Healthcare Access for a Diverse Population with Schizophrenia Following the Onset of the COVID-19 Pandemic.

COVID-19 has had a disproportionate impact on the most disadvantaged members of society, including minorities and those with disabling chronic illnesses such as schizophrenia. We examined the pandemic's impacts among New York State's Medicaid beneficiaries with schizophrenia in the immediate post-pandemic surge period, with a focus on equity of access to critical healthcare. We compared changes in utilization of key behavioral health outpatient services and inpatient services for life-threatening conditions between the pre-pandemic and surge periods for White and non-White beneficiaries. We found racial and ethnic differences across all outcomes, with most differences stable over time. The exception was pneumonia admissions-while no differences existed in the pre-pandemic period, Black and Latinx beneficiaries were less likely than Whites to be hospitalized in the surge period despite minorities' heavier COVID-19 disease burden. The emergence of racial and ethnic differences in access to scarce life-preserving healthcare may hold lessons for future crises.

Remote Schooling and Mothers' Employment During the COVID-19 Pandemic by Race, Education, and Marital Status

Public schools in the United States saw unprecedented reductions to in-person instruction during the 2020–2021 school year. Using the Elementary School Operating Status database, the American Community Survey, and the Current Population Survey, we show remote instruction was associated with reduced employment among mothers compared with fathers and women without children. The gender gap in employment between mothers and fathers grew as much as 5 percentage points in areas with remote instruction. Compared to women without children, mothers' employment fell by as much as 2 percentage points under remote schooling. Employment disparities among mothers deepened by race, educational attainment, and marital status. We show employment disparities endured through spring 2021, even as many school districts returned to in-person instruction.

Vaccination Status and Trends in Adult COVID-19-Associated Hospitalizations by Race and Ethnicity, March 2020-August 2022.

BACKGROUND: We sought to evaluate whether race/ethnicity disparities in severe COVID-19 outcomes persist in the era of vaccination. METHODS: Population-based age-adjusted monthly rate ratios (RR) of laboratory-confirmed COVID-19-asssociated hospitalizations were calculated among adult patients from COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) during March 2020 - August 2022, by race/ethnicity. Among randomly sampled patients, July 2021-August 2022, RRs for hospitalization, intensive care unit (ICU) admission, and in-hospital mortality were calculated for Hispanic, Black, American Indian/Alaskan Native (AI/AN), and Asian/Pacific Islander (API) versus White persons. RESULTS: Based on data from 353,807 hospitalized patients, hospitalization rates were higher among Hispanic, Black and AI/AN versus White persons during March 2020 - August 2022, yet the magnitude of the disparities declined over time (for Hispanic, RR=6.7; 95%CI: 6.5-7.1 in June 2020 vs RR<2.0 after July 2021; for AI/AN, RR=8.4; 95%CI: 8.2-8.7in May 2020 vs RR<2.0 after March 2022; and for Black persons RR=5.3; 95%CI: 4.6-4.9 in July 2020 vs RR<2.0 after February 2022; all p≤0.001). Among 8,706 sampled patients during July 2021 - August 2022, hospitalization and ICU admission RRs were higher for Hispanic, Black, and AI/AN (range for both hospitalization and ICU admission: 1.4-2.4) and lower for API (range for both: 0.6-0.9) versus White persons. All other race and ethnicity groups had higher in-hospital mortality rates versus White persons (RR range: 1.4-2.9). CONCLUSIONS: Race/ethnicity disparities in COVID-19-associated hospitalizations declined but persist in the era of vaccination. Developing strategies to ensure equitable access to vaccination and treatment remains important.

Comparison of Trauma and Burn Evaluations in a Pediatric Emergency Department During Pre, Early and Late COVID-19 Pandemic.

