As of this week, 75% of the adult population in the United States have received at least one dose of a COVID-19 vaccine. While this progress represents a marked achievement in vaccinations that has led to steep declines in COVID-19 cases and deaths, vaccination coverage—and the protections provided by it—remains uneven across the country. With the continued spread of the more transmissible Delta variant, cases, hospitalizations, and deaths are rising, largely among unvaccinated people. While as of late July 2021, White adults accounted for the largest share (57%) of unvaccinated adults, Black and Hispanic people remain less likely than their White counterparts to have received a vaccine, leaving them at increased risk, particularly as the variant spreads.

Reaching high vaccination rates across individuals and communities will be key for achieving broad protection through a vaccine, mitigating the disproportionate impacts of the virus for people of color, and preventing widening racial health disparities going forward. The Centers for Disease Control and Prevention (CDC) has indicated that vaccine equity is an important goal and defined equity as preferential access and administration to those who have been most affected by COVID-19.

The CDC reports demographic characteristics, including race/ethnicity, of people receiving COVID-19 vaccinations at the national level. As of September 8, 2021, CDC reported that race/ethnicity was known for 59% of people who had received at least one dose of the vaccine. Among this group, nearly two thirds were White (60%), 10% were Black, 17% were Hispanic, 6% were Asian, 1% were American Indian or Alaska Native, and <1% were Native Hawaiian or Other Pacific Islander, while 5% reported multiple or other race. However, CDC data also show that recent vaccinations are reaching larger shares of Hispanic and Black populations compared to overall vaccinations. Among vaccines administered in the past 14 days, 26% have gone to Hispanic people and 15% to Black people (Figure 1). These recent patterns suggest a narrowing of racial gaps in vaccinations at the national level, particularly for Hispanic and Black people, who account for a larger share of recent vaccinations compared to their share of the total population (26% vs. 17% and 15% vs. 12%, respectively). While these data provide helpful insights at a national level, to date, CDC is not publicly reporting state-level data on the racial/ethnic composition of people vaccinated.

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Figure 1: Race/Ethnicity of People Receiving a COVID-19 Vaccine in the U.S. as of September 8, 2021

To provide greater insight into who is receiving the vaccine and racial/ethnic disparities in vaccination, KFF is collecting and analyzing state-reported data on COVID-19 vaccinations by race/ethnicity. As of September 7, 2021, 47 states and Washington D.C. were reporting vaccination data by race/ethnicity. This analysis examines how the vaccinations have been distributed by race/ethnicity and the share of the total population vaccinated by race/ethnicity. It also assesses trends in these data since March 1.

Distribution of Vaccinations by Race/Ethnicity

Figure 2 shows the shares of COVID-19 vaccinations, cases, and deaths among Black, Hispanic, Asian, and White people. The data also show the distribution of the total population by these groups as of 2019. Data are not presented for other groups due to data limitations. Together these data show:

Black people have received smaller shares of vaccinations compared to their shares of cases and the total population in more than half of states reporting data. In the remaining reporting states, the share of vaccinations they have received is similar to their shares of cases and the total population. In most reporting states, the share of vaccinations received by Black people is smaller than their share of deaths. For example, in the District of Columbia, Black people have received 44% of vaccinations, while they make up 56% of cases, 71% of deaths, and 46% of the total population.

Reflecting disproportionate levels of infection, Hispanic people have received smaller shares of vaccinations compared to their shares of cases in most reporting states. Their share of vaccinations is similar or higher than their shares of deaths in most reporting states. However, in some states it remains lower. For example, in California, 31% of vaccinations have gone to Hispanic people, while they account for 61% of cases, 47% of deaths, and 40% of the total population in the state.

These current patterns reflect growing shares of vaccinations going to Hispanic and Black people over time. Between March 1 and September 7, the share of vaccinations going to Hispanic people increased in all states reporting data for both periods and increased for Black people in most reporting states. In a few cases, these increases were large. For example, the share of vaccinations going to Black people increased from 26% to 44% in DC and from 25% to 38% in Mississippi. Similarly, the share of vaccinations going to Hispanic people increased by at least 10 percentage points in six states, including Florida (17% to 32%), Nevada (13% to 27%), California (19% to 31%), Texas (23% to 35%), New Jersey (6% to 18%), and New York (9% to 21%). The share of vaccinations going to Asian people also increased in most states reporting data for both periods, while it fell for White people in most reporting states. The share going to White people declined by 10 percentage points or more in 15 states (Arizona, Florida, Nevada, Alabama, Georgia, New Jersey, Tennessee, Virginia, Mississippi, Texas, Maine, Illinois, Colorado, New York, and Indiana).

In nearly all reporting states, the share of vaccinations among Asian people was similar to or higher than their shares of cases, deaths, and total population. For example, in Hawaii, 52% of vaccinations have been received by Asian people, which is higher than their share of the total population (40%) and their shares of cases and deaths (both at 44%).

White people received a higher share of vaccinations compared to their share of cases in most states reporting data. In about half of reporting states they received a similar or higher share of vaccinations compared to their shares of deaths and total population, while in other states it was lower. For example, in Colorado, 76% of vaccinations were received by White people, while they make up 68% of the population. In Tennessee, 65% of vaccinations have been received by White people, which is lower than their share of cases (71%), deaths (78%), and their share of the population (77%).

