3 ; 1 ; in Month : January (2021) Article No : sphrj-v3-1014
Nasser Mikhail, Soma Wali

Abstract
Background: It is unclear to what extent ethnic disparities exist with respect to the coronavirus disease 2019 (COVID-19) vaccination. Objective: To clarify the magnitude of ethnic disparities and attitudes towards COVID-19 vaccine. Methods: Pubmed research up to March 24, 2021. Search terms include COVID-19, vaccine, ethnicity, disparities, equity, African American, Blacks, Hispanics, Asians. Cross-sectional surveys, retrospective investigations, studies, internet data and pre-print studies are reviewed. Results: Minority groups are generally underrepresented in vaccine trials. During the first month after initiation of COVID-19 vaccination, information about race/ethnicity was unknown in 48.1% of vaccine recipients. Compared with White Americans, Black Americans had 6-fold and Hispanics had 2.4-fold higher chance of not intending to receive COVID-19 vaccine. In the largest and most recent survey, compared with White respondents, the odds ratios (OR) of vaccine hesitancy were 3.15, 1.42 and 1.34 for Blacks, Hispanics, and Asians, respectively. The same survey showed that Blacks were less likely to receive the COVID-19 vaccine compared with Whites, (OR) 0.71 (95% CI, 0.64-0.79). This finding was still true even within the subgroup of Black Americans willing to take the vaccine. In most surveys, Asians exhibit low degree of hesitancy towards COVID-19 vaccination. Similar ethnic disparities were shown among health care workers (HCW) and first responders. Main reason of low acceptance of COVID-19 vaccine among Black HCW was “waiting to review safety data.” Conclusions: Large ethnic gaps exist with respect to attitudes and receipt of COVID-19 vaccination. Black Americans have the lowest rates of vaccine acceptance followed by Hispanics. Serious local and national efforts are urgently needed to ensure equitable access and receipt of COVID-19 vaccine.

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