COVID-19 Doesn’t Discriminate Among Races and Settings. So Why Should Vaccination Rates Be Inequitable?

In spite of public health messaging (some of which highlights healthcare providers and patients of color), there continue to be disparities in vaccination rates from one demographic group to another across the United States. As noted in an article just published online by JAMA Health Forum, U.S. neighborhoods with a higher percentage of white and Asian residents and higher mean incomes were more likely to have high rates of vaccination against SARS-CoV-2 compared with neighborhoods with a high percentage of black and Hispanic residents, lower mean incomes, and higher poverty rates. Not surprisingly, fatalities followed suit; through April 13, 2021, death rates were lowest in those same neighborhoods that reported higher vaccination rates—despite the fact that they also tended to be home to more older adults. The authors concluded that “inequities in vaccination rates across neighborhoods likely reflect…systematic underinvestment in public health in segregated communities, unequal access to healthcare information and services, and medical racism that drives legitimate mistrust among members of marginalized groups.” The study reflected data from 1,127 neighborhoods in nine major U.S. cities and surrounding counties: New York City, Los Angeles, Chicago, Houston, Phoenix, Philadelphia, San Antonio, San Diego, and Dallas, representing 40.8 million subjects.