A recent study from the American Journal of Preventive Medicine (AJPM) found socioeconomic and racial/ethnic disparities in vaccine uptake have persisted over the last decade in adults. As COVID-19 vaccine roll-out continues throughout the United States, efforts to promote health equity among racial/ethnic minority and low-income populations are critical to improve population health.

Racial/ethnic minorities and low-income groups are at a higher risk of dying from vaccine-preventable diseases due to socioeconomic and health disparities in vaccine uptake, according to the study conducted by AJPM, which examined trends in adult vaccination rates in the country by race/ethnicity and socioeconomic status from 2010 to 2019.

While vaccines have reduced preventable deaths in children to 300 per year in the United States, more than 42,000 adults die each year from vaccine-preventable diseases. Each year, influenza has been found to cause around 140,000 to 710,000 hospitalizations and approximately 12,000 to 61,000 deaths in adults. Racial/ethnic minorities and low-income individuals are at an even higher risk of hospitalization due to influenza. Pneumococcal disease also causes approximately 242,000 hospitalizations and 16,000 deaths in adults 65 years and older.

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Most recently, COVID-19 has had an impact on millions of individuals around the world, and racial and ethnic minority populations continue to be hardest hit due to longstanding health inequities and social risk factors.  

“Currently, the biggest public health concern we are facing is the COVID-19 pandemic, for which we now have safe and effective vaccines available in the USA,” said study researchers Kosuke Kawai, ScD, institutional centers for clinical and translational research, Boston Children’s Hospital and Harvard Medical School, and Alison Tse Kawai, ScD, RTI Health Solutions, in a study announcement. “Unfortunately, as we observed for vaccines against influenza, pneumococcal, shingles, and Tdap, a combination vaccine that protects against tetanus, diphtheria, and pertussis, adults from racial and ethnic minorities have had lower rates of COVID-19 vaccine uptake.”

The researchers reviewed vaccination trends in the United States for influenza; tetanus, diphtheria, and pertussis (Tdap); pneumococcal; and shingles using the National Health Interview Survey data, which included demographics, health status, insurance coverage, health care access, and health behaviors.

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While vaccination coverage among adults gradually increased from 2010 to 2019, researchers found racial/ethnic and socioeconomic disparities to persist in adults throughout the entire period.

The study found race/ethnicity, household income, education level, and type of health insurance to be significantly associated with acceptance of influenza, pneumococcal, Tdap, and shingles vaccines.

Researchers noted socioeconomic disparities in influenza vaccination improved slightly for adults aged 18-64, which may be due to the Affordable Care Act. But socioeconomic disparities have persisted among adults aged 65 or older.

“Promoting health equity in immunization rates for the new vaccines against COVID-19 during the pandemic is critical because individuals from racial and ethnic minority groups are disproportionately affected by COVID-19,” wrote the AJPM researchers. “Efforts are urgently needed to achieve equity in immunization rates.”