Changes over Time in COVID-19 Vaccination Inequalities in Eight Large U.S. Cities

Area of Science:

• Public Health
• Sociology
• Epidemiology

Background:

• Socioeconomic status (SES) is a known determinant of health outcomes.
• Disparities in coronavirus disease 2019 (COVID-19) vaccination rates have been observed globally.
• Understanding the impact of SES on vaccination uptake is crucial for equitable pandemic response.

Purpose of the Study:

• To examine the association between community socioeconomic composition and changes in COVID-19 vaccination levels.
• To determine if vaccination gaps between high-SES and low-SES communities narrowed after vaccine eligibility expanded.

Main Methods:

• Analysis of COVID-19 vaccination data in eight large cities at three time points (March, April, May).
• Comparison of vaccination rates and changes in vaccination percentages between high-SES and low-SES communities.
• Statistical estimation of associations between community socioeconomic composition and vaccination levels.

Main Results:

• In March, high-SES communities exhibited significantly higher COVID-19 vaccination rates compared to low-SES communities.
• Between March and April, low-SES communities showed significantly smaller increases in vaccination percentages than high-SES communities.
• The disparity in vaccination levels between SES groups did not significantly decrease between April and May, even with expanded eligibility.

Conclusions:

• The study indicates that socioeconomic disparities in COVID-19 vaccination did not diminish with broader eligibility.
• A persistent vaccination gap may contribute to a bifurcated pandemic recovery, with advantaged communities recovering faster.
• Addressing socioeconomic determinants of vaccination is essential for mitigating long-term health inequities.