As of this week, federal data from the Centers for Disease Control and Prevention (CDC) show that 72.1% of the total population in the United States have received at least one dose of a COVID-19 vaccine. While this achievement has led to steep declines in COVID-19 cases and deaths, vaccination coverage—and the protections provided by it—remains uneven across the country. Amid the continued spread of the Delta variant and growing concerns related to the Omicron variant, unvaccinated people are at increased risk for infection, illness, and death. As of December 13, 2021, White people accounted for the largest share (63%) of people who are unvaccinated.1 Over the course of the vaccination rollout, Black and Hispanic people have been less likely than their White counterparts to receive a vaccine, but these disparities have narrowed over time, particularly for Hispanic people. With booster shot eligibility expanded to all individuals ages 16 and older and children ages 5-11 eligible for vaccination, ensuring equity in take-up of booster shots and vaccinations among children also is important. However, to date, limited data are available to examine disparities among booster shot recipients and children.

This data note presents federal data on COVID-19 vaccinations by race/ethnicity, federal data on race/ethnicity of booster shot recipients ages 65 and older, state reported data on COVID-19 vaccinations by race/ethnicity, and state-reported data on COVID-19 vaccinations by race/ethnicity among children, where available.

Federal Data on COVID-19 Vaccinations by Race/Ethnicity

The CDC reports demographic characteristics, including race/ethnicity, of people receiving COVID-19 vaccinations at the national level, including both people who have received one dose and people who have been recently vaccinated (initiated within the last 14 days). As of December 13, 2021, CDC reported that race/ethnicity was known for 70% of people who had received at least one dose of the vaccine. Among this group, nearly two thirds were White (58%), 10% were Black, 19% were Hispanic, 6% were Asian, 1% were American Indian or Alaska Native (AIAN), and <1% were Native Hawaiian or Other Pacific Islander (NHOPI), while 6% reported multiple or other race. White people make up a smaller share of people who have received at least one dose (58%) and people who have recently received a vaccination (50%) compared to their share of the total population (61%). The same pattern is observed among Black people, who make up 10% of people who have received at least one dose and 11% of those recently vaccinated, compared to 12% of the population. In contrast, Hispanic people make up a larger share of vaccinated people (19%) and people who recently received a vaccination (23%) compared to their share of the total population (17%). The share of vaccinated people who are Asian is proportionate to their share of the total population (both 6%), while they make up a higher share (9%) of people initiating vaccination in the last 14 days. (Figure 1).

The CDC also reports race/ethnicity of people ages 65 and older who have received an additional/ booster vaccine dose at the federal level. Among this group, three-quarters of booster recipients were White (74%), 7% were Black, 8% were Hispanic, 4% were Asian, and AIAN and NHOPI people made up less than 1% of recipients (0.5% and 0.1%, respectively). White people make up a similar share of booster dose recipients age 65 and older as their share of fully vaccinated people age 65 and up (74% vs. 73%), while the shares of booster dose recipients who are Black and Hispanic are smaller than their shares of fully vaccinated people age 65 and older. However, the data also show an uptick in the shares of recent booster doses going to Black and Hispanic people, with the shares of recent booster doses going to Black (10%) and Hispanic people (11%) ages 65 and older exceeding their shares of fully vaccinated people ages 65 and older (both at 9%).

While these data provide helpful insights at the national level, to date, CDC is not publicly reporting state-level data on the racial/ethnic composition of people vaccinated. CDC also is not reporting the race/ethnicity of people who have received at least one dose by age, limiting the ability to gain insight into vaccination patterns among children.

State Data on COVID-19 Vaccinations by Race/Ethnicity

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 December 13, 2021, 47 states and Washington D.C. were reporting vaccination data by race/ethnicity, including 45 states that reported race/ethnicity of people who received at least one dose of the vaccine.2 Figure 2 shows the percent of the total population who have been vaccinated by race/ethnicity in each of the 45 states that report people who have received at least one COVID-19 vaccine dose by race/ethnicity and the total across 42 of these states. (Idaho, North Dakota, and New Mexico are excluded from the total due to differences in their reporting of 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. These data will differ from survey estimates of vaccination rates that are limited to adults.

Across these 42 states, as of December 13, 2021, 58% percent of White people had received at least one COVID-19 vaccine dose, which was close to the rate for Hispanic people (56%) but higher than the rate for Black people (51%). White people had a vaccination rate that was higher than the rate for Hispanic people in 27 states, while it was lower in 15 states. White people had a higher rate than Black people in most reporting states, except Oregon, Alaska, Alabama, Mississippi, Pennsylvania, Utah, Washington, Louisiana, and West Virginia. The size of these differences varied widely across states, and they have been narrowing over time. The overall vaccination rate across states for Asian people was higher compared to White people (77% vs. 58%), which is consistent with the pattern in most reporting states. However, Asian people had lower vaccination rates than White people in four states (Colorado, North Dakota, Pennsylvania, and South Dakota).

