State publishing county vaccination data by race and ethnicity to improve local equity efforts The Washington State Department of Health (DOH) COVID-19 data dashboard now includes county-level data on the race and ethnicity of people who have been vaccinated. This newly available data is intended to help counties, local partners and the public understand where there are inequities in order to address them more intentionally. The county-level data was first released in a report on April 23 and includes a race and ethnicity breakdown for people with at least one dose of vaccine and people who are fully vaccinated. For comparison purposes, the dashboard provides each county’s population distribution by race and ethnicity, including one set of percentages for people 16 and older and another for all ages. Locally, residents both initiating a first dose and those fully vaccinated mostly align with the racial makeup of Grays Harbor. 80% of those fully vaccinated are White, with other races also closely matching the population breakdown. The one ethnicity lacking exists within the Hispanic population, where officials state such individuals make up 11% population, but only account for 4% of the vaccinated population. Grays Harbor Statistics People Initiating Vaccine Percent of Race Full Vaccinated Percent Percent of Total County Population 16+/Race County Population/Race Total 26636 20919 Unknown Race 1966 1395 Total with Race Known 24670 19524 White 19385 79% 15555 80% 81% 78% Asian 397 2% 302 2% 2% 2% Hispanic 1286 5% 863 4% 8% 11% Black 138 1% 99 1% 1% 1% American Indian 1088 4% 976 5% 4% 4% Pacific Islander 64 0% 51 0% 0% 0% Other 2312 9% 1678 9% NA NA From Department of Health Since race and ethnicity groups don’t always make up the same proportion of the population across all age groups, and only people 16 and older are currently eligible for vaccine, the most accurate comparison for understanding which groups may be underrepresented is using the population data for people 16 and older. While data vary from county to county, there are some consistent trends. Hispanic people are underrepresented in the vaccinated population in nearly all counties, compared to their proportion of the county’s population. The size of this gap varies, with near-equal proportions in many counties and large gaps in many others. Similarly, Black people are underrepresented in almost all counties. In most counties, the race and ethnicity distribution for people with at least one dose is similar to fully vaccinated people, though there are some exceptions. DOH is using the data to inform state strategies for equitable vaccination, including identifying where more focused help is needed and prioritizing support for the providers and community organizations working to address higher inequities. “Publishing these data at the county level is an important step for transparency and a direct response to feedback we have received from communities,” said Secretary of Health Umair A. Shah, MD, MPH. “This update reflects our commitment to pro-equity vaccination strategies and is another example of our ongoing efforts to gather and implement feedback from those most impacted by COVID-19.” The data have some notable limitations. Race and ethnicity information is not available for everyone who is vaccinated (currently unavailable for about 6% of vaccinated people statewide). While providers must enter race and ethnicity when submitting vaccination data to DOH, they are able to report those categories as unknown. Additionally, race and ethnicity categories don’t match up exactly between data sets. Vaccination data include an “Other” race category (currently represents about 10% of vaccinated people statewide) that is part of a national standard for immunization data, but is not used in overall population data. This limits our ability to make conclusions based on these data. In line with DOH’s standard practice to protect privacy, counts of less than 10 (and some other values that would allow someone to calculate those counts) are not reported on the dashboard. For the county level, the dashboard combines the Other Race and Multiracial categories. This is temporary and allows DOH to publish numbers that might not be reported otherwise. As vaccination counts increase, DOH will continue to assess and adjust how data are reported. DOH recognizes the race and ethnicity categories used for these data do not fully capture the diversity of people in Washington and many communities do not see themselves within these existing data systems. DOH is working with partners to consider other community-informed processes for analysis and has started long-term infrastructure work to improve data equity.