As noted in previous analysis, preventing racial disparities in the uptake of COVID-19 vaccines will be important to help mitigate the disproportionate impacts of the virus for people of color and prevent widening racial health disparities going forward. The Centers for Disease Control and Prevention (CDC) has indicated that vaccine equity is an important goal and defined equity as preferential access and administration to those who have been most affected by COVID-19. Moreover, reaching high vaccination rates across individuals and communities will be key for achieving broader population immunity through a vaccine.
The CDC reports demographic characteristics, including race/ethnicity, of people receiving COVID-19 vaccinations at the national level. As of April 26, 2021, CDC reported that race/ethnicity was known for just over half (55%) of people who had received at least one dose of the vaccine. Among this group, nearly two thirds were White (64%), 12% were Hispanic, 9% were Black, 6% were Asian, 1% were American Indian or Alaska Native, and <1% were Native Hawaiian or Other Pacific Islander, while 8% reported multiple or other race. However, to date, CDC is not providing state-level demographic data for people vaccinated.
To provide greater insight into who is receiving the vaccine and whether some groups are facing disparities in vaccination, KFF is collecting and analyzing state-reported data on COVID-19 vaccinations by race/ethnicity. As of April 26, 2021, 47 states and Washington D.C. were reporting vaccination data by race/ethnicity. This analysis examines how the vaccinations have been distributed by race/ethnicity and the share of the total population vaccinated by race/ethnicity. It also assesses trends in these data since March 1.
Distribution of Vaccinations by Race/Ethnicity
Figure 1 shows the shares of COVID-19 vaccinations, cases, and deaths among Black, Hispanic, Asian, and White people. The data also show the distribution of the total population by these groups as of 2019. Data are not presented for other groups due to data limitations; however, we have conducted separate analysis of vaccination rates among American Indian and Alaska Native people. Together these data show:
As observed in prior weeks, Black and Hispanic people have received smaller shares of vaccinations compared to their shares of cases and deaths and compared to their shares of the total population in most states. For example, in Colorado, 10% of vaccinations have gone to Hispanic people, while they account for 42% of cases, 25% of deaths, and 22% of the total population in the state. Similarly, in the District of Columbia, Black people have received 36% of vaccinations, while they make up 54% of cases, 69% of deaths, and 46% of the total population. However, the size of these differences varies across states. Moreover, there is a small but growing number of states where the shares of vaccinations received by Black and Hispanic people are more proportionate to their shares of the total population and/or their share of cases or deaths in the state. For example, in Oregon, 2% of vaccinations have been received by Black people, similar to their share of cases (3%), deaths (2%), and the total population (2%). In Virginia, 11% of vaccinations have been received by Hispanic people, which is higher than their share of deaths (7%) and similar to their share of the total population (10%), but about half their share of cases (20%). These smaller differences are observed largely in states that have smaller shares of Hispanic and Black residents overall.
In most states, the share of vaccinations among Asian people was similar to or higher than their share of cases and deaths, although, in some states, it was lower. In Alaska, 5% of vaccinations have been received by Asian people, while they have accounted for 11% of deaths. The share of vaccinations among Asian people was similar to their share of the total population in most states, although, in some states, such as Pennsylvania and Virginia it was lower. In Hawaii, 55% of vaccinations have been received by Asian people, which is higher than their share of the total population (40%), but similar to their share of deaths (51%).
White people received a higher share of vaccinations compared to their share of cases and deaths and their share of the total population in most states reporting data. For example, in Colorado, 81% of vaccinations were received by White people, while they make up 68% of the population. In Alaska, over a third (39%) of vaccinations have been received by White people, which is proportional to their share of deaths (38%), but lower than their share of the population (65%). This pattern, in part, reflects that the share of vaccinations received by American Indian and Alaska Native people (20%) is higher than the share of the total population (15%) in Alaska.