BACKGROUND: Pediatric trauma epidemiology altered during early COVID-19 pandemic period but the impact of the ongoing pandemic is unknown. OBJECTIVES: To compare pediatric trauma epidemiology between the pre, early and late pandemic periods and to evaluate the association of race and ethnicity on injury severity during the pandemic. METHODS: We performed a retrospective study of trauma consults for an injury/burn in children ≤16 years between January 1, 2019 and December 31, 2021. Study period was categorized into pre (January 1, 2019-February 28, 2020), early (March 1, 2020-December 31, 2020), and late (January 1, 2021-December 31, 2021) pandemic. Demographics, etiology, injury/burn severity, interventions and outcomes were noted. RESULTS: A total of 4940 patients underwent trauma evaluation. Compared to pre-pandemic, trauma evaluations for injuries and burns increased during both the early (RR: 2.13, 95% CI: 1.6-2.82 and RR: 2.24, 95% CI: 1.39-3.63, respectively) and late pandemic periods (RR: 1.42, 95% CI: 1.09-1.86 and RR: 2.44, 95% CI: 1.55-3.83, respectively). Severe injuries, hospital admissions, operations and death were higher in the early pandemic but reverted to pre-pandemic levels during late pandemic. Non-Hispanic Blacks had an approximately 40% increase in mean ISS during both pandemic periods though they had lower odds of severe injury during both pandemic periods. CONCLUSIONS: Trauma evaluations for injuries and burns increased during the pandemic periods. There was a significant association of race and ethnicity with injury severity which varied with pandemic periods. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.

COVID-19 pandemic-associated changes in overall emergency department visits by age group, race, and ethnicity - United States, January 2019-April 2022.

BACKGROUND: ED data are an important source of surveillance data for monitoring many conditions of public health concern and are especially useful in describing trends related to new, or unusual public health events. The COVID-19 pandemic led to significant changes in emergency care seeking behavior. We described the trends in all-cause emergency department (ED) visit volumes by race, ethnicity, and age using ED data from the National Syndromic Surveillance Program (NSSP) during December 30, 2018-April 2, 2022. METHODS: We described total and race, ethnicity, and age group-specific ED visit volumes during the COVID-19 pandemic by comparing quarterly visit volumes during the pandemic period to the relevant quarters in 2019. We quantified the variability of ED visits volumes by calculating the coefficient of variation in mean weekly ED visit volume for each quarter during Q1 2019-Q1 2022. RESULTS: Overall ED visits dropped by 32% during Q2 2020, when the COVID-19 pandemic began, then rebounded to 2019 baseline by Q2 2021. ED visits for all race, ethnicity, and age groups similarly dropped in Q2 2020 and adults of all race and ethnicity groups rebounded to at or above pre-pandemic levels while children remained at or below the pre-pandemic baseline except during Q3 2021. There was larger variation in mean weekly ED visits compared to the respective quarter in 2019 for 6 of 9 quarters during Q1 2020-Q1 2022. CONCLUSIONS: ED utilization fluctuated considerably during the COVID-19 pandemic. Overall ED visits returned to within 5% of 2019 baseline during Q2 2021, however, ED visits among children did not return to the 2019 baseline until Q3 2021, then again dropped below the 2019 baseline in Q4 2021. Trends in ED visit volumes were similar among race and ethnicity groups but differed by age group. Monitoring ED data stratified by race, ethnicity and age can help understand healthcare utilization trends and overall burden on the healthcare system as well as facilitate rapid identification and response to public health threats that may disproportionately affect certain populations.

Comparison of COVID-19 home-testers vs. laboratory-testers in New York State (excluding New York City), November 2021 to April 2022.

Background: Though the use of coronavirus disease 2019 (COVID-19) home testing kits is increasing, individuals who use home tests are not accounted for in publicly reported COVID-19 metrics. As the pandemic and the methods for tracking cases evolve, it is critical to understand who the individuals excluded are, due to their use of home testing kits, relative to those included in the reported metrics. Methods: Five New York State databases were linked to investigate trends in home-tested COVID-19 cases vs. laboratory-confirmed cases from November 2021 to April 2022. Frequency distributions, multivariate logistic regression adjusted odds ratios (aOR), and 95% confidence intervals (CI) were used to compare the characteristics of the home-tested and laboratory-tested people. Results: Of the 591,227 confirmed COVID-19 cases interviewed, 71,531 (12%) of them underwent home tests, 515,001 (87%) underwent laboratory tests, and 5,695 (1%) underwent both home tests and laboratory tests during this period. Home-tested COVID-19 cases increased from only 1% in November 2021 to 22% in April 2022. Children aged 5-11 years with an aOR of 3.74 (95% CI: 3.53, 3.96) and adolescents aged 12-17 years with an aOR of 3.24 (95% CI: 3.07, 3.43) were more likely to undergo only home tests compared to adults aged 65 years and above. On the one hand, those who were "boosted" (aOR 1.87, 95% CI: 1.82, 1.93), those in K-12 school settings (aOR 2.33, 95% CI: 2.27, 2.40), or those who were possibly infected by a household member (aOR 1.17, 95% CI: 1.13, 1.22) were more likely to report home testing instead of laboratory testing. On the other hand, individuals who were hospitalized (aOR 0.04, 95% CI: 0.03, 0.06), who had underlying conditions (aOR 0.85, 95% CI: 0.83, 0.87), who were pregnant (aOR 0.76, 95% CI: 0.66, 0.86), and who were Hispanic (aOR 0.50: 95% CI: 0.48, 0.53), Asian (aOR 0.31, 95% CI: 0.28, 0.34), or Black (aOR 0.45, 95% CI: 0.42, 047) were less likely to choose home testing over laboratory testing. Conclusion: The percentage of individuals with confirmed COVID-19 who used only home testing kits continues to rise. People who used only home testing were less likely to be hospitalized and were those with a lower likelihood of developing a severe disease given factors such as age, vaccination status, and underlying conditions. Thus, the official COVID-19 metrics primarily reflected individuals with severe illness or the potential for severe illness. There may be racial and ethnic differences in the use of home testing vs. laboratory testing.

