Epidemiology: Assessing racial and ethnic disparities in vaccine uptake in the UK and US

People from racial and ethnic minorities were up to three times as likely to report being unsure or unwilling to get a vaccine, when compared to white participants, during the initial COVID-19 vaccine rollout, suggests a study published in Nature Communications. The study, which is based on self-reported data collected via a smartphone application from participants in the United Kingdom and United States, also suggests that disparities in access might underlie some of the racial and ethnic differences in vaccine uptake in the United States.

Racial and ethnic minorities have been disproportionately impacted by COVID-19 with an increased risk of infection, related complications, and death. In the UK and US, which both have racially and ethnically diverse populations, different approaches have been taken with regards to COVID-19 vaccination campaigns and healthcare delivery. Racial and ethnic disparities in vaccine uptake have been reported for both countries, however, specific data across a broad-community-based sample has been lacking.

Andrew Chan and colleagues used a smartphone application to collect data on vaccine hesitancy and vaccine receipt from 1,254,294 individuals in the UK and from 87,388 individuals in the US between December 2020 and February 2021. The authors found that racial or ethnic minority participants in the UK and the US were up to three times as likely to report that they were unsure or unwilling to get a vaccine compared to white participants. They observe that in the US, Black participants were less likely to report that they had received a vaccine dose than white participants, even if they indicated that they were willing to get vaccinated. This was not observed in the UK cohort and the authors suggest that this could be as a result of a lack of access to the vaccine during early phases of the US mass vaccination campaign.

The authors acknowledge the limitations of the study as it relies on self-reported information from individuals who volunteered to take part in the study, and the collection methods might have led to reporting biases. However, they suggest their findings highlight the need to address disparities in healthcare to achieve health equity and population-scale immunity.