Disparities in COVID-19 vaccination rates improve with increased vaccine availability, but racial and geographic disparities persist

Although people of color have been disproportionately affected by the COVID-19 pandemic, many of these same communities saw lower vaccination rates at the beginning of the vaccine rollout. As COVID-19 vaccines have become more available and states and the federal government have implemented targeted vaccination strategies, disparities in vaccination rates in certain demographic groups have improved. However, available data still shows racial and ethnic disparities in vaccination and infection rates, as well as disparities in vaccination rates in rural populations. Additionally, gaps in data collection and reporting related to COVID-19 cases and vaccination rates make it difficult to fully understand and improve upon these disparities.

Some recent improvement in racial and ethnic disparities in COVID-19 vaccination rates…

In their recent analysis of vaccination data by race/ethnicity, the Kaiser Family Foundation (KFF) noted in regards to recent data from the Centers for Disease Control and Prevention (CDC), “data show that recent vaccinations are reaching larger shares of Hispanic, Asian and Black populations. Over one in five (23%) vaccines administered in the past 14 days have gone to Hispanic people, 8% to Asian people and 10% to Black people. These recent trends suggest a narrowing of racial gaps in vaccinations at the national level, particularly for Hispanic people, who have recently received a larger share of vaccinations compared to their share of the total population (23% vs. 17%).” Additionally, a Kaiser Health News analysis found that “Hispanics in eight states, the District of Columbia and Puerto Rico are now vaccinated at higher rates than non-Hispanic whites.”

…But disparities still exist

Despite some improvements in certain groups, racial/ethnic vaccine disparities still exist.

For 40 states that report race/ethnicity data based on people who have received at least one dose of the vaccine, KFF found that “the percent of white people who have received at least one COVID-19 vaccine dose (43%) was roughly 1.5 times higher than the rate for Black people (29%) and 1.3 times higher than the rate for Hispanic people (32%) as of May 24, 2021.”

In addition, there is a geographic disparity in vaccination rates between rural and urban areas. A recent CDC study found that “COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%).”

There have been several reasons suggested by researchers for the racial and ethnic disparities in vaccination rates, including:

  • Lack of internet access or computer literacy to sign up for appointments on online portals
  • Inability to take time off from work to receive the vaccine
  • Lack of reliable transportation; vaccination sites being set up in more affluent and less diverse areas
  • Vaccination information being unavailable in other languages

For the disparities in vaccination rates in rural populations, a significant factor is vaccine hesitancy. A survey found that rural residents had the highest percentage of people (24%) indicating they will “definitely not” receive a COVID-19 vaccine.

States have been working to address these issues and lessen disparities in vaccination rates, and the federal government has also taken steps, like distributing vaccines to community health centers that provide care to medically underserved communities.

Gaps in data collection and reporting

The CDC is only reporting racial and ethnic vaccination data at the national level. As of June 7, there is race/ethnicity data for only 56.9% of the people who have received at least one dose of a COVID-19 vaccine. Of those people, 9% are Black, 14.5% are Hispanic/Latino and 61% non-Hispanic white. However, CDC data for COVID-19 cases shows that of the nearly 27 million reported cases in the U.S., 11.3% of those people are Black, 28.8% are Hispanic/Latino and 50.2% are non-Hispanic white. Race/ethnicity information is known for only 62% of the reported cases of COVID-19.

The lack of comprehensive race and ethnicity data for vaccination rates is similar to the gaps in demographic data we have seen throughout the COVID-19 pandemic with respect to infection, testing, hospitalization and mortality rates. There are several reasons for the gaps in data, including:

  • Outdated public health data systems
  • Years of underfunding in public health
  • A fragmented data infrastructure through which information does not flow seamlessly from providers to states and federal agencies
  • People not necessarily wanting to provide information on their race or ethnicity, or health care providers not wanting to pry or assume a person’s background

Improvements in vaccination access

With COVID-19’s disproportionate impact on underserved communities and communities of color, we must do everything we can to ensure equitable distribution of the vaccine. An important first step included the American Kidney Fund (AKF) meeting with Congressional and Biden-Harris administration officials to recommend the distribution of COVID-19 vaccines directly to dialysis clinics nationwide. On March 25, the Biden-Harris Administration put this recommendation into action and announced that COVID-19 vaccines will be distributed directly to kidney failure patients at dialysis clinics. By allowing dialysis clinic staff to vaccinate people with kidney failure, who are at high risk for severe cases of COVID-19 and who are disproportionately people of color, they are providing greater access to vaccines.

AKF will continue to work toward ensuring that everyone with kidney disease has access to the vaccine.

Learn more about these efforts on our website.


About the Author

Mike Ly

Mike Ly is the director of public policy at the American Kidney Fund.