Spatial inequities in COVID-19 vaccination in Philadelphia by race and income

Objective: Vaccination is a key intervention to prevent severe COVID-19, but in the early months of vaccination availability in the United States, there were wide spatial inequities in vaccination by neighborood racial-ethnic composition and socioeconomic status. To explore whether and how these ine...

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Main Authors: Angela D'Adamo, Alina Schnake-Mahl, Usama Bilal, Jane Miller
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Preventive Medicine Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2211335525001305
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author Angela D'Adamo
Alina Schnake-Mahl
Usama Bilal
Jane Miller
author_facet Angela D'Adamo
Alina Schnake-Mahl
Usama Bilal
Jane Miller
author_sort Angela D'Adamo
collection DOAJ
description Objective: Vaccination is a key intervention to prevent severe COVID-19, but in the early months of vaccination availability in the United States, there were wide spatial inequities in vaccination by neighborood racial-ethnic composition and socioeconomic status. To explore whether and how these inequities persisted, we examined the association between neighborhood-level income and racial-ethnic composition and COVID-19 vaccination coverage in Philadelphia, and described trends in inequities in 2021 and 2022. Methods: Using vaccination data for 46 Philadelphia neighborhoods (zip codes), from the Philadelphia Department of Public Health, we estimated vaccination coverage on April 18th, September 26th, and November 21st of 2021, as well as April 3rd, June 26th, and August 7th of 2022. We estimated and compared average vaccination coverage by neighborhood-level income and racial-ethnic composition. We explored inequities in coverage by estimating absolute and relative differences in vaccination by date. Results: COVID-19 vaccination coverage varied substantially by neighborhood-level income and racial-ethnic composition. On all dates, rates were higher in high income and non-Hispanic White neighborhoods compared to medium-income, low-income, mixed, and non-Hispanic Black neighborhoods. The absolute and relative differences in vaccination between neighborhoods narrowed over time but persisted through August 2022. Conclusions: This study provides evidence for the importance of policies that target low-income and non-Hispanic Black neighborhoods during pandemics, including during vaccination rollout, as they have experienced a disproportionate infection, hospitalization, and mortality burden due to COVID-19 and experienced lower vaccination rates.
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spelling doaj-art-0bd280c4ea8749b5a102c0375e70d4e52025-08-20T03:13:03ZengElsevierPreventive Medicine Reports2211-33552025-06-015410309110.1016/j.pmedr.2025.103091Spatial inequities in COVID-19 vaccination in Philadelphia by race and incomeAngela D'Adamo0Alina Schnake-Mahl1Usama Bilal2Jane Miller3Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author.Department of Health Management and Policy, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USAUrban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USAEdward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USAObjective: Vaccination is a key intervention to prevent severe COVID-19, but in the early months of vaccination availability in the United States, there were wide spatial inequities in vaccination by neighborood racial-ethnic composition and socioeconomic status. To explore whether and how these inequities persisted, we examined the association between neighborhood-level income and racial-ethnic composition and COVID-19 vaccination coverage in Philadelphia, and described trends in inequities in 2021 and 2022. Methods: Using vaccination data for 46 Philadelphia neighborhoods (zip codes), from the Philadelphia Department of Public Health, we estimated vaccination coverage on April 18th, September 26th, and November 21st of 2021, as well as April 3rd, June 26th, and August 7th of 2022. We estimated and compared average vaccination coverage by neighborhood-level income and racial-ethnic composition. We explored inequities in coverage by estimating absolute and relative differences in vaccination by date. Results: COVID-19 vaccination coverage varied substantially by neighborhood-level income and racial-ethnic composition. On all dates, rates were higher in high income and non-Hispanic White neighborhoods compared to medium-income, low-income, mixed, and non-Hispanic Black neighborhoods. The absolute and relative differences in vaccination between neighborhoods narrowed over time but persisted through August 2022. Conclusions: This study provides evidence for the importance of policies that target low-income and non-Hispanic Black neighborhoods during pandemics, including during vaccination rollout, as they have experienced a disproportionate infection, hospitalization, and mortality burden due to COVID-19 and experienced lower vaccination rates.http://www.sciencedirect.com/science/article/pii/S2211335525001305COVID-19VaccinationIncomeRace-ethnicityHealth inequities
spellingShingle Angela D'Adamo
Alina Schnake-Mahl
Usama Bilal
Jane Miller
Spatial inequities in COVID-19 vaccination in Philadelphia by race and income
Preventive Medicine Reports
COVID-19
Vaccination
Income
Race-ethnicity
Health inequities
title Spatial inequities in COVID-19 vaccination in Philadelphia by race and income
title_full Spatial inequities in COVID-19 vaccination in Philadelphia by race and income
title_fullStr Spatial inequities in COVID-19 vaccination in Philadelphia by race and income
title_full_unstemmed Spatial inequities in COVID-19 vaccination in Philadelphia by race and income
title_short Spatial inequities in COVID-19 vaccination in Philadelphia by race and income
title_sort spatial inequities in covid 19 vaccination in philadelphia by race and income
topic COVID-19
Vaccination
Income
Race-ethnicity
Health inequities
url http://www.sciencedirect.com/science/article/pii/S2211335525001305
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