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Lingering Vaccination Gaps in Massachusetts

By Anne Calef and Luc Schuster, with contributions from Rich Parr, MassINC Polling Group

August 9, 2021

With the Delta variant leading to a rise in COVID cases, and with education leaders making final preparations for what will hopefully be a full year of in-person schooling, the next few weeks will be critical for ramping up state vaccination efforts. This brief summarizes ongoing research that Boston Indicators is publishing through our COVID Community Data Lab, highlighting vaccination gaps by race, municipality, political affiliation, and educational attainment. Most of the graphs in this brief are interactive, allowing you to find details for different cities and towns across the state.

Before we walk through these different gaps, a quick update on state-level trends: In aggregate Massachusetts has the third-highest state vaccination rate, but progress slowed during the summer, as it did across much of the country.

After plateauing at about 9,000 doses per day by mid-July, we’ve seen a slight increase in new vaccinations since late July. This uptick during the Delta variant surge is smaller than in some other parts of the country, but this may be explained by the fact that Massachusetts was starting from a higher baseline level of vaccinations.

Black and Hispanic vaccination rates remain relatively low.

Statewide, vaccination rates for Black and Latinx residents have lagged behind vaccination rates for White and Asian residents. While the gap between Latinx and White vaccination rates persists, it has narrowed from a high of 22 percentage points in early May to 13 percentage points in early August. The state’s shift in focus from mass vaccination sites to smaller, community-based settings has made the vaccine more accessible to residents, particularly lower-income residents who may have had a hard time traveling to vaccination sites. Many residents of color have also been wary of the health-care system that has historically harmed or neglected patients of color. Ongoing work by local and national organizations has helped to build trust, communicate the benefits of the vaccine, and help individuals get vaccinated.

While the graph above shows aggregate rates statewide, racial disparities are much higher in some cities and towns, highlighting the need for targeted outreach. In Lynn, for example, 71 percent of White residents have been vaccinated, compared to 61 percent of Asian residents and just 44 percent of Latinx and Black residents. In Springfield, where rates are lower across the board, large racial gaps also remain: White and Asian vaccination rates are in the 50 percent range compared to the 30 percent range for Black and Latinx residents.

Importantly, many unvaccinated Black and Latinx residents remain open to the idea of getting vaccinated, according to new data from the Census Bureau’s Household Pulse Survey. Sample sizes are too small to allow state-level reporting on this question, but nationally we see that more than half of Black, Latinx, and Asian unvaccinated adults either still intend to get vaccinated or are willing to consider it. Unvaccinated White respondents, by contrast, appear much firmer in their commitment not to get vaccinated. This highlights the potential benefits of continued vaccine outreach that is culturally relevant and targeted to a range of racial and ethnic groups.

Vaccination rates lag in towns with high Trump vote share.

In addition to racial vaccination gaps, it appears likely that as attitudes toward COVID vaccines became politically polarized, conservative Americans with strong attachments to the Trump wing of the Republican party remain skeptical about getting vaccinated. We don’t have local data that connects individual party affiliation with COVID vaccination, but we can use town-level data to get a sense of how politics might be affecting vaccination. Echoing national trends, we find that towns where Trump won a larger share of the 2020 vote also have lower vaccination rates.

Figure 1 Created by Rich Parr (MassINC Polling Group)

National poll data has found that 93 percent of Democrats have been vaccinated or plan to be vaccinated, compared to just 51 percent of Republicans. A separate survey found that among Republicans who have not been vaccinated, only 12 percent are waiting for more information, while an overwhelming 67 percent “will definitely not get vaccinated.”

Vaccination rates lag in places with lower levels of education.

Education level is also linked with willingness to get a COVID vaccine. Nationally, college graduates are more likely to be vaccinated, or open to vaccination, than those without a college degree. This holds true across racial and partisan lines. While we don’t have local data linking educational attainment to vaccination, we can again use town-level data to see that towns with a smaller share of residents with a college degree have lower vaccination rates.

Figure 2 Created by Rich Parr (MassINC Polling Group)

Because class overlaps with so many factors, this scatterplot emphasizing the class vaccination gap in many ways echoes other data presented in this brief. Education level and party affiliation are linked, particularly among White voters, so this image largely mirrors the Trump vote share graph above. Many of the larger municipalities that have a low share of adults with a college degree and low vaccination rates are Gateway Cities, where residents are also more likely to be residents of color and face barriers accessing the vaccine, as detailed earlier.

Vaccination rates lag in smaller towns and in lower-income Gateway Cities.

Large vaccination gaps also exist between cities and towns. Many of the cities and towns with the lowest vaccination rates are Gateway Cities and small towns where vaccine access and hesitancy have been harder to address. Compared to vaccination rates nearing 90 percent in wealthy suburbs like Northborough and Needham, vaccination rates in the Central Massachusetts towns Winchendon and Dudley are just 50 percent. This could be due to difficulty accessing the vaccine in rural areas, vaccine skepticism driven by political messaging, or hesitancy due to misconceptions about the safety or origins of the vaccine.

In addition to having some of the lowest vaccination rates, many Gateway Cities also have some of the highest cumulative incidence of COVID-19 due, in part, to larger shares of residents working in frontline positions and residing in crowded living situations. These cities and towns also have higher shares of residents living below the poverty line, who are unemployed, or do not have a high school diploma, as captured below by the CDC Social Vulnerability Index.

The CDC Index makes the inequities depressing vaccination rates clear. But it doesn’t have to be that way. Chelsea, with the heaviest COVID burden and a high level of socioeconomic vulnerability, is a notable exception to the pattern. Its relatively high vaccination rate compared to other Gateway Cities is likely due to high levels of community organizing and activism that, for example, secured an early vaccination site in the city.

As vaccination efforts enter their next and hopefully final stretch, culturally relevant and adequately translated public information campaigns, trust building, community mobilization, and innovative distribution and incentive programs will be critical to achieving vaccine equity, and the “herd immunity” that will serve everyone.

Read more briefs from the COVID Community Data Lab