Inequities in COVID-19 vaccination rates among adolescents in Massachusetts: a cross-sectional study

Abstract

BACKGROUND: The COVID-19 pandemic has disproportionately affected more socioeconomically disadvantaged persons and areas. We sought to determine how certain sociodemographic factors were correlated to adolescents' COVID-19 vaccination rates in towns and cities ("communities") in the Commonwealth of Massachusetts. METHODS: Data on COVID-19 vaccination rates were obtained over a 20-week period from March 30, 2021 to August 10, 2021. Communities' adolescent (ages 12-19) vaccination rates were compared across quintiles of community-level income, COVID-19 case rate, and proportion of non-Hispanic Black or Hispanic individuals. Other variables included population density and earlier COVID-19 vaccination rates of adolescents and adults, averaged from March 30 to May 11 to determine their effects on vaccination rates on August 10. Linear and logistic regression was used to estimate individual effects of variables on adolescent vaccination rates. RESULTS: Higher median household income, lower proportion of Black or Hispanic individuals, higher early adolescent COVID-19 vaccination rates, and higher early adult COVID-19 vaccination rates were associated with higher later adolescent COVID-19 vaccination rates. Income per $10,000 (adjusted odds ratio=1.01 [95% confidence interval=1.01-1.02]), proportion of Hispanic individuals (1.33 [1.13-1.56]), early adolescent COVID-19 vaccination rates (5.28 [4.67-5.96]), and early adult COVID-19 vaccination rates (2.31 [2.02-2.64]) were associated with higher adolescent COVID-19 vaccination on August 10, while proportion of Black individuals approached significance (1.26 [0.98-1.61]). CONCLUSIONS: Vaccination efforts for adolescents in Massachusetts should focus on boosting vaccination rates early in communities with the lowest incomes and greatest proportion of Hispanic individuals and consider targeting communities with a greater proportion of Black individuals.