COVID-19 vaccine uptake inequality among older adults: A multidimensional demographic analysis

Am J Infect Control. 2025 Jan;53(1):115-125. doi: 10.1016/j.ajic.2024.09.007. Epub 2024 Sep 12.

Abstract

Background: Age, race, ethnicity, and sex are important determinants of coronavirus disease of 2019 (COVID-19) outcomes. Older adults (65 years and older) are at the highest risk of COVID-19 morbidity and mortality. Analyzing their vaccine uptake by subclassifying demographics is rare and can assist vaccination policies. This study investigates COVID-19 dose 1 and 2 vaccine uptakes among them by race, ethnicity, and sex.

Methods: Immunization registry data were used to calculate temporal changes in older adults' COVID-19 vaccine uptake by race, ethnicity, race-sex, and ethnicity-sex in Kentucky's most populous county, Jefferson County, during the first 6 quarters of the COVID-19 vaccination program.

Results: By May 2022, the county's Asian residents had the highest dose 1 and 2 vaccination rates (97.0% and 80.4%), then White residents (90.0% and 80.2%). Black residents had one of the lowest COVID-19 vaccination rates (87.3% and 77.3%). The rate among Hispanic residents (82.0% and 66.4%) was considerably lower than non-Hispanic residents (90.2% and 80.1%). The rates were consistently lower in males.

Conclusions: Racial, ethnic, and sex-based COVID-19 vaccine inequalities were largely maintained during the study period. Vaccine rollout practices and promotional programs should aim to boost the uptake of the COVID-19 vaccination among racial minority and male older adults.

Keywords: 65 years and older; COVID-19 vaccination; Ethnicity; Multidimensional; Race; Sex.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Black or African American
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19* / prevention & control
  • Demography
  • Female
  • Hispanic or Latino
  • Humans
  • Kentucky
  • Male
  • Vaccination Coverage* / statistics & numerical data
  • White

Substances

  • COVID-19 Vaccines