As of this week, federal data from the Centers for Disease Control and Prevention (CDC) shows that 66% of the total United States population have received at least one dose of a COVID-19 vaccine. Although this achievement has led to a sharp drop in COVID-19 cases and deaths, vaccine coverage – and the protections it provides – remains uneven across the country. With the continued spread of the more transmissible Delta variant, unvaccinated people remain at increased risk of infection, disease and death. Although as of October 25, 2021, whites made up the largest share (60%) of those unvaccinated,1 Blacks and Hispanics remain less likely than their white counterparts to have received a vaccine, putting them at increased risk, especially as the variant spreads. However, data shows that these disparities are narrowing over time, especially for Hispanics.
Achieving high immunization rates among individuals and communities will be key to achieving broad protection from a vaccine, mitigating the disproportionate impacts of the virus on people of color, and preventing further racial disparities in health in the world. to come up. The CDC indicated that vaccine equity is an important goal, with equity defined as preferential access and administration to those most affected by COVID-19.
Federal data on COVID-19 vaccinations by race / ethnicity
The CDC reports the demographic characteristics, including race / ethnicity, of people vaccinated against COVID-19 nationally. As of October 18, 2021, the CDC reported that race / ethnicity was known for 62% of people who had received at least one dose of the vaccine. Of this group, almost two-thirds were white (60%), 11% were black, 17% were Hispanic, 6% were Asian, 1% were American Indian or native to Alaska, and less than 1% were native to Hawaii or other Pacific Islanders, while 5% reported more than one race or one race. CDC data also shows that the recent share of vaccinations reaching the black population is similar to their share of the total population (both at 12%). The share of overall vaccinations that went to Hispanic people is the same as their share of the total population (both at 17%). The share of recent vaccinations intended for Hispanics is 14%, which is a decrease from previous periods when the share of recent vaccinations intended for Hispanics was greater than their share in the total population (Figure 1). While this data provides useful information at the national level, to date the CDC does not publish state-level data on the racial / ethnic makeup of those vaccinated.
State data on COVID-19 vaccinations by race / ethnicity
To better understand who gets the vaccine and racial / ethnic disparities in immunization, KFF collects and analyzes state-reported data on COVID-19 vaccinations by race / ethnicity. As of October 18, 2021, 47 states and Washington DC were reporting vaccination data by race / ethnicity, including 45 states that reported the race / ethnicity of people who received at least one dose of the vaccine.2 Figure 2 shows the percentage of the total population who have been vaccinated by race / ethnicity in each of the 45 states that report people who have received at least one dose of COVID-19 vaccine by race / ethnicity and the total in 43 of those states . (North Dakota and New Mexico are excluded from the total due to differences in reporting the data.) It also shows the ratio of vaccination rates of whites to those of blacks, Hispanics, and Asians, as well. as the percentage point difference between vaccination rates of whites and rates of other groups. These data will differ from survey estimates of vaccination rates that are limited to adults.
Overall, in these 43 states, the percentage of whites who received at least one dose of COVID-19 vaccine (54%) was 1.2 times the rate for blacks (47%) and 1.1 times the rate for Hispanics (52%) as of October 18, 2021. Whites had a higher vaccination rate than Hispanics in most reporting states except Missouri, Vermont, Tennessee, DC, Nevada, New York, Virginia, Louisiana, South Carolina, Kansas, Texas, Alabama and Delaware. Whites also had a higher rate than blacks in most reporting states except Oregon, Alaska, Idaho, Mississippi, Pennsylvania, Washington, Louisiana and Alabama. The magnitude of these differences varied considerably from state to state, and they narrowed over time. The overall state vaccination rate for Asians was higher than that for whites (70% vs. 54%), which is consistent with the pattern in most reporting states. However, Asians had lower vaccination rates than whites in six states (Colorado, Iowa, North Dakota, Utah, Pennsylvania, and South Dakota).
