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Quantifying and Benchmarking Disparities in COVID-19 Vaccination Rates by Race and Ethnicity

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Unequal COVID-19 vaccination rates in the United States have compounded existing disparities in cases, hospitalizations, and deaths among Black and Hispanic populations.13 In this study, we quantify how differential vaccine uptake by race and ethnicity within each US state produced substantial vaccination coverage disparities during the initial scale-up among older adults. We model alternative scenarios for the period after eligibility opened to all adults, including a scenario of persistent differential uptake and scenarios that include efforts to reduce disparities by addressing access barriers, increasing vaccine confidence, and prioritizing disadvantaged geographic areas.

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Article Information

Accepted for Publication: August 17, 2021.

Published: October 20, 2021. doi:10.1001/jamanetworkopen.2021.30343

Correction: This article was corrected on November 11, 2021, to fix the phrase “Black and Hispanic adults” in the first sentence of the second paragraph in the Results; the terms “Black” and “Hispanic” had been incorrectly transposed.

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Reitsma MB et al. JAMA Network Open.

Corresponding Author: Joshua A. Salomon, PhD, Department of Health Policy, Stanford University School of Medicine, 117 Encina Commons, Stanford, CA 94305 (salomon1@stanford.edu).

Author Contributions: Ms Reitsma had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Reitsma, Salomon.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: All authors.

Obtained funding: Goldhaber-Fiebert, Salomon.

Supervision: Goldhaber-Fiebert, Salomon.

Conflict of Interest Disclosures: Dr Goldhaber-Fiebert reported receiving grants from the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists, grants from the National Institute on Drug Abuse, and grants from the State of California during the conduct of the study; and donation of servers from AMD and grants from the Horowitz Foundation outside the submitted work. Dr Salomon reported receiving grants from the Centers for Disease Control and Prevention to his institution through the Council of State and Territorial Epidemiologists, grants from the National Institute on Drug Abuse, and grants from the State of California during the conduct of the study. No other disclosures were reported.

Funding/Support: Ms Reitsma, Dr Goldhaber-Fiebert, and Dr Salomon are supported by the Stanford Clinical and Translational Science Award to Spectrum (UL1TR003142). Ms Reitsma is supported by Stanford’s Knight-Hennessy Scholars program. Drs Goldhaber-Fiebert and Salomon are supported by funding from the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists (NU38OT000297), and from the National Institute on Drug Abuse (3R37DA01561217S1). Drs Goldhaber-Fiebert and Salomon are supported by a contract with the State of California (SPO 184726).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Information: State-level results and code for the analysis are available at https://github.com/PPML/covid_vaccination_disparities.

References
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Moore  JT , Ricaldi  JN , Rose  CE ,  et al; COVID-19 State, Tribal, Local, and Territorial Response Team.  Disparities in incidence of COVID-19 among underrepresented racial/ethnic groups in counties identified as hotspots during June 5-18, 2020—22 states, February-June 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(33):1122-1126. doi:10.15585/mmwr.mm6933e1PubMedGoogle ScholarCrossref
2.
Gold  JAW , Rossen  LM , Ahmad  FB ,  et al.  Race, ethnicity, and age trends in persons who died from COVID-19—United States, May-August 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(42):1517-1521. doi:10.15585/mmwr.mm6942e1PubMedGoogle ScholarCrossref
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Painter  EM , Ussery  EN , Patel  A ,  et al.  Demographic characteristics of persons vaccinated during the first month of the COVID-19 vaccination program—United States, December 14, 2020-January 14, 2021.   MMWR Morb Mortal Wkly Rep. 2021;70(5):174-177. doi:10.15585/mmwr.mm7005e1PubMedGoogle ScholarCrossref
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Ruggles  S , Flood  S , Foster  S ,  et al.  IPUMS USA: Version 11.0 2015-2019 American Community Survey. Minneapolis, MN: IPUMS; 2021. doi:10.18128/D010.V11.0
5.
Reitsma  M , Artiga  S , Goldhaber-Fiebert  J ,  et al. Disparities in reaching COVID-19 vaccination benchmarks: projected vaccination rates by race/ethnicity as of July 4. Kaiser Family Foundation. Published June 14, 2021. Accessed August 3, 2021. https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-reaching-covid-19-vaccination-benchmarks-projected-vaccination-rates-by-race-ethnicity-as-of-july-4/
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Bibbins-Domingo  K .  This time must be different: disparities during the COVID-19 pandemic.   Ann Intern Med. 2020;173(3):233-234. doi:10.7326/M20-2247PubMedGoogle ScholarCrossref
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