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. 2021 Aug 17;118(33):e2107873118.
doi: 10.1073/pnas.2107873118.

Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination

Ritu Agarwal  1   2 , Michelle Dugas  3   2 , Jui Ramaprasad  3 , Junjie Luo  3   2 , Gujie Li  3   2 , Guodong Gordon Gao  3   2
Affiliations

Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination

Ritu Agarwal et al. Proc Natl Acad Sci U S A. .

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.

Keywords: COVID-19; racial disparity; social determinants of health; vaccination.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Fig. 1.
Fig. 1.
(A) Distribution of county-level COVID-19 vaccination rates by race (19 April 2021). (B) Distribution of county-level flu vaccination rates among Medicare beneficiaries for the year 2019 by race. (C) Weighted average of Black and White rates for COVID-19 vaccination and their disparity. (D) Weighted average of Black and White rates for flu vaccination and their disparity. Error bars represent 95% confidence intervals.
Fig. 2.
Fig. 2.
Contrast of regression coefficients for indicators of social determinants of health for COVID-19 and flu vaccine disparities (n = 756). Percentage point change in disparities associated with one SD increase in predictor variables. Error bars represent 95% confidence intervals.
See this image and copyright information in PMC

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