Between October 4 and October 18, blacks and Hispanics experienced a slightly larger increase in vaccination rates compared to whites, while Asians’ vaccination rates remained about the same (Figure 3). Vaccination rates increased 1 percentage point for Hispanics and Blacks, from 50.6% to 51.6% and from 45.8% to 46.8%, respectively. Vaccination rates have remained roughly unchanged for Asians and Whites. The small rate increases for blacks and Hispanics continued to narrow the gap in vaccination rates between these groups and whites. Overall, between the end of April 2021, when eligibility was open to most adults in all states, and October 18, 2021, the gap in vaccination rates between whites and blacks increased from 14 percentage points (38% vs. 24%) to 7 percentage points (54% vs. 47%) while the difference between the vaccination rates of whites and Hispanics decreased by 13 percentage points (38% vs. 25%) at three percentage points (54% vs. 52%).
Vaccination rates are higher and the gaps for Hispanics narrow when the analysis is limited to the population aged 12 and older who are currently eligible for vaccines. Among people aged 12 and older, as of October 18, 2021, 65% of Hispanics and 62% of whites had received at least one dose of the COVID-19 vaccine, compared to 56% of blacks. Asians continued to have the highest vaccination rate at 79%. The reduction in disparities in immunization rates among Hispanics by limiting themselves to the eligible population reflects that a high proportion of children under 12 who are not yet eligible for the vaccine are Hispanic. The gap in vaccination rates between blacks and whites persists among the eligible population, but is smaller than the gap among the total population.
Discussion
Growing data indicates a significant increase in the risk of illness and death from COVID-19 for unvaccinated people. Whites make up the largest share of unvaccinated people, but overall blacks and Hispanics are less likely than their white counterparts to have received a vaccine, putting them at increased risk. At the same time, data shows these disparities are narrowing, especially for Hispanics, and survey data, including the KFF COVID-19 Vaccine Monitor survey from September 2021, shows these gaps have closed among the adults.
The increasing equity in immunization rates likely reflects a combination of efforts focused on increasing immunization rates among people of color through awareness and education and reducing access and logistical barriers to immunization, increased interest in the vaccine due to the spread of the Delta variant and the increase in vaccinations among young adults and adolescents that include higher shares of people of color compared to other adults. Despite this progress, persistent disparities in rates underscore the importance of continued efforts to increase immunization rates and close immunization gaps both geographically and between racial / ethnic groups.
While the data provides useful information, it also remains subject to gaps, limitations and inconsistencies that limit the ability to get a complete picture of who gets vaccinated and who does not. The completeness of race / ethnicity data has improved in most states over time as the shares of immunization with an unknown or missing race have declined. However, some states still have relatively high shares of vaccinations among people classified with an “unknown†race / ethnicity and three states still do not report vaccination data by race / ethnicity. Inconsistencies in racial / ethnic classifications between states as well as separate reporting of data for federally administered vaccinations, including those provided by the Indian Health Service and the Federal Long-Term Care Partnership Program, limit the ability to interpret the data.
In addition, continuous changes and updates to data can make it difficult to interpret the data and its trend over time. For example, between October 4 and 18, some states reported a drop in cumulative immunizations for certain racial / ethnic groups. These declines reflected a variety of factors, including changes in state reporting methods. For example, Arizona changed its default statement from county of administration to county of residence, which excluded the number of vaccinations provided to non-residents. Additionally, several states indicated that the declines may reflect updates in the racial / ethnic classifications of individuals over time. For example, an individual’s self-reported race / ethnicity may change if they register a different classification upon receiving a subsequent dose of COVID-19 vaccine or another vaccine, such as the vaccine against influenza. Such updates may be particularly likely if a person has received a first injection of COVID-19 at a mass vaccination site, and then a subsequent vaccine at their usual health care provider or community pharmacy, who may have available more precise demographic data.
Finally, although federal and state data are available for vaccinations by race / ethnicity and age separately, only a handful of states report data in a way that allows for analysis of vaccination rates by race / ethnicity within. age groups. Having data to understand vaccination patterns by race / ethnicity and age will be particularly important when eligibility expands to children. Overall, comprehensive standardized data in all states is essential to monitor and ensure equitable access and use of the vaccine.
Complete data on vaccine distribution by race / ethnicity as well as the percentage of the total population that has received at least one dose of COVID-19 vaccine is available through our COVID-State Policy and Data Tracker- 19 and downloadable via our State of Health. Facts Tables online. KFF will continue to update this data regularly in the future as immunization distribution continues.
