COVID-19 Vaccinations by Race/Ethnicity: Differences and Limitations Across Measures

Racial equity has been the focus of COVID-19 vaccination rates since the introduction of the COVID-19 vaccines. Ensuring equality with COVID-19 vaccinations is important as COVID-19 has disproportionately affected people of color and can widen underlying health inequalities. Data is key to identifying differences in COVID-19 vaccination rates and directing resources and efforts to correct them. However, there are gaps in the federally reported COVID-19 vaccination data by race / ethnicity from the Centers for Disease Control and Prevention (CDC). To fill these gaps in federal data, KFF and others conducted an ongoing analysis of state-reported vaccination data by race and ethnicity, as well as regular COVID-19 vaccine monitor surveys among adults. This data has provided further insights into COVID-19 vaccination patterns by race / ethnicity, but is also subject to limitations. This executive summary provides an overview of these data sources, discusses their limitations, and explains why their results may vary.

Vaccination rates according to data sources

Federal and state administrative data, as well as Vaccine Monitor surveys, all show that black and Hispanic people are less likely to receive a COVID-19 vaccine than their white counterparts since vaccination began, but these differences narrow over time to have. However, they differ in the results on the extent of this narrowing (Figure 1 and Table 1):

• Federal data from the CDC shows that between late April and late September 2021, the gap between whites and blacks in the general population decreased by 2 percentage points (from 8 to 6 percentage points), while the gap between whites and Hispanic Americans decreased by 9 percentage points (from 8 to 6 percentage points) to -1 percentage points).
• The state-reported data shows that the gap between whites and blacks for the general population decreased by 6 percentage points (from 14 to 8 percentage points) over this period, while the gap between whites and Hispanic Americans decreased by 9 percentage points (13 to 4 percentage points).
• The Vaccine Monitor survey data shows the same trend, with the difference between rates for white and black adults decreasing by 8 percentage points (from 9 to 1 percentage point) and the gap between white and Hispanic adults narrowing by 15 percentage points (from 13 on -2.). Percentage points).

Figure 1: The percentage difference between vaccination rates for whites and rates for blacks and Hispanic Americans fell across all data sources

As of September 2021, the CDC federal data shows similar vaccination rates between Hispanic and white people, with the lower rates continuing for blacks and the highest rate for Native American and Alaskan Native Americans and Asians. Analysis of government data shows that blacks and Hispanics are less likely to be vaccinated than whites, but with a smaller gap for Hispanics. The Vaccine Monitor survey data shows that the gaps in the rates of black and Hispanic adults compared to white adults have closed with no statistically significant differences in vaccination rates between these groups. A poll conducted by the Pew Research Center in August found similar results.

These different results reflect differences in the measurements from the data sources. Vaccination rates from the Vaccine Monitor surveys are based on adults, while rates based on federal and state administrative data are for the entire population (including children under 12 who are currently unable to be vaccinated). Including children in vaccination rates may result in greater differences due to racial differences in the rates of vaccination among adolescents eligible for the vaccines (ages 12-17 years old) and the greater racial diversity of children compared to adults. In addition, both the survey data and the administrative data are subject to different sources of measurement error, as explained below.

Federal COVID-19 Vaccination Data by Race / Ethnicity

The CDC reports the distribution of COVID-19 vaccinations and the percentage of the total population who received a COVID-19 vaccine, by race / ethnicity at the national level. As of September 27, 2021, however, more than 40% of people who received at least one dose were missing information on race / ethnicity. Additionally, the data does not represent all states or jurisdictions because not all states and territories report demographics about vaccine recipients to the CDC. Given these data gaps, the CDC advises that the data cannot be generalized to the entire population of people vaccinated against COVID-19. CDC does not report state-level data on COVID-19 vaccinations by race / ethnicity. Although the CDC reports vaccinations separately by race / ethnicity and age, no data are published that allow an analysis of vaccinations by race / ethnicity and age. Therefore, the data cannot be used to examine whether there are major racial differences in vaccination rates between certain age groups, such as adolescents or younger adults.

