The Association of Social Factors and Health Insurance Coverage with COVID-19 Vaccinations and Hesitancy, July 2021

Abstract

Background: There are racial differences in COVID-19 vaccination rates, but social factors, such as lack of health insurance or food insecurity, may explain some of the racial disparities. Objective: To assess social factors, including insurance coverage, that may affect COVID-19 vaccination as of June–July 2021 and vaccine hesitancy among those not yet vaccinated, and how these may affect racial equity in vaccinations. Design: Cross-sectional analysis of nationally representative survey data. Participants: Adults 18 to 64 participating in the Census Bureau’s Household Pulse Survey for June 23 to July 5, 2021. Main Measures: Vaccination: receipt of at least one dose of a COVID-19 vaccine. Vaccine hesitancy: among those not yet vaccinated, intent to definitely or probably not get vaccinated. Key Results: In unadjusted analyses, black adults were less likely to be vaccinated than other respondents, but, after social factors were included, including health insurance status, food sufficiency, income and education, and state-level political preferences, differences between black and white adults were no longer significant and Hispanics were more likely to be vaccinated (OR = 1.87, p