The affluent town of Woodbridge, Conn., has less than half the population of neighboring Ansonia, and yet it’s home to more people who have received a Covid-19 vaccine. The inequity is stark: In Woodbridge, where residents have a median household income of $138,320 a year, 19.3% of the population had been vaccinated as of Feb. 4, according to Connecticut health department data. In Ansonia, where the median income is $45,563 a year, just 7.1% have received their first shot.
Connecticut has the most glaring disparity in vaccination rates between its richest and poorest communities — a difference of 65% — according to a STAT analysis of local-level vaccine data in 10 states with the biggest wealth gaps. Four other states — California, Florida, New Jersey, and Mississippi — also have vaccinated a significantly higher proportion of people in the wealthiest 10% of counties.
The discrepancies vary: In California, 156 shots have been given to residents in the richest areas for every 100 vaccines in the poorest counties, while in Mississippi, 111 vaccines have been given to residents of the richest counties for every 100 doses in the poorest places.
In Washington, D.C., the vaccination rate in the wealthiest two wards is more than double that in the two least wealthy.
The findings back up, with hard data, anecdotal reports from around the country that wealthy people have been able to gain access to vaccines ahead of low-income people. “We’re seeing individuals who have privilege and access who are edging out the people who don’t,” said Tekisha Dwan Everette, executive director of Health Equity Solutions in Connecticut and a member of the governor’s Covid-19 advisory task force in that state.
But the analysis also reveals that some states appear to be distributing vaccines more equitably than others. Among states with the greatest wealth gaps, Texas, Tennessee, New Mexico, Pennsylvania, and Illinois did not show a significant county-level income divide in vaccination rates. The analysis excluded states, including Georgia, Louisiana, and Massachusetts, that do not publicly share county-level data on vaccine recipients.
Because counties can contain diverse populations, the analysis is not a definitive indicator of equity, however. Several experts said they expected more precise data would reveal wealth inequalities even in those states with equitable county-level data. And in a number of these states, racial disparities were still evident.
Any gap in vaccinating rich versus poor inevitably exacerbates racial divides. Black and Latino people are far more likely to live in poverty than white people, and despite having died at higher rates throughout the pandemic, they are receiving fewer vaccines than white people.
The data suggest that, in some states, the first wave of vaccines has favored the rich. “There really are two Conneticuts. We, as a state, need to put more focus on that,” said Tiffany Donelson, chief executive of the Connecticut Health Foundation.
Inequity has been a feature of the pandemic since the start, said Everette, citing Covid-19 testing sites that have been more accessible to wealthier populations. “Instead of learning from that lesson, we’re recreating the privilege,” she said.
Simply locating vaccination sites in diverse and lower-income areas isn’t enough: “People are traveling outside their own geographic region to get a vaccine in another place,” she said.
Similar issues have been seen in California. “We’ve heard those stories of people in LA driving to Compton or to another part where there are other sites,” said Anthony Wright, executive director of Health Access California.
State policies can help address inequalities. Texas vaccination hubs are required to set aside a portion of vaccines for vulnerable communities, work with local leadership, and distribute the vaccine in racially diverse areas, said Imelda Garcia, chair of the Texas Expert Vaccine Allocation Panel. By contrast, in California, counties are expected to focus on equity, but aren’t given specific requirements on how to do so, said California Covid-19 vaccine task force spokesperson Darrel Ng.
But the vaccine rollout in Texas, though it hasn’t reflected income inequality, has disproportionately benefited white residents, the state’s data show. Racial data hasn’t been recorded for all vaccinations, said Garcia, and more complete data collection could show more equitable distribution: “The data doesn’t reflect what’s occurring. I can tell the data is missing.”
Similar concerns about missing data apply to the county-level analysis, as several states with the greatest divides have not released this information. Tracking and sharing this data is one way to improve equality, said Julie Swann, head of the department of industrial and systems engineering at North Carolina State University. “If we start measuring who they’re reaching in terms of race, ethnicity, or income, then they’ll do the extra things necessary to reach everyone.”
The rush to vaccinate people as quickly as possible likely limited equity in the first phase of the rollout. “[States] were worried they’d lose their allocation if they did not move quickly,” said Swann. “Everyone freaked out.”
Vaccine distribution so far has predominantly focused on health care workers and those over 75. “Equity is our north star for vaccine distribution and as the state rolls out its new vaccine distribution network, we will be able to more precisely target our efforts to vaccinate disproportionately impacted communities,” said California’s Ng.
But the lack of equality in the first phase for health care workers is also indicative of disadvantages faced by poorer communities. Fewer people will be vaccinated in areas with a scarcity of hospitals, which are often poorer, rural areas. California’s Central Valley, for example, has a far less robust health care system than Silicon Valley.
