19 vaccinations at the county level. Analyzing vaccination data from 19 April 2021, when nearly half of the US adult population was at least partially vaccinated, we find associations between racial disparities in COVID-19 vaccination and median income (negative), disparity in high school education (positive), and vote share for the Republican party in the 2020 presidential election (negative), while vaccine hesitancy is not related to disparities. We examine differences in associations for COVID-19 vaccine uptake as compared with influenza vaccine. Key differences include an amplified role for socioeconomic privilege factors and political ideology, reflective of the unique societal context in which the pandemic has unfolded.
Highlights
Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress
For each variable where data are available by race we model the racial disparity in addition to the level
We find that COVID-19 Vaccination Disparities (CVD) is associated with median income, education, and political ideology
Summary
Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress. Systemic racial inequities in the United States pose the risk of disparities in vaccination rates among vulnerable populations. This is especially important as COVID-19 has disproportionately impacted racial minorities [1, 2]. Prior studies have documented significant racial disparities in vaccination rates for other diseases, with the most persistent differences observed between Blacks and Whites [4]. Explanations for such disparities abound, including structural racism, medical mistrust, and individual vaccine hesitancy [5]. The two diseases are distinct in that COVID-19 is deadlier, and COVID-19 vaccines were developed rapidly and deployed with limited supply in the early days of their temporary-use authorization [7]
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