Provide COVID-19 vaccination dates by race / ethnicity

Because the CDC does not report COVID-19 vaccination data at the state level by race / ethnicity, KFF has conducted an ongoing analysis of the data reported directly by the state. As of September 20, 2021, 45 states, including Washington, DC, were publicly reporting data on people who had received at least one COVID-19 vaccine by race / ethnicity, and KFF was able to achieve total vaccination rates by race / ethnicity for 43. calculate these states. (Two states were excluded from the total due to differences in the way they report their data). In general, these data are more complete than the data reported by the CDC, with the proportion of vaccinations of unknown or missing race / ethnicity being lower in most states. However, they also have gaps, limitations, and inconsistencies. As with federal data, they don't include data from all states and jurisdictions, and some states have relatively high proportions of vaccinations of unknown race / ethnicity. For example, in Alabama, 37% of vaccinations on September 20, 2021 were of an unknown breed. Additionally, states differ in their racial / ethnic classification used to report the data, including the classification of people who identify as more than one race. Some state-reported data does not include vaccinations given through federal programs, including the Indian Health Service or Long-Term Care Partnership Program.

COVID-19 vaccine monitor and other survey data

Since December 2020, KFF has been using the COVID-19 Vaccine Monitor to conduct ongoing, nationally representative surveys among adults in the USA. While these surveys have a broader purpose of measuring vaccine confidence, information needs, trustworthy messengers, and messages, we have also used them to track the percentage of adults who say they have been vaccinated against COVID-19 over time to be. These surveys are based on probability-based sampling, and the researchers are taking additional steps to ensure that populations that are often overlooked in surveys are included (including surveys in English and Spanish and over-sampling of prepaid cell phones, often used by low-income adults be used). . Each survey also includes additional interviews with black and Hispanic adults – using weighting to match respondents to the distribution of adults in the United States – in order to have greater statistical confidence in reporting these groups (see the full methodology). .

Like all surveys, the Vaccine Monitor surveys are subject to a sampling margin of error around each estimate. For the September survey, the margin of error in sampling plus or minus 3 percentage points for the entire sample, 4 percentage points for white adults, and plus or minus 7 percentage points for black and Hispanic adults. Additionally, surveys can have other sources of error, including non-response errors (certain types of people choosing not to take the survey or not answering the question of whether they have been vaccinated), measurement errors (respondents understand the question being asked was not asked) and social desirability bias (respondents give answers they think the interviewer would want to hear). Despite these potential sources of error, the Vaccine Monitor polls pretty much matched the CDC's estimates of the percentage of total adults vaccinated over time and a recent analysis by the Pew Research Center of 98 different public surveys conducted by 19 different polling companies between December 2020 and conducted, tracked June 2021 (including the Vaccine Monitor surveys) found that estimates of adult vaccination rates, on average, are within about 2.8 percentage points of the rate calculated by the CDC.

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Data is critical to identifying and addressing inequalities in healthcare and healthcare. In the course of the COVID-19 pandemic, the available data gaps by race / ethnicity have made limited efforts to understand and address disparities. The availability and quality of data has improved over the course of the pandemic, but data gaps and limitations remain. In order to close gaps in the data reported by the federal government on COVID-19 vaccinations by race / ethnicity, KFF and others have provided an ongoing analysis of the government-reported data on COVID-19 vaccinations and regular COVID-19 vaccine monitor surveys Adults That Have Increased Understanding of COVID-19 Vaccination Patterns by Race / Ethnicity. This, in turn, has helped channel resources and efforts to address racial differences in vaccination rates. While the federal, state, and survey data all show a decrease in racial disparities in COVID-19 vaccination rates over time, they vary in the magnitude of that decrease, with some polls showing that the gaps have been closed while the administrative data is on indicate some remaining differences. This variation in results reflects both differences and limitations in the data sets. Going forward, continued efforts to increase the availability of comprehensive, high-quality data will be critical in identifying and addressing disparities for COVID-19 and the healthcare and healthcare sectors in general. In addition, it will be important to continue to prioritize equity as vaccination efforts continue, people are entitled to booster vaccinations, and eligibility is expanded to include children, especially given the significant racial diversity of children.