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Racial Differences in COVID-19 Vaccine Uptake in US and UK

Not all people unvaccinated against COVID-19 people are actively avoiding the vaccine. A new study shows that Black people were vaccinated at lower rates than White people in the US early on, even after they indicated they were willing to get the shot. The study’s authors explain the reasons behind this.

It’s been well established that COVID-19 vaccine uptake in the US has been lower among Black individuals and members of some other minority groups than among White people. Many in the scientific community have declared that the reason for this hesitancy is a distrust of the medical community due to historic racism, such as was displayed in the infamous Tuskegee Study. Yet while Black people in the United Kingdom also may feel slighted by healthcare providers and claim to be hesitant about the vaccine at higher levels than their White counterparts, during the early rollout they received the vaccine at rates comparable to those of white individuals, a new study shows.

The study, conducted as a joint venture between Massachusetts General Hospital and King’s College London, examined data collected prior to and during the early rollout of vaccines. Participants, including 1,254,294 people in the UK and 87,388 in the US, enrolled in a smartphone-based COVID-19 symptom study that ran from March 2020 to February 2021. In the US, 4715 out of 64,244 (7.35%) White people indicated that they were hesitant to get a vaccine, while 611 out of 2179 Black people (28.04%;) said the same. In the UK, 56,734 out of 1,110,544 (5.1%) of White people were hesitant, compared with 1616 out of 8787 (18.39%) of Black people.

Yet when asked whether they had actually gotten a COVID-19 vaccine, the answers revealed disparities between racial groups in the US that were larger than in the UK. During the study period, 15,341 out of 64,144 (23.91%) White subjects in the US received a vaccine compared with 362 out of 2,179 (16.61%) Black subjects. In the UK, 171,453 out of 1,110,544 (15.43%) White participants got the vaccine, while 1022 out of 8,787 (11.63%) Black participants did the same.

Among those who specifically indicated that they were willing to get vaccinated, disparities in vaccine uptake among different races persisted–but only in the US. In the US, 15,062 out of 59,429 (25.34%) White vaccine-willing participants had received the vaccine, while 328 out of 1568 (20.91%) Black vaccine-willing participants had received it. In the UK, however, uptake rates between the racial groups were closer, with 168,369 out of 1,053,810 (15.97%) White subjects getting vaccinated and 951 out of 7,171 (13.26%) Black subjects getting vaccinated.

That fewer Black people in the US than in the UK had received a vaccine, even if they were willing to get it, suggests that minority populations in the US may face additional barriers to access, the study’s authors said. “We found that even among the vaccine-willing participants in the US with access to smartphone technology in the early phases of the mass vaccination campaigns, Black participants were less likely to receive a vaccine, whereas in the UK study, no consistent disparities in vaccine uptake were observed,” they wrote. The authors speculated that the UK’s National Health Service, with its centralized vaccine-delivery efforts, may have made it easier for Black communities to find and receive vaccines compared with the patchwork efforts seen in the US–efforts that were not necessarily focused on the needs of minority communities.

The authors acknowledged that the study had a couple of limitations. One was the reliance on subjects to volunteer accurate information, although a follow-up validation study confirmed that the information subjects gave was correct. The study also included fewer minority participants than White participants, although the absolute number of participants in all racial and ethnic groups was high. Education and income data, which also could have impacted participants’ vaccine uptake levels, was omitted for privacy.