Reduced Access to Preventive Care Due to the COVID-19 Pandemic, by Chronic Disease Status and Race and Hispanic Origin, United States, 2020-2021.

OBJECTIVES: The COVID-19 pandemic has disproportionately affected racial and ethnic minority populations in the United States. The National Center for Health Statistics adapted the Research and Development Survey (RANDS), a commercial panel survey, to track selected health outcomes during the pandemic using the series RANDS during COVID-19 (RC-19). We examined access to preventive care among adults by chronic condition status, race, and Hispanic origin. METHODS: NORC at the University of Chicago conducted RC-19 among US adults in 3 rounds (June-July 2020 [round 1, N = 6800], August 2020 [round 2, N = 5981], and May-June 2021 [round 3, N = 5458]) via online survey and telephone. We evaluated reduced access to ≥1 type of preventive care due to the pandemic in the past 2 months for each round by using logistic regression analysis stratified by chronic condition status and race and Hispanic origin, adjusting for sociodemographic and health variables. RESULTS: Overall, 35.8% of US adults reported missing ≥1 type of preventive care in the previous 2 months in round 1, 26.0% in round 2, and 11.2% in round 3. Reduced access to preventive care was significantly higher among adults with ≥1 chronic condition (vs no chronic conditions) in rounds 1 and 2 (adjusted odds ratios [aOR)] = 1.5 and 1.4, respectively). Compared with non-Hispanic White adults, non-Hispanic Black adults reported significantly lower reduced access to preventive care in round 1 (aOR = 0.7), and non-Hispanic Other adults reported significantly higher reduced access to preventive care in round 2 (aOR = 1.5). CONCLUSIONS: Our findings may inform policies and programs for people at risk of reduced access to preventive care.

Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis.

OBJECTIVE: To determine whether inequities in COVID-19 infection and hospitalization differ from those for common medical conditions: influenza, appendicitis, and all-cause hospitalization. DESIGN: Retrospective study based on electronic health records of three healthcare systems in San Francisco (university, public, and community) examining (1) racial/ethnic distribution in cases and hospitalization among patients with diagnosed COVID-19 (March-August 2020) and patients with diagnosed influenza, diagnosed appendicitis, or all-cause hospitalization (August 2017-March 2020), and (2) sociodemographic predictors of hospitalization among those with diagnosed COVID-19 and influenza. RESULTS: Patients 18 years or older with diagnosed COVID-19 (N = 3934), diagnosed influenza (N = 5932), diagnosed appendicitis (N = 1235), or all-cause hospitalization (N = 62,707) were included in the study. The age-adjusted racial/ethnic distribution of patients with diagnosed COVID-19 differed from that of patients with diagnosed influenza or appendicitis for all healthcare systems, as did hospitalization from these conditions compared to any cause. For example, in the public healthcare system, 68% of patients with diagnosed COVID-19 were Latine, compared with 43% of patients with diagnosed influenza, and 48% of patients with diagnosed appendicitis (p < 0.05). In multivariable logistic regressions, COVID-19 hospitalizations were associated with male sex, Asian and Pacific Islander race/ethnicity, Spanish language, and public insurance in the university healthcare system, and Latine race/ethnicity and obesity in the community healthcare system. Influenza hospitalizations were associated with Asian and Pacific Islander and other race/ethnicity in the university healthcare system, obesity in the community healthcare system, and Chinese language and public insurance in both the university and community healthcare systems. CONCLUSIONS: Racial/ethnic and sociodemographic inequities in diagnosed COVID-19 and hospitalization differed from those for diagnosed influenza and other medical conditions, with consistently higher odds among Latine and Spanish-speaking patients. This work highlights the need for disease-specific public health efforts in at-risk communities in addition to structural upstream interventions.

