Inequities in COVID-19 Vaccination Coverage Among Pregnant Persons, by Disaggregated Race and Ethnicity - Massachusetts, May 2021-October 2022

Abstract

National estimates suggest that COVID-19 vaccination coverage among pregnant persons is lower among those identifying as Hispanic or Latino (Hispanic) and non-Hispanic Black or African American. When examining COVID-19 vaccination coverage during pregnancy by race and ethnicity, however, data are typically limited to large, aggregate categories that might obscure within-group inequities. To address this, Massachusetts examined COVID-19 vaccination coverage among pregnant persons by combinations of 12 racial and 34 ethnic groupings. Among 102,275 persons with a live birth in Massachusetts during May 1, 2021-October 31, 2022, receipt of ≥1 dose of a COVID-19 vaccine before or during pregnancy was 41.6% overall and was highest among persons who identified as Asian (55.0%) and lowest among those who identified as Hispanic (26.7%). However, within all broad racial and ethnic groupings, disparities in COVID-19 vaccination coverage were identified when the data were disaggregated into more granular categories; for example, COVID-19 vaccination coverage ranged from 10.8%-61.1% among pregnant persons who identified as Hispanic. Disaggregated analyses reveal diverse experiences within broad racial and ethnic groupings. This information can be used to guide outreach to pregnant persons in communities with lower rates of COVID-19 vaccination coverage during pregnancy.

FIGURE 1

COVID-19 vaccination timing in relation to pregnancy as of October 31, 2022, by month of delivery — Massachusetts, May 1, 2021–October 31, 2022

FIGURE 2

COVID-19 vaccination coverage before or during pregnancy by race and ethnicity (large groupings overall and racial and ethnic subgroups with highest and lowest rates of coverage within these large groupings)^,,,,,,,, among pregnancies resulting in live birth — Massachusetts, May 1, 2021–October 31, 2022 Abbreviations: AI/AN = American Indian or Alaska Native; NH/OPI = Native Hawaiian or other Pacific Islander. * Receipt of >1 dose of a COVID-19 vaccine (primary series or any subsequent dose). ^† The Hispanic overarching category includes persons who selected one or more of the following races on the birth certificate: Hispanic/Latina/Black, Hispanic/Latina/White, or Hispanic/Latina/other. ^§ Massachusetts birth certificates include an AI/AN option for race and a Native American option for ethnicity. Whereas the AI/AN overarching category includes those who identify as being racially AI/AN, there are also persons who identify as ethnically Native American (and who might identify as racially AI/AN). ^¶ The AI/AN overarching category includes persons who selected AI/AN as their race (or one of their races) on the birth certificate. ** The Asian overarching category includes persons who selected Asian as their race (or one of their races) on the birth certificate. ^†† The NH/OPI overarching category reflects persons who selected one or more of the following races on the birth certificate: Guamanian or Chamorro, Native Hawaiian, Samoan, or other Pacific Islander. ^§§ The Black or African American (Black) overarching category includes persons who selected Black as their race (or one of their races) on the birth certificate. ^¶¶ Among Black pregnant persons, the lowest rate of COVID-19 vaccination uptake before or during pregnancy was tied between three groupings: persons who also identified as other South American ethnicity (50.0%), Mexican ethnicity (50.0%), or Asian Indian ethnicity (50.0%). *** The White overarching category includes persons who selected White as their race (or one of their races) on the birth certificate. ^††† The “another” race category includes persons who selected “other race not listed” on the birth certificate as one of their races or for whom no race category was selected or who opted not to identify their race, so the birth registrar indicated this as a refusal.