SHP-Kaiser Collaboration on Estimates and Projections of Racial/Ethnic Disparities in COVID-19 Vaccination Coverage

Stanford Health Policy and the Kaiser Family Foundation are collaborating to examine the disparities in meeting vaccination benchmarks by using state-reported vaccination data by race/ethnicity and projecting vaccine coverage going forward.
Woman gets vaccinated.

With the COVID-19 vaccination rate slowing, President Biden in early May unveiled the goal of getting 70% of adults at least one inoculation by the Fourth of July. He pledged to make vaccines more accessible at pharmacies and boost confidence in the safety and efficacy of the drugs.

So how are we doing?

New joint research by Stanford Health Policy and the Kaiser Family Foundation indicates that at the current pace of vaccination, 65% of those ages 12 and older in the United States would be at least partially vaccinated by July 4 — but that rates would be lower for Hispanic and Black people.

“To date, vaccination rates among Black and Hispanic people have lagged behind those of White people, largely due to access and logistical barriers as well as concerns about safety and potential side effects,” the researchers wrote in their study published by the foundation. “As such, even if broad national vaccination goals are achieved, these groups may remain at higher risk, which could lead to widening health disparities and limit the nation’s recovery from the pandemic.”

They found that based on current trends, Asian people are the only group estimated to reach 70% vaccination coverage among those ages 12 and older by July 4, while White and Hispanic people will be just shy of that benchmark, at 66% and 63% respectively. They found that only about 51% of Black people in the eligible age group will have received at least one COVID-19 vaccine by July 4.

If the current pace of vaccination continues, they found, Hispanic people nationally would reach a 70% threshold by the end of July, White people would reach it by early August, but Black people would still not have reached this coverage level by the beginning of September. Hispanic people are projected to reach 70% coverage faster than White people despite having a lower rate of vaccination by July 4 because their recent pace of vaccination has been faster.

“The CDC and several news organizations track overall progress toward the President’s vaccination goal,” said Joshua Salomon, PhD, professor of medicine and director of Stanford’s Prevention Policy Modeling Lab. “But measures of vaccination coverage at national or state levels mask important disparities across racial/ethnic groups, and the information needed to evaluate and track these disparities has not been readily available.”

So he and colleagues at SHP have partnered with the Kaiser Family Foundation to curate vaccination data by race and ethnicity from state-reported websites and use these data to develop estimates of past trends and current levels of vaccination disparities. By projecting these trends forward in time, they estimate when different racial/ethnic groups in U.S. states and nationally might reach 70% vaccination coverage among eligible people.

Kaiser Family Foundation graphic on COVID-19 vaccine disparities.

Marissa Reitsma, a PhD candidate at SHP and lead author on the study, noted vaccine data by race and ethnicity are inconsistently reported across states, making it hard to monitor vaccine equity. The team uses a standard set of definitions and rules for reconciling data to enable more transparent and accurate estimates of coverage that are comparable over time and across place.

“With the delta variant causing growing concern, addressing gaps in coverage is urgently needed to prevent further widening of disparities,” Reitsma said. “Monitoring is critical to intervention, and we hope this work drives progress toward equity.”

As a next step, the team is aiming to launch an interactive website that will provide ongoing tracking of vaccination coverage and other key policy outcomes by race/ethnicity and state.

The other members of the SHP team are Jeremy Goldhaber-Fiebert, PhD, associate professor of medicine, and program manager Neesha Joseph. They are members of the Stanford-CIDE Coronavirus Simulation Model Consortium (SC-COSMO), which has developed a modeling framework that has been simulating the epidemiology of COVID-19 for diverse populations and geographies — including the state of California and its prison system — since the beginning of the pandemic.

The Kaiser Family Foundation team include Larry Levitt, vice president for health policy; Samantha Artiga, vice president and director of the Racial Equity and Health Policy Program at the foundation; Jennifer Kates, senior vice president and director of global health and HIV policy; and data analyst Anna Rouw.

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