COVID Vaccine Equity Research Dialogues (CoVEReD)
COVID Vaccine Equity Research Dialogues (CoVEReD)
April 20, 2021
Jennifer Tolbert
When everyone is eligible, what happens to vaccine equity? 
In today's edition of our COVID Vaccine Equity Research Dialogues (CoVEReD), Jennifer Tolbert, MPH, MSW joins hosts Alison Buttenheim, PhD, MBA and Harald Schmidt, PhD, MA to discuss how the eligibility expansion affects equity in vaccine administration, particularly in states with larger shares of disadvantaged populations and lower vaccination rates.
Alison Buttenheim, Harald Schmidt
Tolbert is Director of State Health Reform at the Kaiser Family Foundation and an Associate Director for the Program on Medicaid and the Uninsured.  
Watch the 14-minute video discussion below, followed by a written episode overview.
CoVEReD Video
Episode Overview
Despite the temporary "pause" on the J&J COVID-19 vaccine because of reports of rare blood clots, overall vaccine supply may soon exceed demand in the U.S. Moreover, most states have now expanded vaccine eligibility to all individuals 16 years and older. How does the eligibility expansion affect equity in vaccine administration, particularly in states with larger shares of disadvantaged populations and lower vaccination rates?
This week's CoVEReD guest, Jennifer Tolbert, explains that part of the issue has been limited race and ethnicity data, which are available for only 45% of vaccines administered at the state level. Initial analysis by the Kaiser Family Foundation (KFF) of available CDC county vaccination data, she says, found that "counties that scored higher on the social vulnerability indexes that had higher shares of people of color had lower vaccination rates." Without dedicated efforts to reach disadvantaged populations, expanding eligibility could widen this gap, particularly given existing differences in vaccine rates between states.
What explains this gap? Alison Buttenheim points to the combined role of hesitancy and access. In KFF's most recent survey, Tolbert finds some positive news: hesitancy appears to have decreased. But long-standing structural barriers, such as transportation, technology, and language, persist.
As eligibility expands and disadvantaged groups are no longer prioritized, Harald Schmidt argues that state allocation to disadvantaged areas, in addition to targeted community outreach, will be key to reducing disparities in vaccine rates. We will need to double down on these efforts, says Tolbert, allowing states flexibility to make these allocation decisions. "I think those efforts are…more needed now than before, now that everyone is eligible and that the demand for the vaccine is going to grow."
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