Multidimensional Demographic Analyses of COVID-19 Vaccine Inequality in the United States: A Systematic Review

COVID-19 vaccination uptake is associated with demographic characteristics such as age, sex, and ethnicity-race in the United States (U.S.). Prior research predominantly analyzed COVID-19 vaccination uptake unidimensionally, limiting insights into multidimensional demographic inequalities. Multidimensional studies provide a closer insight into vaccination inequality and assist in designing more effective vaccination strategies.

Review descriptive studies of the COVID-19 vaccination uptake across combinations of at least two of the three key demographic characteristics: age, sex, and ethnicity-race in the U.S.

A systematic review was performed using the Joanna Briggs Institute methodology and adhering to the PRISMA-ScR principles for reporting. Six impartial reviewers examined all of the papers. The data were obtained using a tailored data extraction template.

A total of 2793 records were initially downloaded, 461 of them were dropped for duplication, and 2332 were reviewed. Based on the title and abstract reviews, 2115 records were excluded. After reviewing the full text of the remaining records, 212 more records were excluded. The remaining six records were reviewed to identify and compare their population, study period, data, the studied dose number, methodology, and results.

Multidimensional COVID-19 vaccine uptake analyses are rare and mostly focused on the dose-one vaccination. Improving researchers' access to immunization registry data while preserving data security is a prerequisite for such analyses.