D'Adamo Angela, Schnake-Mahl Alina, Bilal Usama, Miller Jane
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Health Management and Policy, Drexel Dornsife School of Public Health, Philadelphia, PA, USA.
Prev Med Rep. 2025 Apr 26;54:103091. doi: 10.1016/j.pmedr.2025.103091. eCollection 2025 Jun.
Vaccination is a key intervention to prevent severe COVID-19, but in the early months of vaccination availability in the United States, there were wide spatial inequities in vaccination by neighborood racial-ethnic composition and socioeconomic status. To explore whether and how these inequities persisted, we examined the association between neighborhood-level income and racial-ethnic composition and COVID-19 vaccination coverage in Philadelphia, and described trends in inequities in 2021 and 2022.
Using vaccination data for 46 Philadelphia neighborhoods (zip codes), from the Philadelphia Department of Public Health, we estimated vaccination coverage on April 18th, September 26th, and November 21st of 2021, as well as April 3rd, June 26th, and August 7th of 2022. We estimated and compared average vaccination coverage by neighborhood-level income and racial-ethnic composition. We explored inequities in coverage by estimating absolute and relative differences in vaccination by date.
COVID-19 vaccination coverage varied substantially by neighborhood-level income and racial-ethnic composition. On all dates, rates were higher in high income and non-Hispanic White neighborhoods compared to medium-income, low-income, mixed, and non-Hispanic Black neighborhoods. The absolute and relative differences in vaccination between neighborhoods narrowed over time but persisted through August 2022.
This study provides evidence for the importance of policies that target low-income and non-Hispanic Black neighborhoods during pandemics, including during vaccination rollout, as they have experienced a disproportionate infection, hospitalization, and mortality burden due to COVID-19 and experienced lower vaccination rates.
接种疫苗是预防重症 COVID-19 的关键干预措施，但在美国疫苗可供接种的最初几个月里，按邻里的种族构成和社会经济地位划分，疫苗接种存在广泛的空间不平等现象。为探究这些不平等现象是否持续以及如何持续，我们研究了费城邻里层面的收入和种族构成与 COVID-19 疫苗接种覆盖率之间的关联，并描述了 2021 年和 2022 年不平等现象的趋势。
利用费城公共卫生部提供的费城 46 个邻里（邮政编码区域）的疫苗接种数据，我们估算了 2021 年 4 月 18 日、9 月 26 日和 11 月 21 日以及 2022 年 4 月 3 日、6 月 26 日和 8 月 7 日的疫苗接种覆盖率。我们估算并比较了按邻里层面收入和种族构成划分的平均疫苗接种覆盖率。我们通过估算不同日期疫苗接种的绝对差异和相对差异来探究覆盖率方面的不平等现象。
COVID-19 疫苗接种覆盖率因邻里层面的收入和种族构成而有很大差异。在所有日期，高收入和非西班牙裔白人邻里的接种率高于中等收入、低收入、混合以及非西班牙裔黑人邻里。邻里之间疫苗接种的绝对差异和相对差异随时间推移有所缩小，但一直持续到 2022 年 8 月。
本研究证明了在大流行期间，包括在疫苗接种推广期间，针对低收入和非西班牙裔黑人邻里制定政策的重要性，因为这些邻里因 COVID-19 承受了不成比例的感染、住院和死亡负担，且疫苗接种率较低。
