COVID

New study links vaccine rates to socioeconomic factors

“Language barriers, lack of regular health providers, absence of paid time off to get vaccinated and recover, and lack of trust in the health system all play a role in undermining vaccine coverage.”

April 14, 2022

3 minutes to read

A new study of vaccination data in Massachusetts found that significant differences in vaccine and booster rates still exist in the state, often linked to socio-economic factors, leaving thousands vulnerable to variants of COVID-19, according to researchers.

“Despite a lull in COVID-19 infection rates, MA is in a precarious position,” they wrote. “So long as large gaps in vaccine coverage persist, public health measures such as mask mandates, closures, and capacity limits may have to be reinstated to save lives during a future surge.”

In the report, authored by members of Boston University’s School of Public Health and the city’s Public Health Commission, researchers analyzed state data on residents vaccinated and boosted by ZIP code through March 1.

They also examined socioeconomic and demographic data, including education level, household income, and profession, by ZIP code.

When the authors took education and age into account, they found that many communities with large concentrations of Black and Latino residents and essential workers had higher vaccination levels than similar communities with higher levels of white residents and fewer essential workers.

The researchers concluded that educational level likely serves as a stronger predictor than race for vaccination coverage.

“Although ‘vaccine hesitancy’ dominates media coverage, in fact, language barriers, lack of regular health providers, absence of paid time off to get vaccinated and recover, and lack of trust in the health system all play a role in undermining vaccine coverage,” the study’s authors wrote.

“This is not to say that race doesn’t matter,” the study’s lead author Jacob Bor, an assistant professor in epidemiology and global health at Boston University, told The Boston Globe.

Factors like income, race, age, ethnicity, and education levels overlap, he said.

“These differences in income and education among Black, Latino, and Indigenous populations are a product of longstanding patterns of differential access to education, wealth, and opportunity,” Bor said, according to the Globe.

According to the report, a $10,000 increase in a ZIP code’s median household income led to higher vaccination and booster rates. Booster coverage increased from under 30 percent to over 60 percent when examining the rates tied to those with the lowest and highest income levels, according to the study.

In areas with high numbers of college-educated residents, about 70 percent of children have been vaccinated, according to the study. Meanwhile, in ZIP codes with a low percentage of college-educated residents, less than 40 percent of children have been vaccinated, including those areas with the highest percentages of Black, Latino, and Indigenous populations.

“We must redouble our ongoing efforts to overcome barriers related to poverty and education like collaborating with community partners who offer vaccination outside of health care venues, after hours, and on weekends, and provide clear and accurate information from trusted sources,” said Dr. Bisola Ojikutu, Boston’s Commissioner of Public Health and a co-author of the study, told the Globe.

The study, though published online, hasn’t been published yet in a peer-reviewed journal. However, researchers say the report could help policymakers better address vaccination disparities.

“This report highlights that people with complicated lives, and a lot of folks stereotyped as being hesitant, actually had high vaccination rates. And it really points to this being an access issue and we have to be better,” Atyia Martin, executive director for Next Leadership Development, a nonprofit that focuses on building resilience in Black communities, told the Globe.

While local pharmacies and doctor’s offices offer vaccines, Martin noted the system might not make sense for lower-income essential workers. According to the Globe, she pointed out that those workers likely lack transportation or time off to get the shot, particularly if they suffer side effects after getting vaccinated.

“We have to have strategies that are more sophisticated and account for people’s real lives and what they’re dealing with,” Martin told the paper. “And we have to let the data be the guide for the decisions we are making.”

The study’s authors pointed out that successful strategies used during the initial vaccine rollout, which made the shot available at more convenient places and times for essential workers, could be extended for boosters.

They also advised state officials to target the vaccine push in lower-educated communities, regardless of racial composition.