“Those areas more heavily resourced with health care infrastructure and workers, by definition got more of the vaccine,” said Wright, of Health Access California.
Connecticut is taking several steps to address the vaccine inequality, said state health department spokesperson Maura Fitzgerald, including setting aside vaccines for those in vulnerable communities, and creating a vaccine phone line for residents without the internet.
In New Jersey — where STAT found the vaccination rate is 28% higher in the richest counties — the health department is working with partners including places of worship and senior centers to provide education and access to vaccines through mobile clinics and potentially door-to-door vaccinations in areas badly affected by Covid-19, said state health department spokesperson Donna Leusner. Washington, D.C., has partnered with hospitals, community health centers, and other organizations to help achieve equity, wrote a health department spokesperson and around 20% to 30% of vaccine supply is targeted to diverse populations including homeless shelters and faith-based initiatives.
Meanwhile, Mississippi health department spokesperson Liz Sharlot said the state is working with Black pastors, historically Black colleges and universities, and prominent African American doctors to address the disparity. And Florida — where the vaccination rate is 23.6% higher in the richest counties — is working with places of worship and other sites in underserved communities where the vaccine can be administered, said a health agency spokesperson. Florida vaccine allocations per county are based on the size of the population over 65 years old.
While older people are more vulnerable to Covid-19, distributing the vaccines based on age can contribute to inequities. In Connecticut, the northeast section of Hartford has a life expectancy of 68.9 years, compared to 84.6 years in West Hartford Center, so a smaller share of its residents have been eligible for vaccination so far. The state opened vaccinations to those aged 65 to 75 only this week. “In Hartford, you’re missing a substantial piece of the population,” said Donelson, of the Connecticut Health Foundation.
Online reservation systems have also contributed to the disparities. A vaccine distribution system that gives appointments to those who can book them fastest inevitably rewards those with the time and connections. People often have to call around five different health care centers to try get onto a vaccination list, said Georges Benjamin, executive director of the American Public Health Association. “It tells you a lot about the lack of planning,” he said.
Online booking systems require a computer, Wi-Fi, and the ability to navigate a complicated system, said Wright. Richer people are more able to take time off work and have easier access to the transportation needed to be vaccinated.
“People who are wealthier will be more dialed into the vaccination rollout,” he said. “It shows how much more we need to do to make proactive efforts to reach the most vulnerable.”
STAT examined discrepancies in 10 states with the highest wealth gap, as measured by the Gini coefficient, that provided county-level or equivalent local data on population vaccination rates.
For each state, we examined the vaccine distribution rates in the richest 10% and poorest 10% of counties. For most states, we used federal data on median household income. In Connecticut, we used vaccine data and median household income for cities and towns. And we analyzed the median household income and vaccination rates for each ward in Washington, D.C. In New Jersey, which has 22 counties, we compared the richest and poorest three counties.
STAT used vaccination rates posted on local health department websites from Feb. 6 to 10. Connecticut, Florida, and New Jersey provided the percentage of residents who had received their first doses; Mississippi provided the vaccine doses administered by county of residence; California provided the vaccine doses administered per 10,000 residents; Washington, D.C. provided the number of residents fully vaccinated by ward.
I’m the second oldest in my family but it looks like at age 64 I will probably be the last to be vaccinated. I have two siblings who are already scheduled for shots because of their jobs, and one who is in the same “group” as me but better situated with a car and a more affluent city to get access to vaccines. My family is actually impatient for me to get my shots but I said I’m not in the pool of permitted people yet (it feels ironic to miss by a hair, so to speak, as my 65th birthday is this September) so I told them I will just continue to wear masks and stay away from people.
Even you got vaccinated, you should continue to wear mask. 95% effective means 95 out of 100 people will develop some sort of immunity and not develop symptoms. With the 95, there will be asymptotic people.
It seems you have the misconception that just because you get the vaccine you won’t get infected. I guess that’s how some the people who get the vaccine got infected by covid and die. They have the same misconception as you that they don’t have to wear mask once they got vaccinated. Wake up, you can still get sick and infect other people even of you have the vaccine.
Don’t feel bad Therese, I am 74 and cannot receive a vaccine through my medical provider as they are currently allocating vaccines to individuals over the age of 75, but first they have to receive a supply of the vaccine to administer as they currently do not have any. If you have online capabilities and transportation, individuals can go to the Walgren’s and Walmart’s to receive a vaccination. That is if you have the capability to go online before their allotment runs out.
