Dept of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
J Gen Intern Med. 2022 Feb;37(2):409-414. doi: 10.1007/s11606-021-07213-6. Epub 2021 Nov 29.
There are racial differences in COVID-19 vaccination rates, but social factors, such as lack of health insurance or food insecurity, may explain some of the racial disparities.
To assess social factors, including insurance coverage, that may affect COVID-19 vaccination as of June-July 2021 and vaccine hesitancy among those not yet vaccinated, and how these may affect racial equity in vaccinations.
Cross-sectional analysis of nationally representative survey data.
Adults 18 to 64 participating in the Census Bureau's Household Pulse Survey for June 23 to July 5, 2021.
Vaccination: receipt of at least one dose of a COVID-19 vaccine. Vaccine hesitancy: among those not yet vaccinated, intent to definitely or probably not get vaccinated.
In unadjusted analyses, black adults were less likely to be vaccinated than other respondents, but, after social factors were included, including health insurance status, food sufficiency, income and education, and state-level political preferences, differences between black and white adults were no longer significant and Hispanics were more likely to be vaccinated (OR = 1.87, p < .001). Among those not yet vaccinated, black and Hispanic adults were vaccine hesitant than white adults (ORs = .37 and .45, respectively, both p < .001) and insurance status and food insufficiency were not significantly associated with vaccine hesitancy. The percent of state voters for former President Trump in 2020 was significantly associated with lower vaccination rates and with increased vaccine hesitancy.
The results indicate that much of the gap in COVID vaccination rates for minority adults are due to social barriers, rather than differences in racial attitudes. Unvaccinated minority adults expressed less vaccine hesitancy than white adults. Social barriers like food insecurity and insurance coverage could have deterred prompt COVID-19 vaccinations. Reducing these problems might help increase vaccination rates.
新冠疫苗接种率存在种族差异，但社会因素，如缺乏医疗保险或粮食不安全，可能解释了部分种族差异。
评估社会因素，包括保险覆盖范围，这些因素可能会影响截至 2021 年 6 月至 7 月的新冠疫苗接种情况以及尚未接种疫苗者的疫苗犹豫情况，以及这些因素如何影响疫苗接种方面的种族公平。
全国代表性调查数据的横断面分析。
参加 2021 年 6 月 23 日至 7 月 5 日美国人口普查局家庭脉搏调查的 18 至 64 岁成年人。
疫苗接种：至少接种一剂新冠疫苗。疫苗犹豫：在尚未接种疫苗的人群中，打算肯定或可能不接种疫苗的意愿。
在未调整的分析中，黑人成年人接种疫苗的可能性低于其他受访者，但在纳入社会因素（包括医疗保险状况、粮食充足程度、收入和教育水平以及州级政治偏好）后，黑人和白人成年人之间的差异不再显著，而西班牙裔成年人更有可能接种疫苗（比值比 = 1.87，p < .001）。在尚未接种疫苗的人群中，黑人和西班牙裔成年人比白人成年人更犹豫接种疫苗（比值比分别为 0.37 和 0.45，均 p < .001），而保险状况和粮食不足与疫苗犹豫之间没有显著关联。2020 年，前总统特朗普在该州的选民比例与较低的疫苗接种率和更高的疫苗犹豫率显著相关。
研究结果表明，少数族裔成年人在新冠疫苗接种率方面的差距在很大程度上是由于社会障碍，而不是种族态度的差异。未接种疫苗的少数族裔成年人比白人成年人表示的疫苗犹豫程度更低。粮食不安全和保险覆盖等社会障碍可能阻碍了新冠疫苗的及时接种。解决这些问题可能有助于提高疫苗接种率。