Racial disparities in vaccination rates have narrowed over time and have nearly closed for Hispanic people. Between November 29 and December 13, vaccination rates increased by 1.0 percentage points for Black people (from 50.3% to 51.3%), by 1.1 percentage points for Hispanic people (from 55.3% to 56.4%), and by 1.2 percentage points for Asian people (from 75.3% to 76.5%). In contrast, they remained roughly stable for White people (at 58%). Over the course of the vaccination rollout, differences between vaccination rates for Black, Hispanic, and White people have narrowed, and the gap between rates for White and Hispanic people has nearly closed. Between late April 2021, when most adults became eligible for vaccines across states, and December 13, 2021, the gap in vaccination rates between White and Black people fell from 14 percentage points (38% vs. 24%) to 7 percentage points (58% vs. 51%) while the difference between White and Hispanic vaccination rates decreased from 13 percentage points (38% vs. 25%) to two percentage points (58% vs. 56%).

State Data on COVID-19 Vaccinations for Children by Race/Ethnicity

CDC reports that as of December 13, 2021, 19.2% of children ages 5-11 and 62.1% of children ages 12-17 have received at least one COVID-19 vaccine dose. However, CDC does not currently report race/ethnicity of vaccinated children. As of December 10, 2021, only nine states reported COVID-19 vaccination data by race/ethnicity for children: Connecticut, the District of Columbia, Kansas, Michigan, Minnesota, North Carolina, South Carolina, Wisconsin, and Vermont (Figure 4). While these states report race/ethnicity of vaccinated children, they vary in their racial/ethnic categorizations and age groups, making it challenging to compare vaccination rates data across states. Seven states (Connecticut, District of Columbia, Michigan, Minnesota, North Carolina, South Carolina, and Vermont) reported race/ethnicity data separately for children ages 5-11, the group who most recently became eligible for the vaccine.

The data from these nine states have mixed findings regarding vaccinations by race/ethnicity among children. Black children had lower vaccination rates than White children in most but not all of the reporting states. Asian children had the highest vaccination rate in most reporting states. Rates for Hispanic children were lower than rates for White children among those in the age 5-11 age group, while their rates were higher or similar to White children’s rates among those ages 12 and older or children overall (in states that do not include separate age breaks among children). Overall, it remains challenging to draw strong conclusions about racial equity in COVID-19 vaccinations among children due to the dearth of comprehensive data, inconsistency in reporting, and the lack of disaggregated data for smaller racial/ethnic groups, particularly NHOPI children.

Discussion

Growing data point to significantly increased risks of COVID-19 illness and death for people who remain unvaccinated. White people account for the largest share of people who remain unvaccinated. Black and Hispanic people have been less likely than their White counterparts to have received a vaccine over the course of the vaccination rollout, but these disparities have narrowed over time and largely closed for Hispanic people.

The increasing equity in vaccination rates likely reflects a combination of efforts focused on increasing vaccination rates among people of color through outreach and education and reducing access and logistical barriers to vaccination, increased interest in getting the vaccine due to the spread of the Delta variant, the emergence of the Omicron variant, and 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. Moreover, it will be important to prevent disparities in uptake of booster shots and among children between ages 5 to 11, the latest group to become eligible for the vaccine.

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. The completeness of race/ethnicity data has improved in most states over time as the shares of vaccinations with unknown or missing race have declined. However, some states still have relatively high shares of vaccinations among people classified with “unknown” race/ethnicity and three states still are not reporting vaccination data by race/ethnicity. Inconsistences in racial/ethnic classifications across states as well as separate reporting of data for federally administered vaccinations, including those provided through the Indian Health Service and federal long-term care partnership program, also limit the ability to interpret the data.

In addition, ongoing changes and updates to the data may make it challenging to interpret the data and trend it over time. For example, some states have reported declines in cumulative vaccinations for some racial/ethnic groups over time. These declines reflect a variety of factors, including changes in state reporting methods and recoding of individuals’ racial/ethnic classifications over time. For example, several states have indicated that an individual’s self-reported race/ethnicity may change if he or she records a different classification when receiving a subsequent COVID-19 vaccine dose or another vaccination, such as the flu shot.

Lastly, although federal and state data are available for vaccinations by race/ethnicity and age separately, only a handful of states report data in a way that allows for analysis of vaccination rates by race/ethnicity within age groups. Without improved reporting to analyze vaccinations by race/ethnicity and age, it will not be possible to identify disparities in vaccination uptake among children. Similarly, limited data are available on race/ethnicity of COVID-19 booster shot recipients. While the CDC has begun reporting race/ethnicity of booster dose recipients at the federal level, these data currently are limited to people over age 65. A total of twelve states (Alaska, California, Colorado, Delaware, Idaho, Illinois, Iowa, Michigan, Mississippi, New Jersey, Ohio, Oregon) report race/ethnicity of booster dose recipients. Overall, comprehensive standardized data across states are vital to monitor and ensure equitable access to and uptake of the vaccine.

Complete data on the distribution of vaccinations by race/ethnicity as well as the percent of the total population that has received at least one COVID-19 vaccine dose are available 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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