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. 2022 Jan 3;40(1):107-113.
doi: 10.1016/j.vaccine.2021.11.040. Epub 2021 Nov 18.

Disparities in national and state estimates of COVID-19 vaccination receipt and intent to vaccinate by race/ethnicity, income, and age group among adults ≥ 18 years, United States

Kimberly H Nguyen  1 , Elyssa Anneser  2 , Alexander Toppo  3 , Jennifer D Allen  4 , J Scott Parott  5 , Laura Corlin  6
Affiliations

Disparities in national and state estimates of COVID-19 vaccination receipt and intent to vaccinate by race/ethnicity, income, and age group among adults ≥ 18 years, United States

Kimberly H Nguyen et al. Vaccine. .

Abstract

Introduction: COVID-19 morbidity and mortality has disproportionately affected vulnerable populations such as minority racial/ethnic groups. Understanding disparities in vaccine intentions and reasons for vaccine hesitancy are important for developing effective strategies for ameliorating racial/ethnic COVID-19 inequities.

Methods: Using six waves of the large, nationally representative Census Bureau's Household Pulse Survey data from January 6-March 29, 2021 (n = 459,235), we examined national and state estimates for vaccination intent, defined as receipt of ≥ 1 dose of the COVID-19 vaccine or definite intent to be vaccinated, by race/ethnicity with stratification by household income and age group. In separate logistic regression models, we also examined the interaction between race/ethnicity and household income, and race/ethnicity and age group, and its association with vaccination intent. Lastly, we examined reasons for not vaccinating by race/ethnicity.

Results: Vaccination intent differed by racial/ethnic group, household income, and age group nationally and by Health and Human Services (HHS) region and state. A significant interaction was observed between race/ethnicity and household income (F(8,72) = 4.50, p < 0.001), and race/ethnicity and age group (F(8,72) = 15.66, p < 0.001). Non-Hispanic Black adults with lower income (<$35,000) and younger age (18-49 years) were least likely to intend to vaccinate. Similar disparities across racial/ethnic groups were seen across most HHS regions and states. Concerns about possible side effects and effectiveness were significantly higher among all minority groups compared to non-Hispanic White adults.

Conclusion: Disparities in vaccination intent by racial/ethnic groups underscore the need for interventions and recommendations designed to improve vaccination coverage and confidence in underserved communities, such as younger and lower income racial/ethnic minority groups. Efforts to reduce disparities and barriers to vaccination are needed to achieve equity in vaccination coverage, and ultimately, to curb COVID-19 transmission.

Keywords: COVID-19 vaccination; Disparities; Ethnicity; Race; Vaccine confidence; Vaccine hesitancy.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Predicted proportion of vaccination intent by racial/ethnic and income group, United States, January 6 - March 29, 2021. Abbreviations: NH-W = Non-Hispanic White; NH-B = Non-Hispanic Black; H = Hispanic; NH-A = Non-Hispanic Asian, NH-O = Non-Hispanic other/multiple race category.
Fig. 2
Fig. 2
Predicted proportion of vaccination intent by racial/ethnic and age group, United States, January 6 - March 29, 2021. Abbreviations: NH-W = Non-Hispanic White; NH-B = Non-Hispanic Black; H = Hispanic; NH-A = Non-Hispanic Asian, NH-O = Non-Hispanic other/multiple race category.
See this image and copyright information in PMC

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