Completeness of Race and Ethnicity Reporting in Person-Level COVID-19 Surveillance Data, 50 States, April 2020-December 2021.

OBJECTIVES: Black, Indigenous, and People of Color have borne a disproportionate incidence of COVID-19 cases in the United States. However, few studies have documented the completeness of race and ethnicity reporting in national COVID-19 surveillance data. The objective of this study was to describe the completeness of race and ethnicity ascertainment in person-level data received by the Centers for Disease Control and Prevention (CDC) through national COVID-19 case surveillance. METHODS: We compared COVID-19 cases with "complete" (ie, per Office of Management and Budget 1997 revised criteria) data on race and ethnicity from CDC person-level surveillance data with CDC-reported aggregate counts of COVID-19 from April 5, 2020, through December 1, 2021, in aggregate and by state. RESULTS: National person-level COVID-19 case surveillance data received by CDC during the study period included 18 881 379 COVID-19 cases with complete ascertainment of race and ethnicity, representing 39.4% of all cases reported to CDC in aggregate (N = 47 898 497). Five states (Georgia, Hawaii, Nebraska, New Jersey, and West Virginia) did not report any COVID-19 person-level cases with multiple racial identities to CDC. CONCLUSION: Our findings highlight a high degree of missing data on race and ethnicity in national COVID-19 case surveillance, enhancing our understanding of current challenges in using these data to understand the impact of COVID-19 on Black, Indigenous, and People of Color. Streamlining surveillance processes to decrease reporting incidence and align reporting requirements with an Office of Management and Budget-compliant collection of data on race and ethnicity would improve the completeness of data on race and ethnicity for national COVID-19 case surveillance.

Non-pharmaceutical Interventions and COVID-19: Do County- and State-Level Policies Predict the Spread of COVID-19?

This study examines the impact of county- and state-level policies on the spread and severity of COVID-19 in communities in the USA during the first wave of the COVID-19 pandemic. We use county-level COVID-19 death and case data to examine the impact of county- and state-level mandates and non-pharmaceutical interventions (NPIs) on the spread and severity of COVID-19. Following previous work by Amuendo-Dorantes et al. (2020), we utilize a strategy that incorporates the duration of NPI implementation within a county. Specifically, we examine aggregated measures of mask mandates, daycare closures, stay-at-home orders, and restaurant and bar closures. In addition to the implementation and duration of NPI policy, we examine the role of pre-existing factors that contribute to social determinants of health in a locality. We incorporate information on the incidence of prior health conditions, socio-economic factors, and demographics including racial and ethnic composition, share of immigrant population of counties, and state governance in our estimations. To alleviate the possible endogeneity of COVID-19 outcomes and NPIs, we use instrumental variable estimation and our results show that collectively NPIs decreased the intensity of the pandemic by decreasing the total deaths and cases. Furthermore, we find the magnitude of the impact of NPIs increases the longer they are implemented. We also estimate a specification that allows for heterogeneity of NPI impact based on the racial and ethnic composition of counties. Our results suggest that NPIs have a non-uniform impact in counties with different racial and ethnic compositions.

The association of race and ethnicity on obstetric patients' COVID-19 outcomes: A summary of current literature.

Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, evidence suggests racial and ethnic disparities in COVID-19-related outcomes. Given these disparities, it is important to understand how such patterns may translate to high-risk cohorts, including obstetric patients. A PubMed search was performed to identify studies assessing pregnancy, neonatal, and other health-related complications by race or ethnicity in obstetric patients with COVID-19 infection. Forty articles were included in our analysis based on novelty, relevance, and redundancy. These articles revealed that Black and Hispanic obstetric patients present an increased risk for SARS-CoV-2 infection and maternal mortality; racial and ethnic minority patients, particularly those of Black and Asian backgrounds, are at increased risk for hospitalization and ICU admission; racial and ethnic minority groups, in particular Black patients, have an increased risk for mechanical ventilation; Black and Hispanic patients are more likely to experience dyspnea; Hispanic patients showed higher rates of pneumonia; and Black patients present an increased risk of acute respiratory distress syndrome (ARDS). There is conflicting literature on the relationship between race and ethnicity and various pregnancy and neonatal outcomes. Several factors may underly the racial and ethnic disparities observed in the obstetric population, including biological mechanisms and social determinants of health.

