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CIDRAP - Low COVID vaccine uptake, worse outcomes noted in racial minorities

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  • CIDRAP - Low COVID vaccine uptake, worse outcomes noted in racial minorities

    Source: https://www.cidrap.umn.edu/news-pers...ial-minorities


    Low COVID vaccine uptake, worse outcomes noted in racial minorities
    Filed Under:
    COVID-19
    Mary Van Beusekom | News Writer | CIDRAP News
    | Oct 21, 2021


    Two new JAMA Network Open studies confirm that US racial minorities have borne an outsized burden during the COVID-19 pandemic, with showing a 30% higher rate of vaccination in White adults compared with their Black and Hispanic peers, and the other finding that non-White coronavirus patients were much more likely to be hospitalized, need intensive care, and die.

    Delays in reaching 50% vaccine uptake

    In a research letter yesterday, Stanford University researchers described how they used demographic data from the American Community Survey and state- and Centers for Disease Control and Prevention (CDC)-reported COVID-19 vaccination rates to model vaccine uptake in adults during the initial vaccination scale-up.
    Relative state-reported vaccine uptake for most states by Mar 31, 2021, was a median of 1.3 times higher among White versus Black and Hispanic adults, with estimated coverage among Black and Hispanic adults at 29%, one-third less than among White adults, at 43%.
    Assuming that disparities in state-reported relative vaccine uptake by race and ethnicity would continue beyond the end of March, Hispanic and Black adults across the country were projected to reach 50% coverage with at least one vaccine dose 57 days and 26 days later, respectively, than their White counterparts.
    After modeling the effect of doubling vaccination rates in the most disadvantaged quartile of US Census tracts over 6 weeks starting Apr 1 using the CDC's Social Vulnerability Index, delays were estimated to fall by 30 and 17 days for Black and Hispanic adults, respectively.
    Under this scenario, delays in reaching 50% coverage would decrease to 13 days for Black adults and 8 days for Hispanic adults, and vaccination disparities between Hispanic and White adults would reach zero by Jul 1; the coverage gap would fall 76% for Black adults by that time.
    Real-life national vaccine coverage on Jul 1 was 68% for Hispanic adults, 67% for White adults, and 54% for Black adults. Models estimated that doubling vaccination rates among the most disadvantaged Black adults would achieve a 30-day reduction in reaching 50% coverage in only 10 of 30 states with reported data and sufficient populations. Among Hispanic adults, coverage would reach that rate in 20 of 27 states analyzed by that time.
    The study authors said that the results underscore the urgent need for policies and interventions to reduce COVID-19 vaccine inequities. "Our results additionally demonstrate the benefits of place-based targeting of efforts to promote vaccination uptake," they wrote.
    "By applying consistent rules, we reconciled heterogeneous reporting data to quantify vaccination disparities and demonstrated the need for equity-focused policies to ensure that underserved communities are not left behind."

    Native groups at 7 times higher risk for death

    Today, a study led by CDC researchers analyzed data from 143,342 hospitalized COVID-19 patients of all ages from 99 counties in 14 US states participating in the COVID-19–Associated Hospitalization Surveillance Network from Mar 1, 2020, to Feb 28, 2021. States were California, Colorado, Connecticut, Georgia, Iowa, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee, and Utah.
    Of all patients, 73.5% were 50 years and older, 50.3% were male, 44.6% were White, 28.5% were Black, 20.1% were Latino, 5.4% were Asian or Pacific Islander, and 1.4% were American Indian or Alaska Native. Most had at least one chronic underlying condition, the most common of which were high blood pressure, obesity, and diabetes.
    Relative to White patients, all studied racial minority patients were at higher cumulative age-adjusted risk for hospitalization, intensive care unit (ICU) admission, and death.
    Specifically, for American Indians and Alaska Natives, the relative risk (RR) was 3.70 for hospitalization, 6.49 for intensive care unit (ICU) admission, and 7.19 for death. RRs for the same outcomes among Latino patients were 3.06, 4.20, and 3.85, respectively.
    For Black patients, RRs were 2.85, 3.17, and 2.58 for hospitalization, ICU admission, and death, respectively. RRs for the same outcomes among Asian or Pacific Islander patients were 1.03, 1.91, and 1.64, respectively.
    The researchers said that the disparities are likely due to factors such as a higher prevalence of underlying illnesses in Black and American Indian or Alaska Native people, community SARS-CoV-2 spread and exposure, structural racism, poverty, unstable housing, reliance on public transportation, lack of work-from-home opportunities, lack of health insurance, low health literacy, and low access to quality education.
    The authors called for more research on the relationship between race and COVID-19 outcomes. "An emphasis on studying how socioeconomic inequities, structural racism, and cultural differences can result in immediate and long-term barriers to adequate health care for these populations may lead to successful interventions that improve health," they wrote.
    "Equitable access to preventive measures, such as vaccination, and treatments should be urgently optimized among these groups."



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