Racial concentration and dynamics of COVID-19 vaccination in the United States

Wu, Cary

doi:10.1016/j.ssmph.2022.101198

Cited by 11 publications

(10 citation statements)

References 79 publications

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“…These findings—lower vaccine uptake among counties with a large proportion of white individuals—are in contrast to studies using 2021 data, which found that lower vaccination coverage was present among Black and Latino communities [ 47 , 48 , 49 , 50 ]. However, this study uses April 2022 data, and results are consistent with research by Wu [ 50 ], which indicate that, over time (2021 to 2022), the association between white concentration and vaccination went from highly positive to highly negative. These results help to explain why population-level disparities in U.S. vaccine coverage diminished between racial and ethnic groups by the end of 2021, once the vaccine had become more widely available [ 8 ].…”

Section: Discussioncontrasting

confidence: 99%

“…While there is a plethora of studies that focus on the barriers to vaccination faced by minoritized racial and ethnic groups [ 56 , 57 , 58 , 59 , 60 ], there is a dearth of research investigating psychological barriers to vaccine uptake among white Americans. Newer studies suggest that political ideology, rugged individualism, mediate intake and moral concerns may be factors to explore in additional research [ 50 , 61 , 62 , 63 ]. This gap in our knowledge has detrimental implications for population health in the U.S.…”

Section: Discussionmentioning

confidence: 99%

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The Moderating Effect of Vaccine Hesitancy on the Relationship between the COVID-19 Vaccine Coverage Index and Vaccine Coverage

et al. 2023

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To examine COVID-19 vaccination barriers in the US, this study drew on publicly available county-level data (n = 3130) to investigate the impact of vaccine hesitancy on the relationship between county-level social/structural barriers and vaccine coverage. A hierarchical regression was performed to establish the relationship between the COVID-19 Vaccine Coverage Index (CVAC) and vaccine coverage, assess the moderating effect of vaccine hesitancy on this relationship, and explore the influence of ethno-racial composition on vaccine coverage. A significant, negative relationship (r2 = 0.11, f2 = 0.12) between CVAC and vaccine coverage by county was established (step 1). When vaccine hesitancy was introduced as a moderator (step 2), the model significantly explained additional variance in vaccine coverage (r2 = 0.21, f2 = 0.27). Simple slopes analysis indicated a significant interaction effect, whereby the CVAC–vaccine coverage relationship was stronger in low hesitancy counties as compared with high hesitancy counties. Counties with low social/structural barriers (CVAC) but high hesitancy were projected to have 14% lower vaccine coverage. When county-level ethno-racial composition was introduced (step 3), higher proportions of white residents in a county predicted decreased vaccination rates (p < 0.05). Findings indicate that CVAC should be paired with vaccine hesitancy measures to better predict vaccine uptake. Moreover, counties with higher proportions of white residents led to decreases in vaccine uptake, suggesting that future intervention strategies should also target whites to reach herd immunity. We conclude that public health leaders and practitioners should address both social/structural and psychological barriers to vaccination to maximize vaccine coverage, with a particular focus on vaccine hesitancy in communities with minimal social/structural barriers.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Moderating Effect of Vaccine Hesitancy on the Relationship between the COVID-19 Vaccine Coverage Index and Vaccine Coverage

et al. 2023

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“…6 Research has shown that communities of color are disproportionately impacted by challenges to vaccine access such as lack of information about when and where to receive a vaccine, difficulty scheduling vaccination appointments, insufficient transportation, reduced access to childcare, and reduced flexibility in taking time off work. 6,16,17 Studies show that communities with higher proportions of people of color report significantly lower vaccination rates 7,[18][19][20] and experience higher COVID-19 infections and deaths. 18,[21][22][23][24][25] There is also research that explores the association between racial segregation and COVID-19 deaths in the United States.…”

mentioning

confidence: 99%

“…Studies show that communities with higher proportions of people of color report significantly lower vaccination rates7,18–20 and experience higher COVID-19 infections and deaths 18,21–25. There is also research that explores the association between racial segregation and COVID-19 deaths in the United States 9,10,21.…”

mentioning

confidence: 99%

“…6,16,17 Studies show that communities with higher proportions of people of color report significantly lower vaccination rates 7,[18][19][20] and experience higher COVID-19 infections and deaths. 18,[21][22][23][24][25] There is also research that explores the association between racial segregation and COVID-19 deaths in the United States. 9,10,21 To the best of our knowledge, however, research specifically examining the association between segregation and vaccination at the national level is lacking.…”

mentioning

confidence: 99%

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Association Between Racial Segregation and COVID-19 Vaccination Rates

Swietek

Gianattasio

Henderson

et al. 2023

Journal of Public Health Management and Practice

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Objective: To examine the association between county-level Black-White residential segregation and COVID-19 vaccination rates. Design: Observational cross-sectional study using multivariable generalized linear models with state fixed effects to estimate the average marginal effects of segregation on vaccination rates. Setting: National analysis of county-level vaccination rates. Main Outcome Measure: County-level vaccination rates across the United States. Results: We found an overall positive association between county-level segregation and the proportion population fully vaccinated, with a 6.8, 11.3, and 12.8 percentage point increase in the proportion fully vaccinated by May 3, September 27, and December 6, 2021, respectively. Effects were muted after adjustment for sociodemographic variables. Furthermore, in analyses including an interaction term between the county proportion of Black residents and the county dissimilarity index, the association between segregation and vaccination is positive in counties with a lower proportion of Black residents (ie, 5%) but negative in counties with the highest proportions of Black residents (ie, 70%). Conclusions: Findings highlight the importance of methodological decisions when modeling disparities in COVID-19 vaccinations. Researchers should consider mediating and moderating factors and examine interaction effects and stratified analyses taking racial group distributions into account. Results can inform policies around the prioritization of vaccine distribution and outreach.

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