Social determinants of health (SDOHs) play a critical role in the effectiveness and equitable access of vaccinations. SDOHs are the conditions in which people are born, grow, live, work, and age. Socioeconomic status, education, housing, access to healthcare, and community support systems are some of the determinants that influence health and wellbeing.
Image from Healthy People 2023
Understanding and addressing these social determinants is crucial to promoting vaccine equity and ensuring that vaccination efforts reach all segments of the population, including adolescents and young adults.
COVID-19 as a Case Study
The COVID-19 pandemic is a prominent example of how social determinants are linked to health disparities and vaccine access. A team of researchers stated, “COVID-19’s mortal impact is defined as much by socioeconomic inequities as it is by viral biology.” Historically marginalized communities, particularly Black, Hispanic, and Native American populations, were disproportionately affected by the pandemic in terms of infections and deaths. Black, Hispanic and Native American individuals were 2x, 3x, and 2.4x more likely than White individuals to die, respectively, due to COVID-19. Studies also demonstrate a significant difference in vaccination among ethnic and racial groups. As of July 2022, 87% of Asian, 67% of Hispanic, and 64% of White people had received at least one COVID-19 vaccine dose, higher than the rate for Black people (59%). These differences can be due to a variety of factors including, but not limited to, geography and socioeconomic status.
Rural and remote regions fared worse when compared to urban areas, as living in a more isolated environment can often make it difficult for residents to access vaccination sites or healthcare resources and facilities in a timely manner. However, living in urban, city centers does not guarantee access to healthcare. Even in densely populated urban centers, the pandemic was a true case study for the effects of social determinants of health as low-income and historically marginalized communities within urban areas faced barriers to accessing vaccines, such as a lack of transportation to vaccination sites or the inability to take time off work to get vaccinated or receive proper treatment.
Another significant barrier to health – and social determinant – is access to accurate health information. During the COVID-19 pandemic, the messages surrounding masking and vaccine safety varied widely. For many, it was difficult to assess the accuracy of available information. For individuals with limited health literacy, inconsistent messages and misinformation made deciding on whether or not to get vaccinated more difficult than it already was. As a result, vaccine hesitancy has remained prevalent in some communities and increased in others, leading to persistent low vaccination rates across the board. Today, misinformation and concerns about safety play a significant role in the reluctance of all groups to get any of the recommended vaccinations.
What can you do?
Addressing social determinants requires a multifaceted approach, involving collaboration between healthcare providers, public health agencies, community organizations, and policymakers. Strategies to improve vaccine confidence and uptake among adolescents and young adults may include:
- Designing targeted interventions to bridge the gap. This may include being intentional about the locations where vaccines are offered and increasing their reach to improve accessibility (i.e. schools, colleges, pharmacies, churches, and community centers).
- Understanding the specific concerns and barriers in different communities and crafting effective communication strategies and educational campaigns to increase vaccine confidence. Clear and accurate vaccine information, delivered with confidence in a culturally sensitive manner can help build trust and address concerns among parents, adolescents and young adults.
- Championing the allocation of resources from policymakers to support public health agencies and other stakeholders. This may include advocating for solutions that address vaccination challenges and remove barriers for young people such as increasing health literacy to empower them to make informed decisions about immunization.
- Engaging community leaders and influencers to promote vaccine confidence within specific cultural or social groups. Adolescents and young adults are often influenced by their peers and family members, making community engagement and culturally adapted messaging essential for promoting vaccine confidence.
By addressing social determinants and tailoring vaccination efforts to the needs of adolescents and young adults, we can work towards achieving higher vaccination rates and better overall public health outcomes. Understanding social determinants of health helps ensure equitable access to vaccines, reduce health disparities, and increase vaccine acceptance.
For the most current information on vaccine availability and disparities in the United States, I recommend referring to up-to-date sources such as the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services (HHS).