Anti-Asian Discourse in Quora: Comparison of Before and During the COVID-19 Pandemic with Machine- and Deep-Learning Approaches

The current study attempts to compare anti-Asian discourse before and during the COVID-19 pandemic by analyzing big data on Quora, one of the most frequently used community-driven knowledge sites. We created two datasets regarding "Asians” and "anti-Asians” from Quora questions and answers between 2010 and 2021. A total of 1,477 questions and 5,346 answers were analyzed, and the datasets were divided into two time periods: before and during the COVID-19 pandemic. We conducted machine-learning-based topic modeling and deep-learning-based word embedding (Word2Vec). Before the pandemic, the topics of physical difference and racism were prevalent, whereas, after the pandemic, the topics of hate crime, the need to stop Asian hate crimes, and the need for the Asian solidarity movement emerged. Above all, the semantic similarity between Asian and Black people became closer, while the similarity between Asian people and other racial/ethnic groups was diminished. The emergence of negative and radical language, which increased saliently after the outbreak of the pandemic, and the considerably wider semantic distance between Asian and White people indicates that the relationship between the two races has been weakened. The findings suggest a long-term campaign or education system to reduce racial tensions during the pandemic. © The Author(s) 2022.

The Asian American Vote in 2020: Indicators of Turnout and Vote Choice.

What were the indicators of voter turnout and presidential vote choice among Asian Americans in 2020? We argue that 2020 was a unique year in which race was salient for Asian Americans due to the rise of anti-Asian attitudes attributed to the COVID-19 pandemic and the opportunity to elect a vice presidential candidate of Asian descent. Because of this, racial considerations played a unique role that informed Asian American political participation and attitudes in this election. Using data from the 2020 Collaborative Multiracial Post-Election Survey, we identify the individual-level factors associated with turnout and presidential vote choice among Asian Americans. We find that stronger perceptions of racial discrimination were related to a higher likelihood of turnout and voting in support of the Democratic Party, especially among Asian immigrants relative to the native-born. This study offers new insight for when we can expect racial considerations to inform the politics of Asian Americans, who are the fastest growing racial group in the United States and therefore an increasingly important bloc of the electorate. Supplementary Information: The online version contains supplementary material available at 10.1007/s11109-022-09844-9.

The correlations among racial/ethnic groups, hypertriglyceridemia, thrombosis, and mortality in hospitalized patients with COVID-19.

Reports of racial and ethnic disparities regarding both rates of infection of the SARS-CoV-2 virus and morbidity of the coronavirus disease-19 (COVID-19) contain profound differences depending on the population. Our previous study has shown that patients with COVID-19 who developed hypertriglyceridemia during hospitalization have a 2.3 times higher mortality rate. However, whether the correlation between hypertriglyceridemia and mortality has disparity among different racial and ethnic groups is unknown. In this study, we investigated the impact of race/ethnicity on the correlation between hypertriglyceridemia and mortality in hospitalized patients with COVID-19. De-identified information from 904 hospitalized patients diagnosed with COVID-19 between March 2020 and June 2021 were extracted from the Medical College of Wisconsin Clinical Data Warehouse. A multivariable regression analysis suggested that the Asians and non-White Hispanics had 4 or 3.9 times higher mortality rate, respectively, after adjusting for age, morbid obesity (BMI ≥40), and gender. The hypertriglyceridemia (≥150 mg/dL) was associated with higher mortality, after adjusting for age, gender, and morbid obesity. The baseline hypertriglyceridemia occurrence had relevantly more consistent percentages among all racial/ethnic groups. However, non-White Hispanic and Asian patients had the highest frequencies of peak hypertriglyceridemia occurrence during hospitalization. The peak hypertriglyceridemia developed during hospitalization correlates with the incidence of thrombosis after adjusting for morbid obesity, age, and sex. In summary, in this retrospective study of 904 hospitalized COVID-19 patients, Asians and non-White Hispanics had a greater likelihood of developing hypertriglyceridemia during hospitalization and mortality than White patients.

