COVID-19 & The Legacy of Racism: Vaccine Hesitancy, Access & Uptake

Published on: February 08, 2021. Updated on: February 11, 2021.

43% of Black adults

say they want to wait and see about the vaccine

About this Date Insights

This new infographic highlights the pandemic’s devastating impact on Black, Latino and Native American communities and looks at the role of vaccine hesitancy and access challenges on vaccine uptake rates across the United States. It also outlines several key immediate and long-term strategies to address systemic racism and its health impacts.

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Long history of discrimination:

COVID-19 hospitalizations: Centers for Disease Control and Prevention, Hospitalization rates per 100,000 population by age and race and ethnicity — COVID-NET, March 1, 2020–October 24, 2020

COVID-19 cases and death statistics: The COVID Tracking Project, The COVID Racial Data Tracker

  • NOTE: Data gathered on 2/11/21; The COVID Racial Data Tracker manually compiles key statistics from each state and territory public health authority website and other sources and updates their tracker on a daily basis. Represented statistics reflect only deaths where race/ethnicity is known and rates are not age-adjusted.

Vaccination rate data: Kaiser Family Foundation, Latest Data on COVID-19 Vaccinations Race/Ethnicity, Published: Feb 02, 2021


  • From the KFF release: “These data raise early concerns about disparities in vaccination but are also subject to gaps, limitations, and inconsistencies that limit the ability to draw strong conclusions and compare data across states. The data are still early, with vaccinations not yet broadly available to the public in many areas. Moreover, some states have high shares of vaccination data with unknown race/ethnicity and/or reporting “other or multiple races.” Further, over half of states are not yet reporting vaccinations by race/ethnicity. Comprehensive standardized data across states will be vital to monitor and ensure equitable access to and take-up of the vaccine.”

  • Data was collected on February 1, 2021. At that time, Hispanic data was not available for Louisiana and West Virginia.

Vaccine hesitancy survey: Kaiser Family Foundation, KFF COVID-19 Vaccine Monitor: January 2021, Vaccine Hesitancy.

Vaccine access:

Immediate & actionable strategies:

Establish equitable distribution plans for treatment & vaccines:

Provide culturally competent care and translation services: The Importance of Effective Communication in Healthcare Practice, Harvard Public Health Review

Increase community outreach & engagement:

Improve locations of COVID-19 testing centers: “In Large Texas Cities, Access To Coronavirus Testing May Depend On Where You Live,” NPR Shots

Addressing Vaccine Hesitancy, The 3 Cs Model: World Health Organization, Report of the SAGE Working Group on Vaccine Hesitancy, 2014

Long term strategies:

Work within the community to build trust: Mother Jones, There’s Never Been a More Urgent Moment to Build Black Americans’ Trust in the Medical System, May 8, 2020

Support community health workers and centers: Advancing Health Equity Through Community Health Workers and Peer Providers: Mounting Evidence and Policy Recommendations, Families USA

Address determinants of health: Kaiser Family Foundation, Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity, May 10, 2018

Diversify the workforce and medical school pipeline: How Health Equity Gaps Affect COVID-19 Impact, Blue Cross Blue Shield of Illinois

Provide implicit bias and anti-racism training:

Increase access to health insurance and care: Addressing Racial Health Disparities In The COVID-19 Pandemic: Immediate And Long-Term Policy Solutions, Health Affairs Blog, July 20, 2020. DOI:10.1377/hblog20200716.620294

Utilize available data to inform strategies, improve data collection: BCBST/Meharry partnership as discussed during NIHCM Foundation’s webinar, “COVID-19 and the Legacy of Racism: Vaccine Hesitancy and Treatment Bias

Identify & address bias in algorithms & other tools: Brookings, Algorithmic bias detection and mitigation: Best practices and policies to reduce consumer harms, May 22, 2019

Address provider & health system behavior through incentive measures: “Value-Based Health Care Must Value Black Lives, " Health Affairs Blog, September 3, 2020.


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