Inequalities in the US COVID-19 vaccination drive

The coronavirus disease 2019 (COVID-19), a severe acute respiratory illness is rapidly spreading. The virus has claimed more than 5.25 million lives to date.

The United States successfully vaccinated millions of people every week against COVID-19, in early 2021. However, it’s not clear whether the recovery of households that live in neighborhoods with low incomes lag behind those living in more prosperous areas, following the shortened time frames for vaccination.

Study: Changes Over Time in COVID-19 Vaccination Inequalities in Eight Large U.S. Cities. Image Credit: Yuganov Konstantin/Shutterstock

A new study has been published on the preprint server. The study used data on vaccination from eight US cities and covered three time points between March 21st and May 3rd, 2021.


In late April 2021, approximately one-quarter of the American population had been fully vaccine-free. This significantly reduced the risk of infection, hospitalization, and even death. Vaccine doses were not equally accessible in all regions of the country, and doses were not common in many urban areas. One may think that the response and recovery during the pandemic were unequal, depending on the socioeconomic (SES) disadvantage of certain communities. Indeed, research has shown that sections of the population that faced disadvantages prior to the onset the public health crisis fared worse both during and after the crisis , and the current situation is no different.

In the early stages of the pandemic, regions that had more socioeconomic disadvantage were the hardest hit. These regions had higher mortality rates and infections. This study examines the question of the inequal response and recovery to the COVID-19 pandemic that is currently sweeping the globe. These findings contribute to the increasing research on the inequalities triggered by the pandemic as well as the recovery and response phases.

A new study

Official information on the proportion of people who had at least one dose of a COVID-19 vaccine, by communities, were gathered. These cities comprised New York, Chicago and Houston, Phoenix, Philadelphia San Antonio, San Diego, San Diego, San Diego, San Diego, San Antonio, and San Diego. The data were gathered on March 21, April 12, and May 3, 2021. To determine the community’s composition, the researchers used American Community Survey (ACS) to determine the proportion of people employed in “healthcare and social assistance” and those who are 65 years old and over. Additional information was obtained about health insurance coverage, ethnicity, and position relative to the poverty line. Each “SES variable” was transformed into quartiles and then standardized by city.

Key results

On the first day of observation in March, 23.01% of individuals living in low SES communities were vaccinated in contrast to 34.73 in high SES communities. In April the gap between low and high SES communities was widened. On the second date of observation, 35.79% of individuals in low SES communities were vaccinated , whereas this number was 51.65 percent for high SES communities. Finally, in May, in low SES communities 45.65 percent of people had been vaccinated, while in high SES communities, 60.46% were vaccinated. In terms of the changes in the percentage vaccined over time, between March and April, low SES communities had a lower percentage of people of people who were vaccinated, i.e., 12.78%. The change in percent for high SES communities was 16.92 percent. However the difference between April and May was not that significant. The change for low SES communities was 9.86 percent and 8.82 percent in high SES communities.


In the current study, researchers examined the changes in COVID-19 vaccination in eight of the ten most populous cities in the United States. The percentage of low-SES communities that were vaccinated was significantly lower than that of high SES communities in March April and May. Another important aspect to be noted was that the large percent disparity between communities didn’t shrink when eligibility opened up in late April and early May. Scientists concluded that despite widespread vaccination, significant gaps remained. This is a troubling finding since the same communities that were harder hit, in terms of infection and mortality, from COVID seem to have lower levels of community-based vaccination during restricted vaccine eligibility. Even after eligibility was reopened the gap continued to exist.

The connection between disadvantage in the community and vaccination is alarming. These disparities have led to massive numbers of people who are not vaccinated in certain segments of the population. This is a problem that could prolong the negative effects of the pandemic, in terms of rising cases as well as the emergence of new variants. This inequality could lead to a split recovery, which isn’t desirable. The goal will be to recover together from this pandemic in a way that is inclusive.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

Content Source:

Gemma Wilson

Gemma is a journalism graduate with keen interest in covering business news – specifically startups. She has as a keen eye for technologies and has predicted quite a few successful startups over the last couple of years.

Related Articles