Percent of the Total Population Vaccinated by Race/Ethnicity
We also calculate the percent of the total population that has received a COVID-19 vaccine for the 45 states that report racial/ethnic data based on people who have received at least one dose of the vaccine. (States that report race/ethnicity based on total doses administered are excluded from this analysis.) Figure 2 shows the percent of the total population who have been vaccinated by race/ethnicity in each of these states and the total across 43 of these states. (North Dakota and New Mexico are excluded from the total due to differences in how they report their data.) It also shows the ratio of vaccination rates for White people compared to those of Black, Hispanic, and Asian people as well as the percentage point difference between vaccination rates for White people and the rates for the other groups.
Overall, across these 43 states, the percent of White people who have received at least one COVID-19 vaccine dose (38%) was 1.6 times higher than the rate for Black people (24%), and 1.5 times higher than the rate for Hispanic people (25%) as of April 26, 2021. White people had a higher vaccination rate compared to Hispanic people all reporting states, except Virginia, Missouri, and Alaska, and a higher rate than Black people in every reporting state, except Alaska. However, the size of these differences varied widely across states. For example, White people were over twice as likely to have received a vaccine as Hispanic people in Colorado, Iowa, Pennsylvania, and Arizona, and had at least a 2.5 times higher vaccination rate than Black people in South Dakota, Iowa, and Pennsylvania. The overall vaccination rate across states for Asian people was higher compared to White people (45% vs. 38%), which is consistent with the pattern in most reporting states. However, Asian people had lower vaccinations rates than White people in some states.
Since March 1, the share of the population who has received at least one dose of a COVID-19 vaccine has increased across racial/ethnic groups, but disparities for Black and Hispanic people have persisted and widened (Figure 3). The gap between vaccination rates for White and Hispanic people has grown from 8 percentage points as of March 1 to 13 percentage points as of April 26, 2021, and the gap in rates between White and Black people has grown from 6 percentage points to 14 percentage points over the period. Over the past week (April 19 to April 26, 2021) vaccination rates for White and Hispanic people increased by 3 percentage points, while the rate for Black people increased by 2 percentage points. Asian people remained more likely to have received a vaccine than White people. This difference widened over the past week as their vaccination rate increased at a faster pace, rising by 6 percentage points.
The completeness of race/ethnicity data has improved in most states since March 1. Some states, such as Arizona, Texas, Alaska, and Michigan, have had large declines in the share of vaccinations with unknown or missing race.
Together, these data raise concerns about racial disparities in COVID-19 vaccinations. Preventing such disparities will be important to mitigate the disproportionate impacts of the pandemic for people of color, prevent widening disparities going forward, and achieve broad population immunity. A number of states are implementing strategies to address these disparities, and the federal government is launching a range of approaches to expand vaccine access and uptake, with a particular focus on reaching underserved areas and communities hardest hit by the pandemic. The broadening of eligibility for vaccinations across states should also lead to increasing vaccinations among Black and Hispanic people, who are younger overall than White people. Yet, despite these efforts and broadening eligibility, disparities in vaccination rates are persisting. This pattern points to the importance of continued efforts to prioritize equity and reduce barriers to vaccination. Monitoring these data over time will be important for tracking progress toward reducing racial gaps in vaccinations and directing continued action going forward.
While the data provide useful insights, they also remain subject to gaps, limitations, and inconsistencies that limit the ability to get a complete picture of who is and who is not getting vaccinated. For example, data gaps and separate reporting of data for vaccinations administered through the Indian Health Service limit the ability to analyze vaccinations among American Indian and Alaska Native and Native Hawaiian and Other Pacific Islander people. As such, we have conducted separate analysis of vaccinations among American Indian and Alaska Native people. Moreover, some states have high shares of vaccinations that are missing race/ethnicity or that are classified as “other,” limiting the ability to interpret the data. For example, in Alaska, over 30% of vaccinations were among people classified as “other” race, and race was unknown for 41% of vaccinations in Virginia. Three states were not reporting vaccination data by race/ethnicity. Comprehensive standardized data across states will be vital to monitor and ensure equitable access to and take up of the vaccine.
All reported data on vaccinations by race/ethnicity are available through our COVID-19 State Data and Policy Actions tracker and downloadable through our State Health Facts Online tables. KFF will be continuing to update these data on a regular basis going forward as vaccination distribution continues and more people become eligible.