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. 2022 Apr;62(4):596-601.
doi: 10.1016/j.amepre.2021.08.027. Epub 2021 Oct 21.

Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine Uptake

Taona P Haderlein  1 , Michelle S Wong  1 , Kenneth T Jones  2 , Ernest M Moy  2 , Anita H Yuan  1 , Donna L Washington  3
Affiliations

Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine Uptake

Taona P Haderlein et al. Am J Prev Med. 2022 Apr.

Abstract

Introduction: Equitable COVID-19 vaccine access is imperative to mitigating negative COVID-19 impacts among racial/ethnic minorities. U.S. racial/ethnic minorities have lower COVID-19 vaccination rates than Whites despite higher COVID-19 death/case rates. The Veterans Health Administration provides the unique context of a managed care system with few access barriers. This study evaluates race/ethnicity as a predictor of Veterans Health Administration COVID-19 vaccination.

Methods: The cohort was composed of Veterans Health Administration outpatient users aged ≥65 years (N=3,474,874). COVID-19 vaccination was assessed between December 14, 2020 and February 23, 2021. Multivariable logistic regressions were conducted, controlling for demographics, medical comorbidity, and influenza vaccination history. Proximity to Indian Health Service Contract Health Service Delivery Areas was tested as a moderator. Data analyses were conducted during 2021.

Results: Blacks (OR=1.28, 95% CI=1.17, 1.40), Hispanics (OR=1.15, 95% CI=1.05, 1.25), and Asians (OR=1.21, 95% CI=1.02, 1.43) were more likely than Whites to receive Veterans Health Administration COVID-19 vaccinations. American Indian/Alaska Natives were less likely than Whites to receive Veterans Health Administration COVID-19 vaccinations, but only those residing in Contract Health Service Delivery Area counties (OR= 0.58, 95% CI= 0.47, 0.72). Influenza vaccine history positively predicted COVID-19 vaccine uptake (OR= 2.28, 95% CI=2.22, 2.34).

Conclusions: In the Veterans Health Administration, compared with the general U.S. population, COVID-19 vaccine receipt is higher among most racial/ethnic minority groups than Whites, suggesting reduced vaccination barriers . The Indian Health Service may provide a safety net for American Indian/Alaska Native populations. Addressing vaccination access barriers in non-Veterans Health Administration settings can potentially reduce racial/ethnic disparities.

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Figures

Figure 1
Figure 1
Race/ethnicity and CHSDA residence as predictors of COVID-19 vaccine uptake. CHSDA, Indian Health Service Contract Health Service Delivery Area.
See this image and copyright information in PMC

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