Why Are Black Americans Receiving the COVID-19 Vaccine at Lower Rates?

Despite being nearly four times as likely to be hospitalized for a severe case of COVID-19, Black Americans’ vaccination rates are significantly lower than that of White Americans, according to a Kaiser Health News analysis.

Several state reports show a stark racial disparity in vaccine distribution. In Indiana, 86.2% of the vaccinated population were White, but only 4.0% were Black. Tennessee’s vaccination rates also exhibit this contrast with more White people—69.56%—vaccinated than Black people—6.64%. Florida’s data shows that 64% of the residents who have been vaccinated were White, but only 5.1% were Black. Texas’ report, though largely incomplete, shows this disparity as well. 

“The reasons for lower vaccination rates among Black Americans fall under two broad categories: access and trust,” Deidra Crews, MD, ScM, associate director for research development at the Johns Hopkins Center for Health Equity in Maryland, tells Verywell. This mistrust is rooted in historical and present-day experiences with unjust and discriminatory treatment by the healthcare, biomedical research, and public health systems, she says.

Why Is There a Disparity in Vaccination Rates?

Experts cite a number of issues fueling these numbers, from distrust of medical institutions to the accessibility of vaccine centers or appointments. 

Accounting for Mistrust and Fear

Historically, the Black community in the U.S. has experienced mistreatment and violations of consent at the hands of the medical system.

Fola P. May, MD, PhD, health equity research and quality director at the University of California, Los Angeles Health, references the 1932 Tuskegee Experiment, a 40-year study about the natural progression of untreated syphilis among Black men. Researchers misled the participants by failing to let them know that they wouldn't be treated, continuing the experiment without their informed consent. May also points to the case of Henrietta Lacks, a Black woman whose cells—which became one of the most important cell lines in the history of medical research—were extracted without consent nor compensation.

Fear and mistrust over medical care stem from violations like these, but also from the continuous bias and unfair treatment that Black communities experience from healthcare systems to this day, resulting in COVID-19 vaccine hesitancy. 

A poll conducted by the Kaiser Family Foundation shows that Black adults—43%—are more likely than White adults—26%—to “wait and see” how the vaccine is working before getting it themselves. Black respondents, around 75%, were also more concerned than White respondents—49%—that the COVID-19 vaccines aren't as safe as they are said to be.

Accessibility Issues

Beyond the issue of vaccine hesitancy, inaccessibility is also a major factor. According to May, those without regular primary care providers, access to health centers, or information about how to sign-up for a vaccine are automatically disadvantaged in vaccine distribution. This doesn’t just result in racial disparities with the vaccination rates, but socioeconomic disparities as well.

“Wealthy individuals always have first access to scientific advancements,” May tells Verywell. “They have access to regular primary care providers, connectedness to health centers, and, in many cases, even other means to getting the vaccine as soon as it is available to them.”

This can be observed in Florida’s Miami-Dade County, where wealthier neighborhoods get vaccinated at a faster rate than lower-income neighborhoods, and all the neighborhoods with vaccination rates above 10% are among the top 20 wealthiest ZIP codes in the county.

“We could be in a situation where White and affluent communities who took the vaccine are protected while the virus continues to circulate among Black and Brown populations,” May says, emphasizing that it will be difficult to reach herd immunity as a nation if the trends in vaccination inequities continue. 

Crews highlights how vaccination centers aren’t accessible to those without personal means of transportation, so there is a pressing need to expand to rural communities where there is limited access to medical centers. 

“We should take the vaccine to where people of color are, as opposed to expecting them to find the vaccines themselves,” Crews says. “This would include offering vaccinations at churches, community centers and neighborhood pharmacies.” 

On February 2, President Joe Biden announced that the federal government would be shipping vaccines directly to select pharmacies in order to increase accessibility. Soon those eligible will be able to make appointments at locations like CVS and Walgreens. 

Experts say the vaccine should also be offered on weekends and outside of office hours to accommodate essential workers who can’t take time off of work to schedule appointments.

How to Bridge the Gap

To bridge these gaps in vaccination rates, government and public health officials must make racial and economic equity a priority in vaccine distribution and focus on improving its accessibility. 

At a White House press briefing on Monday, Marcella Nunez-Smith, chair of Biden's COVID-19 health equity task force, said that as of January 30, they were missing 47% of data on race and ethnicity from states.

There must be accurate, complete, and transparent data about race and ethnicity for vaccine distribution from all the states to quantify the problem, raise awareness, and address the disparities, May says. 

In order to tackle vaccine hesitancy, experts suggest that public health professionals partner with trusted individuals in the Black community, such as religious leaders, physicians, and other community leaders, to combat misinformation and instill trust in the vaccine.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.