“Association is not causation.” As an MD that has lived in CT for over 30 yrs I can tell you why the first paragraph is ludicrous…. Woodbridge, CT is right next to New Haven and half the doctors at Yale live there. As healthcare workers they would get vaccinated early. Perhaps you should see how many doctors live in Woodbrige vs Ansonia…
Spot on! That’s why this entire article is worthless! The occupation of the county residents is essential to the development of stats!
As Geoff’s observation confirms, we are not all in this together.
What a useless data. It does not account those demographic that refuse vaccination. It Latino and Black community, people are doubtful of the new covid19 vaccine and are refusing to be vaccinated.
Though the divide do exist, but it is not rich versus poor. It is more of who has connection and how has not. It was on the news that CVS and Walmart will give excess vaccine to their employee. How can you have excess vaccine at this time when some senior can’t even get a vaccine. If they plan their thawing of the vaccine based on appointment. There won’t be any excess vaccine. It seems just an excuse to give the vaccine to their employees.
Any employee who are force to take a vaccine should be able to get workers compensation in the event the vaccine ends up killing them.
This piece draws undoubtedly pre-formed conclusions based on partial data. It doesn’t bother to compare the demograpgics of the areas in question to the criteria for early vaccination.
This isn’t data. It’s progressive agenda propaganda.
I agree with your first statement, but I do not think this is a matter of “progressive agenda propaganda”. In my view, your pejorative use of the term “progressive” is misdirected. The “progressive agenda” created the very infrastructure, safety net, and government oversight that we rely on for our very lives. Instead, I think the author, like certain others, treats these statistics as though they are proof of some pattern of deliberate actions with pernicious intent to exclude certain groups of people when, in fact, it is the result of a complex combination of many factors, most of which aren’t the “fault” of anyone. It’s just the way things are. I do, however, strongly support all fair and reasonable efforts to get everyone vaccinated as soon as possible.
Exactly. Poor research and poor reporting. All this does is provide inaccurate statements and cause more hard feelings!
The is an ecological fallacy and needs to be controlled by age.
Older people have more money (and have had time to accumulate more wealth).
And we’re vaccinating older people first.
So by vaccinating older people first, you’re vaccinating wealthier people first.
Where do you live? There are so many elderly individuals who have not only limited resources, but also limited mobility and accessibility to obtain a vaccination.
Comparing the rates of vaccinations delivered solely on income levels does little to address whether or not the system is titled towards the wealthy. Demographics based on other factors that may skew the results are not addressed in this article, save the one statement regarding the life expectancy in sections of Hartford. For instance, the Texas A&M study, cited in the journal Social Science and Medicine, found that blacks were 41% less likely to pursue the vaccine. It also found that women were 71% more likely to decline the vaccine. Black families, headed more often by women than other races, may therefore be adversely affected by this result.
Age distribution in wealthier counties versus poorer counties (older persons generally have more wealth than younger), relative numbers of health care workers in wealthier counties versus poorer counties (as addressed by the article) will necessarily skew the results without a racial inequity being built into the distribution system.
The one inequity I can personally attest to is the access to both the time and equipment needed to make the initial vaccine appointment. A NY state resident with access to computers, and being self employed, I was able to acquire an appointment through the NYS webpage. This was done by starting the process immediately at 8:00 AM when appointments came on line. My attempts (virtually every few minutes for 5 1/2 hours), were rewarded when I finally got through an obviously overwhelmed system at 1:30 PM. bagging an appointment a week later. Continued attempts resulted in me once again getting through (this time at 1:30 AM the next morning) getting my wife an appointment 2 week out. I just got my second shot yesterday (Pfizer, with only minor side effects) and my wife will get her second next week. At 66 with a significant comorbidity, I consider myself extremely fortunate to be at this stage of the process. Those less diligent, and those without technology access, have not been so lucky.
At 74, I’m still not eligible in MA. I know about 10 people who have been vaccinated and only 1 of them is really at risk(94 y/o). All the others are physician’s family members, who “work” in their offices or people in labs or allied professions who have no contact with covid, but whose work qualifies loosely as “health care”.
What percentage of people living in Woodbridge, CT, are doctors (and so within their rights for receiving a vaccine before others)?
notice the highest rate differential is DC the home of both congress and the federal government it is totally expected
Thank you, Geoff. Yes, and no surprise. Lucky are those who have their employers (us, the taxpayers) provide their medical benefits. To bad, for those of us who are doing the providing and are left out in the cold. Time for universal health care. As to some of the other comments, there is some truth, but as we’ve seen in MA, those with access, insider knowledge, and/or the time and financial means to shop around and travel far, are getting to the head of the line. The hurdles automatically exclude low income wage earners and people of color.
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