The largest risk-group we must reach to reduce COVID vaccination disparities


Last night I downloaded the latest Census Bureau July-August week 34 PULSE data. Over two cups of coffee, I ran the obvious multivariable logistic regressions to examine who is now fully vaccinated against COVID.  See the above of this post for the full set of resulting Logit coefficients.

I’m sure Reviewer 2 would order due refinements to my quick analysis, were it immediately submitted for peer-review publication. My capacious study limitations section would note the inherent challenges of population surveys to gauge contentious questions like this. These data surely include response biases and likely overstate the true prevalence of COVID vaccination.

The overall patterns and disparities remain clear enough. Of course, we see huge disparities across regions, by education and by income. A bit more surprising: One group appears especially vulnerable and requires specific outreach…Yup. We must formulate culturally competent public health messaging for heterosexual non-Hispanic white Americans. This group conspicuously lags in vaccination status.

Among self-identified male respondents, heterosexual men were almost four times as likely to report not to be fully vaccinated (19%) as were gay men (5%)–an absolute different quite similar to the gradient observed between men with incomes less than $25,000 and those with incomes between $75,000 and $100,000.

I know that there daunting obstacles to reaching this disparity-population of heterosexual American men. We can’t let these barriers deter us. I’m joking–sort of. OK not really.

Political and social polarization are serious obstacles to our COVID efforts. Tribalization of public health may ironically increase vaccination rates among sexual and gender minorities, the educated, residents of blue states, and the socially liberal. We must find ways to push past these divides.

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