Geographical Patterns of COVID-19 Vaccine Inequality by Race and Ethnicity and Sociodemographic Determinants of Health: Evidence from Louisville, Kentucky.

BACKGROUND

Infectious diseases accounted for approximately 18.4% of global mortality in 2019. According to the World Health Organization (WHO), vaccines are available for about 30 potentially lethal diseases. Vaccination prevents substantial mortality and hospitalization. However, its ability to improve overall public health depends on equitable access across all populations, regardless of race, ethnicity, education, or socioeconomic status.

OBJECTIVES

This study aims to examine how disparities in social determinants of health (SDOH) affect COVID-19 vaccination uptake across Jefferson County, Kentucky. Using ZIP code-level spatial mapping, this study investigates the intersection of SDOH, racial composition, and geographic characteristics to identify inequities and inform equitable interventions.

METHODS

Data from the Kentucky Immunization Registry (KYIR) were analyzed to assess two-dose COVID-19 vaccination rates at the ZIP code and regional levels in Jefferson County, Kentucky. Vaccination rates were stratified by race and ethnicity and linked with SDOH, including education, employment, insurance status, and income, obtained from the 2021 American Community Survey.

RESULTS

By May 2021, vaccination rates ranged from 25.9% in the West region to 57.0% in the Inner East region; by May 2022, these rates increased to 46.2% and 73.9%, respectively. White residents consistently had the highest two-dose vaccination rates (66.4% by May 2022), while Black and Hispanic residents had lower rates (45.7% and 43.9%, respectively). Vaccination rates were strongly correlated with SDOH, especially educational attainment, average family income, and employment rate, underscoring the role of socioeconomic inequities in vaccination disparities.

CONCLUSIONS

Geographical and racial disparities emphasize the influence of social and economic inequality on vaccine uptake.