Self-reported COVID-19 vaccine hesitancy and uptake among participants from different racial and ethnic groups in the United States and United Kingdom

Nguyen, Long H.; Joshi, Amit D.; Drew, David A.; Merino, Jordi; Ma, Wenjie; Lo, Chun‐Han; Kwon, Sohee; Wang, Kai; Graham, Mark S.; Polidori, Lorenzo; Menni, Cristina; Sudre, Carole H.; Anyane‐Yeboa, Adjoa; Astley, Christina M; Warner, Erica T.; Hu, Christina; Selvachandran, Somesh; Davies, Richard; Nash, Denis; Franks, Paul W.; Wolf, Jonathan; Ourselin, Sébastien; Steves, Claire J.; Spector, Tim D.; Chan, Andrew T.

doi:10.1038/s41467-022-28200-3

Cited by 159 publications

(145 citation statements)

References 21 publications

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“…In contrast, little or no racial disparity in vaccine uptake has been observed in the U.K., despite racial disparities in vaccine hesitancy in the U.K. similar to those observed in the U.S. 13 . Collectively, these findings suggest that “issues related to access may underlie the observed lower vaccine uptake among minority populations in the U.S.” 13 . In that case, new approaches are needed to help understand and overcome the barriers to racial and ethnic equity in COVID-19 vaccine access in the U.S.…”

Section: Introductionmentioning

confidence: 87%

“…Racial and ethnic disparities in COVID-19 vaccine hesitancy in the U.S. have declined only slightly in the past year 13,14 , whereas Black/White disparities in vaccination rates have dropped by over 90% in that time 15,16 . In at least nine states, including Pennsylvania, Black people are now more likely than White people to have been vaccinated 17 .…”

Section: Introductionmentioning

confidence: 99%

“…Nationally, the Hispanic and Latino/a/e/x population has now been vaccinated at higher rates than the non-Hispanic, non-Latino/a/e/x population 15 . Racial disparities in vaccine uptake have been observed in the U.S. even among people who are not hesitant to be vaccinated 13 . In contrast, little or no racial disparity in vaccine uptake has been observed in the U.K., despite racial disparities in vaccine hesitancy in the U.K. similar to those observed in the U.S. 13 .…”

Section: Introductionmentioning

confidence: 99%

“…Racial disparities in vaccine uptake have been observed in the U.S. even among people who are not hesitant to be vaccinated 13 . In contrast, little or no racial disparity in vaccine uptake has been observed in the U.K., despite racial disparities in vaccine hesitancy in the U.K. similar to those observed in the U.S. 13 . Collectively, these findings suggest that “issues related to access may underlie the observed lower vaccine uptake among minority populations in the U.S.” 13 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Did COVID-19 Vaccines Go to the Whitest Neighborhoods First? Racial Inequities in Six Million Phase 1 Doses Shipped to Pennsylvania

Holtzman

Yang

Louis

2022

Preprint

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Research on racial disparities in COVID-19 vaccination rates has focused primarily on vaccine hesitancy. However, vaccine hesitancy research is increasingly unable to account for racial disparities in vaccination rates in the U.S., which have shrunk rapidly over the past year. This and other evidence suggests that inequities in vaccine allocation and access may have contributed to vaccination rate disparities in the U.S. But to our knowledge, no previously published research has examined whether the geographic distribution of COVID-19 vaccines has led to greater access for White Americans than for Black Americans. Here, we link neighborhood-level data on vaccine allocation to data on racial demographics to show that in the first 17 weeks of Pennsylvania's COVID-19 vaccine rollout (Phase 1), White people were 25% more likely than Black people to live in neighborhoods (census tracts) that received vaccine shipments. In the 17 weeks of Pennsylvania's de jure restrictions on vaccine eligibility, de facto geographic restrictions on vaccine access disproportionately disadvantaged Black people and favored White people. In revealing these vaccine inequities, our work builds on prior work to develop a theory-driven, evidence-based, reproducible framework for studying racial inequities in the distribution of COVID-19 vaccines.

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Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Did COVID-19 Vaccines Go to the Whitest Neighborhoods First? Racial Inequities in Six Million Phase 1 Doses Shipped to Pennsylvania

Holtzman

Yang

Louis

2022

Preprint

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“…The advent of the COVID-19 pandemic and rapid development of vaccines has brought the extensive challenges in vaccine deployment and uptake to the forefront of both public and scientific discourse [ 11 ]. Vaccine hesitancy (VH), in particular, and under-vaccination more broadly, have emerged as polarizing social and political issues, as well as preeminent public health challenges, prompting widespread debate, disparate responses, and a plethora of studies amid the pandemic [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccine hesitancy among marginalized populations in the U.S. and Canada: Protocol for a scoping review

