COVID-19 vaccination rates vary by community vulnerability: A county-level analysis

Abstract

We used the COVID-19 Community Vulnerability Index and 7 theme scores to assess associations between vulnerability and county-level COVID-19 vaccination (n = 2415 counties) through May 25th, 2021. When comparing vaccination rates among quintiles of CCVI scores, Theme 3 (housing type, transportation, household composition, and disability) was associated with the largest disparity, with the least vulnerable counties (Q1) having 33% higher rates of vaccination among individuals aged 18+ (53.5% vs 40.2%) compared to counties with the highest vulnerability (Q5). Using generalized linear models with binomial distributions and log links, we found that a 10-point increase in the CCVI index, socioeconomic vulnerability, housing type and composition, and epidemiological factors were associated with at least a 1.0 percentage point decline in county-level vaccination. The association between community vulnerability and lower vaccination rates suggests the need for continued efforts for equitable COVID-19 vaccination across marginalized communities.

Association of Social Vulnerability, COVID-19 vaccine site density, and vaccination rates in the United States

“…Consistent with other studies, we found a strong association between socioeconomic vulnerability and low vaccination rates that has persisted since our data collection. 2 , 3 , 13 While counties with higher SES vulnerability had more vaccine sites per capita, this increased site density did not mitigate the association of SES with lower vaccination rates. Persistent vaccination inequities may have reflected non-residents using the sites and limited vaccine supply, as well as other access challenges related to lack of transportation and inflexible time-off policies for working class employees.…”

Counties with Lower Insurance Coverage and Housing Problems Are Associated with Both Slower Vaccine Rollout and Higher COVID-19 Incidence

“…Prior studies in the United States [ 14 ] and Israel [ 16 ] have found that socioeconomic vulnerability is linked with lower vaccination rates; however, these studies focus on the concept of a socioeconomic vulnerability index more broadly, rather than on individual socioeconomic factors. Another recent US-based study found that vaccination rates are strongly correlated with housing problems [ 14 , 23 ]; however, this analysis did not consider COVID-19 incidence rates as an additional outcome measure. Furthermore, this current study is novel because it includes a large number of socioeconomic factors in the analysis.…”

SARS-CoV-2 transmission potential and rural-urban disease burden disparities across Alabama, Louisiana, and Mississippi, March 2020 — May 2021

“…This may be due to the low vaccination rates in these counties, poor compliance to public health measures, hospital closures, increased likelihood of unemployment, and delay in seeking care due to lack of insurance. [ 45 , 46 ] This reiterates the need for public health outreach and the development of programs and policies to address the disparity.…”