Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, United States.
Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, United States.
Vaccine. 2022 Jan 3;40(1):107-113. doi: 10.1016/j.vaccine.2021.11.040. Epub 2021 Nov 18.
COVID-19 morbidity and mortality has disproportionately affected vulnerable populations such as minority racial/ethnic groups. Understanding disparities in vaccine intentions and reasons for vaccine hesitancy are important for developing effective strategies for ameliorating racial/ethnic COVID-19 inequities.
Using six waves of the large, nationally representative Census Bureau's Household Pulse Survey data from January 6-March 29, 2021 (n = 459,235), we examined national and state estimates for vaccination intent, defined as receipt of ≥ 1 dose of the COVID-19 vaccine or definite intent to be vaccinated, by race/ethnicity with stratification by household income and age group. In separate logistic regression models, we also examined the interaction between race/ethnicity and household income, and race/ethnicity and age group, and its association with vaccination intent. Lastly, we examined reasons for not vaccinating by race/ethnicity.
Vaccination intent differed by racial/ethnic group, household income, and age group nationally and by Health and Human Services (HHS) region and state. A significant interaction was observed between race/ethnicity and household income (F(8,72) = 4.50, p < 0.001), and race/ethnicity and age group (F(8,72) = 15.66, p < 0.001). Non-Hispanic Black adults with lower income (<$35,000) and younger age (18-49 years) were least likely to intend to vaccinate. Similar disparities across racial/ethnic groups were seen across most HHS regions and states. Concerns about possible side effects and effectiveness were significantly higher among all minority groups compared to non-Hispanic White adults.
Disparities in vaccination intent by racial/ethnic groups underscore the need for interventions and recommendations designed to improve vaccination coverage and confidence in underserved communities, such as younger and lower income racial/ethnic minority groups. Efforts to reduce disparities and barriers to vaccination are needed to achieve equity in vaccination coverage, and ultimately, to curb COVID-19 transmission.
COVID-19 的发病率和死亡率不成比例地影响到弱势群体，如少数族裔。了解疫苗接种意愿和疫苗犹豫的原因方面的差异对于制定改善 COVID-19 种族不平等的有效策略非常重要。
我们使用了 2021 年 1 月 6 日至 3 月 29 日期间来自大型全国代表性人口普查局家庭脉搏调查的六轮数据（n=459,235），按种族/族裔、家庭收入和年龄组对疫苗接种意愿（定义为至少接种了 1 剂 COVID-19 疫苗或明确打算接种疫苗）进行了全国和州的估计。在单独的逻辑回归模型中，我们还检查了种族/族裔与家庭收入以及种族/族裔与年龄组之间的相互作用及其与疫苗接种意愿的关联。最后，我们按种族/族裔检查了不接种疫苗的原因。
全国范围内，疫苗接种意愿因种族/族裔、家庭收入和年龄组而异，因卫生与公众服务部（HHS）地区和州而异。观察到种族/族裔和家庭收入（F（8,72）=4.50，p<0.001）以及种族/族裔和年龄组（F（8,72）=15.66，p<0.001）之间存在显著的相互作用。收入较低（<$35,000）和年龄较小（18-49 岁）的非西班牙裔黑人成年人最不可能打算接种疫苗。在大多数 HHS 地区和州，所有种族/族裔群体都存在类似的差异。与非西班牙裔白人成年人相比，所有少数族裔群体对可能的副作用和有效性的担忧明显更高。
种族/族裔群体之间疫苗接种意愿的差异突出表明，需要采取干预措施和建议，以改善服务不足社区（如年轻和低收入的少数族裔群体）的疫苗接种覆盖率和信心。需要努力减少疫苗接种方面的差异和障碍，以实现疫苗接种覆盖率的公平，并最终遏制 COVID-19 的传播。
