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Singleton is chief of the assessment branch of the CDC’s Immunization Services Division. Walensky is director of the CDC.
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Key takeaways:
- People who reported poor health care experiences because of discrimination were less likely to be vaccinated against COVID-19.
- The findings are similar to disparities previously reported in influenza vaccination rates.
US adults who reported negative health care experiences because of discrimination based on their race or ethnicity were less likely to be vaccinated against COVID-19, a study found.
The results, published recently in MMWR, reflect similar findings on influenza vaccination.
Researchers found that discrimination prevented many nonwhite people from being vaccinated against COVID-19. Image: Adobe Stock
CDC director Rochelle P. Walensky, MD, MPH, has previously noted what she called “striking” equity in the US during the pandemic, including that Black people have been disproportionately impacted by COVID-19.
“We have always known that health inequities and disparities exist, but the COVID-19 pandemic shined a spotlight on this problem,” James Singleton, PhD, chief of the Assessment Branch in the CDC’s Immunization Services Division, told Healio.
“It was important to understand the social determinants of vaccine inequities, including racism, and determine how to make an impact in a way that is meaningful for health care providers,” Singleton said.
Singleton and colleagues analyzed data from 1,154,347 adult respondents aged 18 years and older in the National Immunization Survey — Adult COVID Module. Participants were asked the question, “When seeking health care in the last 2 years, do you feel your experiences were worse than, the same as or better than (those of) persons of other races or ethnicities?”
The researchers also asked participants if they had received at least one dose of a COVID-19 vaccine, what brand of vaccine they received and how many total doses they received. Those who had not been vaccinated were also asked how likely it was that they would get vaccinated.
Overall, 3.5% of adults in the survey felt they had worse experiences than people of other races or ethnicities.
According to the study, a “significantly higher” percentage of non-Hispanic Black or African American (10.7%), non-Hispanic American Indian or Alaska Native (7.2%), non-Hispanic multiple or other race (6.7%), Hispanic or Latino (4.5%), non-Hispanic Native Hawaiian or other Pacific Islander (3.9%) and non-Hispanic Asian (2.8%) people than non-Hispanic white people (1.6%) reported worse experiences than other races.
Unvaccinated respondents were 5.3 times (95% CI, 4.3-6.3) more likely to report worse experiences in health care.
Although studies have linked lower confidence in vaccination and more barriers to access with COVID-19 vaccination disparity, the researchers pointed to other studies that reflect perceived worse health care experiences based on race.
According to Singleton, the findings can help physicians understand the “growing awareness of racism as a cause of health inequities and disparities,” adding that raising awareness could help find solutions to reduce them.
“It is important for health care providers to be aware of patients’ potential negative health care experiences and incorporate this sensitivity into their patient interactions to foster patient trust,” he said.
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