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May 11, 2021
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Social vulnerabilities associated with low vaccination rates among older Americans

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Counties with low COVID-19 vaccination rates have significantly higher percentages of older adults living with certain social vulnerabilities, such as lack of access to a computer, according to CDC researchers.

In a new MMWR report, the researchers also noted that vaccination rates were higher among older men than among older women, and among adults aged 65 to 74 years compared with among adults 75 years or older.

Elderly vaccination
Many older Americans remain unvaccinated against COVID-19.
Source: Adobe Stock.

“Monitoring demographic and social factors affecting COVID-19 vaccine access for older adults and prioritizing efforts to ensure equitable access to COVID-19 vaccine are needed to ensure high coverage among this group,” Ari Whiteman, PhD, a senior geographic information system analyst, and colleagues from CDC COVID-19 Task Force wrote in MMWR.

Whiteman and colleagues analyzed vaccine administration data submitted to the CDC, including vaccination initiation prevalence and demographic information. According to their report, between Dec. 14 and April 10, approximately 42.7 million (79.1%) of the estimated 54 million adults aged 65 years or older in the United States initiated vaccination. (Updated CDC data show that 83.7% of adults in this age group have initiated vaccination as of May 10.)

According to the report, in U.S. counties where less than half of adults aged 65 years or older initiated COVID-19 vaccination as of April 10, 24.6% of them had no access to a computer (95% CI, 22.3%-26.9%) compared with 19.1% (95% CI, 17.8%–20.4%) of older adults in counties with vaccination initiation rates of 75% or more.

Poverty and living alone also were associated with lower vaccination rates. According to the report, counties with vaccination rates lower than 50% had higher percentages of older adults living in poverty (10.3% vs. 7.6%), and higher rates of older adults living alone (14.3% vs. 12.2%) compared with counties where the vaccination rates were higher.

Whiteman and colleagues also reported that the average percentage of older adults indicating a race or ethnicity other than white was similar in counties in counties with lower or higher vaccination rates (8% vs. 9.3%).

The vaccination rate for older men was 79.6% compared with 77.5% for women. In contrast, Whiteman and colleagues said recent estimates suggest no such differences for influenza and shingles vaccination.

The vaccination initiation rate also was higher among people aged 65 to 74 years (79.6%) than 75 years or older (78.3%).

“As COVID-19 vaccine supply expands along with the individual eligibility criteria, state and local jurisdictions can continue to ensure that older adults have equitable access to COVID-19 vaccines, including assistance with scheduling vaccination appointments and transportation to vaccination sites, or vaccination at home if needed for persons who are homebound,” the researchers wrote.

“Assistance to ensure that persons receiving a vaccine that requires two doses to complete the series might be needed as well. Public health officials should continue to monitor vaccination initiation rates in the context of socioeconomic and demographic vulnerability to promote vaccine administration among this population at high risk for severe illness and death from COVID-19.”

References:

CDC. COVID-19 vaccinations in the United States. https://covid.cdc.gov/covid-data-tracker/#vaccinations. Accessed May 11, 2021.

Whiteman A, et al. MMWR Morbid Mortal Wkly Rep. 2021;doi:10.15585/mmwr.mm7019e4.