Only 19 states report vaccinations by race/ethnicity

Every week, I come into your inbox and I say, the vaccine rollout is going badly.  And you’re probably like, yeah, Betsy, I know, it’s on the news every single day.

You probably don’t need me to tell you about the announcement this past Tuesday, from Health and Human Services Secretary Alex Azar, telling states to stop saving their second doses and start prioritizing all adults over the age of 65… or the Washington Post scoop this past Friday, revealing that states couldn’t actually vaccinate more people because the federal vaccine reserve was already used up. (I salute all the policy reporters following this madness. Seriously.)

So instead, today, I’m focusing on a vaccination issue that hasn’t gotten as much press: who is actually getting vaccinated? On the national level, we largely can’t answer this question, thanks to a lack of demographic data.

While the CDC’s vaccination tracker has seen some upgrades recently (such as the inclusion of people receiving two doses and downloadable data), it does not report any information on the race, ethnicity, age, gender, or occupation of those Americans who have gotten shots. And the data aren’t much better at the state level, according to recent analysis from the COVID Tracking Project

The COVID Tracking Project analysis discusses 17 states which report race and/or ethnicity data for vaccine recipients. Since the post was published, two more states—Missouri and West Virginia—have started reporting such data. Still, just reporting these data isn’t sufficient. Alice Goldfarb, Kara Schechtman, Charlotte Minsky, and other Project volunteers who compiled detailed annotations on the vaccine metrics reported by each state found that, even when states do report demographic data, each state uses vastly different categories, making it difficult to compare or combine this state-level information into a useful national dataset.

See the CDD’s updated annotations on both state and national vaccine data sources here.

Using the limited data that are available, though, we can still see that the vaccination effort thus far is incredibly inequitable—despite government promises to prioritize vulnerable populations.

White Americans are getting vaccinated at much higher rates than Black Americans, according to a Kaiser Health News analysis of state data published yesterday. Reporters Hannah Recht and Lauren Weber discuss access issues and mistrust of the healthcare system—tied to systematic racism against Black Americans seeking healthcare—as reasons why Black Americans may be left behind.

But the disparities so far, at a stage of the vaccine rollout that has largely prioritized healthcare workers, means that both national and local public health agencies have a lot of work to do:

“My concern now is if we don’t vaccinate the population that’s highest-risk, we’re going to see even more disproportional deaths in Black and brown communities,” said Dr. Fola May, a UCLA physician and health equity researcher. “It breaks my heart.”

In New York—a state which finally released a vaccine dashboard today, but is not yet reporting demographic data—vaccination trends by hospital suggest a similar pattern. The hospitals with the highest shares of vaccinated workers are, by and large, private hospitals located in Manhattan. The hospitals with fewer vaccinated workers, on the other hand, include those located in Harlem, Brooklyn, and other working-class neighborhoods.

Data are also lacking for long-term care facilities. The CDC reports total vaccine doses administered in these facilities (which include nursing homes, assisted living facilities, and other care homes). But a national total is unhelpful in analyzing where states have been most successful at getting vaccines to this high-priority population. A COVID Tracking Project analysis, published on Thursday, found vaccine data for LTCs in only seven states. South Carolina is the only state releasing detailed data on individual facilities.

Meanwhile, CVS has published a state-by-state dataset of LTC vaccinations administered by this pharmacy chain. The COVID Tracking Project reports that Walgreens may release a similar dataset. It seems pretty wild that independent pharmacy chains are reporting more detailed vaccine data than the federal government itself—until you remember, well, how data reporting has gone this entire pandemic.

Vaccination data, right now, are about as messy as testing data were back in spring 2020. Every state is doing its own thing, and the federal government has yet to provide sufficiently detailed information for meaningful analysis. Readers: I urge you to push for better vaccine demographic data, both in your own region and nationally.

A few more vaccine data updates:

  • Cash incentives for vaccination have little impact
    While politicians at all levels have praised cash incentives, research has shown that this strategy has little impact on actually convincing Americans to get vaccinated. A recent investigation I worked on (at the Documenting COVID-19 project and the Missouri Independent) provides new evidence for this trend: the state of Missouri allocated $11 million for gift cards that residents could get upon receiving their first or second vaccine dose, but the vast majority of local health departments opted not to participate in the program—and a very small number of gift cards have been distributed thus far.
  • Vaccines aren’t enough: What Biden can do about Omicron
    This past Monday, President Biden said in a speech, “We’re throwing everything we can at this virus, tracking it from every angle.” Which I, personally, found laughable. The U.S.’s anti-COVID strategy basically revolves around vaccines, and it’s not sufficient for stopping new surges.
  • Omicron variant: What we know, what we don’t, and why not to panic (yet)
    On Thanksgiving, my Twitter feed was dominated not by food photos, but by news of a novel coronavirus variant identified in South Africa earlier this week. While the variant—now called Omicron, or B.1.1.529—likely didn’t originate in South Africa, data from the country’s comprehensive surveillance system provided enough evidence to suggest that this variant could be more contagious than Delta, as well as potentially more able to evade human immune systems.
  • COVID source callout: CDC’s breakthrough case data
    The CDC has not updated its breakthrough case data since September. A full two months ago.

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