The Political Determinants of Health and Health Equity in the Aging Population

Within the discipline of public health, it is commonly understood that health outcomes are influenced by more than genetics and behavior. Many health problems can be firmly linked to a political determinant that created and is perpetuating health inequities in the United States. The COVID-19 pandemic has exacerbated these inequities, causing disproportionate outcomes, particularly for vulnerable and minoritized groups, including older adults. This article addresses the "isms"plaguing America's health, while offering novel solutions to forge a path toward recovery and, ultimately, advancing health equity. Copyright 2022 American Society on Aging;all rights reserved.

Missing Race and Ethnicity Data among COVID-19 Cases in Massachusetts.

Infectious disease surveillance frequently lacks complete information on race and ethnicity, making it difficult to identify health inequities. Greater awareness of this issue has occurred due to the COVID-19 pandemic, during which inequities in cases, hospitalizations, and deaths were reported but with evidence of substantial missing demographic details. Although the problem of missing race and ethnicity data in COVID-19 cases has been well documented, neither its spatiotemporal variation nor its particular drivers have been characterized. Using individual-level data on confirmed COVID-19 cases in Massachusetts from March 2020 to February 2021, we show how missing race and ethnicity data: (1) varied over time, appearing to increase sharply during two different periods of rapid case growth; (2) differed substantially between towns, indicating a nonrandom distribution; and (3) was associated significantly with several individual- and town-level characteristics in a mixed-effects regression model, suggesting a combination of personal and infrastructural drivers of missing data that persisted despite state and federal data-collection mandates. We discuss how a variety of factors may contribute to persistent missing data but could potentially be mitigated in future contexts.

Access to health care among racialised immigrants to Canada in later life: a theoretical and empirical synthesis

Evidence that immigrants tend to be underserved by the health-care system in the hosting country is well documented. While the impacts of im/migration on health-care utilisation patterns have been addressed to some extent in the existing literature, the conventional approach tends to homogenise the experience of racialised and White immigrants, and the intersecting power axes of racialisation, immigration and old age have been largely overlooked. This paper aims to consolidate three macro theories of health/behaviours, including Bronfenbrenner's ecological theory, the World Health Organization's paradigm of social determinants of health and Andersen's Behavioral Model of Health Service Use, to develop and validate an integrated multilevel framework of health-care access tailored for racialised older immigrants. Guided by this framework, a narrative review of 35 Canadian studies was conducted. Findings reveal that racial minority immigrants’ vulnerability in accessing health services are intrinsically linked to a complex interplay between racial-nativity status with numerous markers of power differences. These multilevel parameters range from socio-economic challenges, cross-cultural differences, labour and capital adequacy in the health sector, organisational accessibility and sensitivity, inter-sectoral policies, to societal values and ideology as forms of oppression. This review suggests that, counteracting a prevailing discourse of personal and cultural barriers to care, the multilevel framework is useful to inform upstream structural solutions to address power imbalances and to empower racialised immigrants in later life.

Racial and ethnic and income disparities in COVID-19 vaccination among Medicare beneficiaries.

BACKGROUND: Older adults have been disproportionately affected by the COVID-19 pandemic. Despite the widespread availability and proved effectiveness of COVID-19 vaccines, the issue of inequity in vaccine uptake in the United States is a potential concern among different populations. This study examined racial and ethnic and income disparities in COVID-19 vaccination rate among Medicare beneficiaries. METHODS: Data from the Medicare Current Beneficiary Survey (MCBS) COVID-19 Winter 2021 Community Supplement were employed (n = 9606 Medicare beneficiaries, weighted N = 50,512,963). We fitted a logistic regression model to determine the association of vaccination status with beneficiary race and ethnicity and income, after controlled for a set of beneficiary characteristics. RESULTS: Compared with non-Hispanic White respondents, Hispanic respondents (OR = 0.72, 95% CI: 0.54-0.96, p = 0.02) and Black respondents (OR = 0.84, 95% CI: 0.67-1.04, p = 0.11) were less likely to receive COVID-19 vaccine. In addition, the likelihood of COVID-19 vaccine uptake for beneficiaries who earn less than $25,000 per year was more than 50% lower than that for those whose annual income was $25,000 or more (OR = 0.44, 95% CI: 0.37-0.53, p < 0.0001). CONCLUSIONS: Racial and ethnic and income disparities exist in COVID-19 vaccination rate among Medicare beneficiaries nationally. Community-based strategies to boost vaccine uptake may target racial and ethnic minorities and socioeconomically disadvantaged groups to reduce such disparities.