{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:46:42Z","timestamp":1791640002752,"version":"4.3.4"},"reference-count":15,"publisher":"National Academy of Sciences","issue":"33","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:p>Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress. Racial disparities in vaccination persist despite the increased availability of vaccines. We ask what factors are associated with such disparities. We combine data from state, federal, and other sources to estimate the relationship between social determinants of health and racial disparities in COVID-19 vaccinations at the county level. Analyzing vaccination data from 19 April 2021, when nearly half of the US adult population was at least partially vaccinated, we find associations between racial disparities in COVID-19 vaccination and median income (negative), disparity in high school education (positive), and vote share for the Republican party in the 2020 presidential election (negative), while vaccine hesitancy is not related to disparities. We examine differences in associations for COVID-19 vaccine uptake as compared with influenza vaccine. Key differences include an amplified role for socioeconomic privilege factors and political ideology, reflective of the unique societal context in which the pandemic has unfolded.<\/jats:p>","DOI":"10.1073\/pnas.2107873118","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T16:10:14Z","timestamp":1627575014000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":140,"title":["Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination"],"prefix":"10.1073","volume":"118","author":[{"given":"Ritu","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Decision, Operations, and Information Technologies, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742;"},{"name":"Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1400-4515","authenticated-orcid":false,"given":"Michelle","family":"Dugas","sequence":"additional","affiliation":[{"name":"Department of Decision, Operations, and Information Technologies, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742;"},{"name":"Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7339-7457","authenticated-orcid":false,"given":"Jui","family":"Ramaprasad","sequence":"additional","affiliation":[{"name":"Department of Decision, Operations, and Information Technologies, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0771-3519","authenticated-orcid":false,"given":"Junjie","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Decision, Operations, and Information Technologies, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742;"},{"name":"Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0685-8238","authenticated-orcid":false,"given":"Gujie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Decision, Operations, and Information Technologies, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742;"},{"name":"Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong (Gordon)","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Decision, Operations, and Information Technologies, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742;"},{"name":"Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, MD 20742"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"e_1_3_4_1_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2021258118"},{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2014746118"},{"key":"e_1_3_4_3_2","unstructured":"Centers for Disease Control and Prevention Media statement from CDC director Rochelle P. Walensky MD MPH on racism and health 8 April 2021. https:\/\/www.cdc.gov\/media\/releases\/2021\/s0408-racism-health.html. Accessed 22 April 2021."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0213972"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.10.083"},{"key":"e_1_3_4_6_2","unstructured":"Health and Human Services Office of Disease Prevention and Health Promotion Social Determinants of Health - Healthy People 2030. https:\/\/health.gov\/healthypeople\/objectives-and-data\/social-determinants-health. 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Tyson Growing share of Americans say they plan to get a COVID-19 vaccine \u2013 or already have. https:\/\/www.pewresearch.org\/science\/2021\/03\/05\/growing-share-of-americans-say-they-plan-to-get-a-covid-19-vaccine-or-already-have\/. Accessed 22 April 2021."},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab102"},{"key":"e_1_3_4_12_2","unstructured":"Centers for Medicare and Medicaid Services Mapping Medicare disparities tool. https:\/\/data.cms.gov\/mapping-medicare-disparities. Accessed 25 March 2021."},{"key":"e_1_3_4_13_2","unstructured":"US Census Bureau County Population by Characteristics: 2010-2019. https:\/\/www.census.gov\/data\/tables\/time-series\/demo\/popest\/2010s-counties-detail.html. Accessed 25 March 2021."},{"key":"e_1_3_4_14_2","unstructured":"Health and Human Services Office of the Assistant Secretary for Planning and Evaluation Vaccine hesitancy for COVID-19: State county and local estimates. https:\/\/aspe.hhs.gov\/pdf-report\/vaccine-hesitancy. Accessed 16 April 2021."},{"key":"e_1_3_4_15_2","doi-asserted-by":"crossref","unstructured":"R. Agarwal . Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination methods and materials. GitHub. https:\/\/github.com\/CHIDS-UMD\/Covid19-Vaccination-Race-Disparity-Publish. Deposited 1 July 2021.","DOI":"10.1073\/pnas.2107873118"}],"container-title":["Proceedings of the National Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pnas.org\/doi\/pdf\/10.1073\/pnas.2107873118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T08:00:42Z","timestamp":1649836842000},"score":1,"resource":{"primary":{"URL":"https:\/\/pnas.org\/doi\/full\/10.1073\/pnas.2107873118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,29]]},"references-count":15,"journal-issue":{"issue":"33","published-print":{"date-parts":[[2021,8,17]]}},"alternative-id":["10.1073\/pnas.2107873118"],"URL":"https:\/\/doi.org\/10.1073\/pnas.2107873118","relation":{},"ISSN":["0027-8424","1091-6490"],"issn-type":[{"value":"0027-8424","type":"print"},{"value":"1091-6490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,29]]},"assertion":[{"value":"2021-07-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2107873118"}}