Percent of the Total Population Vaccinated by Race/Ethnicity

We also calculate the percent of the total population that has received a COVID-19 vaccine for 44 states that report racial/ethnic data based on people who have received at least one dose of the vaccine. (States that report race/ethnicity based on total doses administered are excluded from this analysis.) Figure 3 shows the percent of the total population who have been vaccinated by race/ethnicity in each of these states and the total across 42 of these states. (North Dakota and New Mexico are excluded from the total due to differences in how they report their data.) It also shows the ratio of vaccination rates for White people compared to those of Black, Hispanic, and Asian people, as well as the percentage point difference between vaccination rates for White people and the rates for the other groups.

Overall, across these 42 states, the percent of White people who have received at least one COVID-19 vaccine dose (52%) was roughly 1.2 times higher than the rate for Black people (43%) and 1.1 times higher than the rate for Hispanic people (48%) as of September 7, 2021. White people had a higher vaccination rate compared to Hispanic people in most reporting states, except Missouri, Vermont, Tennessee, Louisiana, DC, Virginia, New York, South Carolina and Nevada. White people also had a higher rate than Black people in every reporting state, except Oregon, Alaska, Mississippi, Washington, Louisiana, and Idaho. The size of these differences varied widely across states and have been narrowing over time. The overall vaccination rate across states for Asian people was higher compared to White people (68% vs. 52%), which is consistent with the pattern in most reporting states. However, Asian people had lower vaccinations rates than White people in five states (Colorado, North Dakota, Utah, Pennsylvania, and South Dakota).

Between August 16 and September 7, Black and Hispanic people experienced a larger increase in vaccination rates compared to White and Asian people, narrowing the disparities in vaccination rates (Figure 4). Vaccination rates increased by 3.1 percentage points for Hispanic people, from 45.1% to 48.2%, and by 2.9 percentage points for Black people, from 40.3% to 43.2%, while vaccination rates increased by 1.0 percentage points for Asian people and by 1.9 percentage points for White people over the period (from 67.1% to 68.1%, and from 50.4% to 52.3%, respectively). The larger increases in rates for Black and Hispanic people continue to narrow the gap in vaccination rates between these groups and White people.

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Figure 4: Percent of Total Population that Has Received at Least One COVID-19 Vaccine Dose by Race/Ethnicity, March 1 to September 7, 2021

 

States with the largest percentage point increases in vaccination rates over the past few weeks included some of those with the highest daily COVID cases per million as of September 8, 2021. For example, Tennessee, Alabama, and Mississippi have some of the worst outbreaks in the country. Tennessee had the fifth largest percentage point increase in the vaccination rates for Hispanic people (4.9 percentage points from 44.9% to 49.8%) and the seventh largest percentage point increase for White people (2.6 percentage points from 39.0% to 41.5%). Alabama had the third largest percentage point increase for White people (3.5 percentage points from 37.2% to 40.7%), the fourth largest percentage point increase for Hispanic people (5.0 percentage point from 33.9% to 38.8%), and the ninth largest percentage point increase for Black people (3.4 percentage points from 37.1% to 40.5%).  Similarly, Mississippi had the largest percentage point increase for White people (4.5 percentage points from 40.7% to 45.1%) and Asian people (4.2 percentage points from 77.3% to 81.5%) and the second largest percentage point increase for Hispanic people (5.9 percentage points from 36.9% to 42.8%) and Black people (4.8 percentage points from 42.3% to 47.1%).

The completeness of race/ethnicity data has improved in most states since March 1. Most states have had declines in their shares of vaccinations with unknown or missing race, with some states, like Arizona, experiencing particularly large declines, falling from (36% of vaccinations with unknown race to 11%).

Discussion

As the Delta variant continues to spread across the country, risks are increasing, particularly for people who remain unvaccinated. White people account for the largest share of people who remain unvaccinated (57%), but Black and Hispanic people are less likely than their White counterparts to have received a vaccine, leaving them at increased risk, which may lead to widening disparities going forward and limit the nation’s recovery.

At the same time, the data show that these disparities are narrowing over time, particularly for Hispanic people. This may reflect a combination of efforts focused on increasing vaccination rates among people of color through outreach and education and reduction of access and logistical barriers to vaccination, increased interest in getting the vaccine as the Delta variant continues to spread, and the increases in vaccinations among younger adults and adolescents who include higher shares of people of color compared to other adults. Despite this progress, the ongoing disparities in rates highlight the importance of continued efforts to increase vaccination rates and to address gaps in vaccination both geographically and across racial/ethnic groups.

While the data provide useful insights, they also remain subject to gaps, limitations, and inconsistencies that limit the ability to get a complete picture of who is and who is not getting vaccinated. For example, data gaps and separate reporting of data for vaccinations administered through the Indian Health Service limit the ability to analyze vaccinations among American Indian and Alaska Native and Native Hawaiian and Other Pacific Islander people. Moreover, some states have high shares of vaccinations that are missing race/ethnicity, limiting the ability to interpret the data. For example, in Washington D.C., 23% of vaccinations were among people classified as “unknown.” Three states were not reporting vaccination data by race/ethnicity. Comprehensive standardized data across states are vital to monitor and ensure equitable access to and take up of the vaccine.

All reported data on vaccinations by race/ethnicity are available through our COVID-19 State Data and Policy Actions tracker and downloadable through our State Health Facts Online tables. KFF will continue to update these data on a regular basis going forward as vaccination distribution continues.

 

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