Newman

Reid

Tepjan³

et al. 2022

PLoS ONE

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Introduction Despite the development of safe and highly efficacious COVID-19 vaccines, extensive barriers to vaccine deployment and uptake threaten the effectiveness of vaccines in controlling the pandemic. Notably, marginalization produces structural and social inequalities that render certain populations disproportionately vulnerable to COVID-19 incidence, morbidity, and mortality, and less likely to be vaccinated. The purpose of this scoping review is to provide a comprehensive overview of definitions/conceptualizations, elements, and determinants of COVID-19 vaccine hesitancy among marginalized populations in the U.S. and Canada. Materials and methods The proposed scoping review follows the framework outlined by Arksey and O’Malley, and further developed by the Joanna Briggs Institute. It will comply with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The overall research question is: What are the definitions/conceptualizations and factors associated with vaccine hesitancy in the context of COVID-19 vaccines among adults from marginalized populations in the U.S. and Canada. Search strategies will be developed using controlled vocabulary and selected keywords, and customized for relevant databases, in collaboration with a research librarian. The results will be analyzed and synthesized quantitatively (i.e., frequencies) and qualitatively (i.e., thematic analysis) in relation to the research questions, guided by a revised WHO Vaccine Hesitancy Matrix. Discussion This scoping review will contribute to honing and advancing the conceptualization of COVID-19 vaccine hesitancy and broader elements and determinants of underutilization of COVID-19 vaccination among marginalized populations, identify evidence gaps, and support recommendations for research and practice moving forward.

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Association of Race and Ethnicity With Initial Prescription of Antiretroviral Therapy Among People With HIV in the US

Zalla

Cole

Eron

et al. 2023

JAMA

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ImportanceIntegrase strand transfer inhibitor (INSTI)–containing antiretroviral therapy (ART) is currently the guideline-recommended first-line treatment for HIV. Delayed prescription of INSTI-containing ART may amplify differences and inequities in health outcomes.ObjectivesTo estimate racial and ethnic differences in the prescription of INSTI-containing ART among adults newly entering HIV care in the US and to examine variation in these differences over time in relation to changes in treatment guidelines.Design, Setting, and ParticipantsRetrospective observational study of 42 841 adults entering HIV care from October 12, 2007, when the first INSTI was approved by the US Food and Drug Administration, to April 30, 2019, at more than 200 clinical sites contributing to the North American AIDS Cohort Collaboration on Research and Design.ExposuresCombined race and ethnicity as reported in patient medical records.Main Outcomes and MeasuresProbability of initial prescription of ART within 1 month of care entry and probability of being prescribed INSTI-containing ART. Differences among non-Hispanic Black and Hispanic patients compared with non-Hispanic White patients were estimated by calendar year and time period in relation to changes in national guidelines on the timing of treatment initiation and recommended initial treatment regimens.ResultsOf 41 263 patients with information on race and ethnicity, 19 378 (47%) as non-Hispanic Black, 6798 (16%) identified as Hispanic, and 13 539 (33%) as non-Hispanic White; 36 394 patients (85%) were male, and the median age was 42 years (IQR, 30 to 51). From 2007-2015, when guidelines recommended treatment initiation based on CD4+ cell count, the probability of ART initiation within 1 month of care entry was 45% among White patients, 45% among Black patients (difference, 0% [95% CI, −1% to 1%]), and 51% among Hispanic patients (difference, 5% [95% CI, 4% to 7%]). From 2016-2019, when guidelines strongly recommended treating all patients regardless of CD4+ cell count, this probability increased to 66% among White patients, 68% among Black patients (difference, 2% [95% CI, −1% to 5%]), and 71% among Hispanic patients (difference, 5% [95% CI, 1% to 9%]). INSTIs were prescribed to 22% of White patients and only 17% of Black patients (difference, −5% [95% CI, −7% to −4%]) and 17% of Hispanic patients (difference, −5% [95% CI, −7% to −3%]) from 2009-2014, when INSTIs were approved as initial therapy but were not yet guideline recommended. Significant differences persisted for Black patients (difference, −6% [95% CI, −8% to −4%]) but not for Hispanic patients (difference, −1% [95% CI, −4% to 2%]) compared with White patients from 2014-2017, when INSTI-containing ART was a guideline-recommended option for initial therapy; differences by race and ethnicity were not statistically significant from 2017-2019, when INSTI-containing ART was the single recommended initial therapy for most people with HIV.Conclusions and RelevanceAmong adults entering HIV care within a large US research consortium from 2007-2019, the 1-month probability of ART prescription was not significantly different across most races and ethnicities, although Black and Hispanic patients were significantly less likely than White patients to receive INSTI-containing ART in earlier time periods but not after INSTIs became guideline-recommended initial therapy for most people with HIV. Additional research is needed to understand the underlying racial and ethnic differences and whether the differences in prescribing were associated with clinical outcomes.

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Self-reported COVID-19 vaccine hesitancy and uptake among participants from different racial and ethnic groups in the United States and United Kingdom

Cited by 159 publications

References 21 publications

Did COVID-19 Vaccines Go to the Whitest Neighborhoods First? Racial Inequities in Six Million Phase 1 Doses Shipped to Pennsylvania

Did COVID-19 Vaccines Go to the Whitest Neighborhoods First? Racial Inequities in Six Million Phase 1 Doses Shipped to Pennsylvania

COVID-19 vaccine hesitancy among marginalized populations in the U.S. and Canada: Protocol for a scoping review

Association of Race and Ethnicity With Initial Prescription of Antiretroviral Therapy Among People With HIV in the US

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