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:

  • Vaccine requirements are the next big strategy
    After vaccine incentives largely failed to drive up vaccination numbers, government agencies and corporations alike are now opting for requirements. Hundreds of thousands of Americans learned this week that, in order to keep their jobs, they need to get their shots—or go through a more arduous process like weekly COVID-19 testing.
  • Breakthrough case reporting: Once again, outside researchers do the CDC’s job
    Now, Delta is causing the vast majority of cases—and the CDC still isn’t reporting on non-severe breakthroughs. As a result, entities outside the federal government are once again compiling data from states in order to fill in gaps left by the national public health agency. On Friday, both Bloomberg and NBC published breakthrough case analyses.
  • Unpacking Delta numbers from this week’s headlines
    It’s no surprise that Delta (B.1.617.2) is bad news. From the moment it was identified in India, this variant has been linked to rapid transmission and rapid case rises, even in areas where the vaccination rates are high. This week, however, the CDC’s changed mask guidance—combined with new reports on breakthrough cases associated with Delta—has triggered widespread conversation about precisely how much damage this variant can do.
  • The booster shot conversation: What you should know
    Recently, a lot of U.S. COVID-19 news has centered around booster shots—additional vaccine doses to boost patients’ immunity against the coronavirus. Questions abound: do we need these shots, when might we need them, how do they impact vaccination campaigns?

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