Income disparities in COVID-19 vaccine and booster uptake in the United States: An analysis of cross-sectional data from the Medical Expenditure Panel Survey

COVID-19 vaccination has significantly decreased morbidity, hospitalizations, and death during the pandemic. However, disparities in vaccination uptake threatens to stymie the progress made in safeguarding the health of Americans. Using a nationally representative adult (≥18 years old) sample from the 2021 Medical Expenditure Panel Survey (MEPS), we aimed to explore disparities in COVID-19 vaccine and booster uptake by income levels. To reflect the nature of the survey, a weighted logistic regression analysis was used to explore factors associated with COVID-19 vaccine and booster uptake. A total of 241,645,704 (unweighted n=21,554) adults were included in the analysis. Average (SD) age of the population was 49 (18) years old, and 51% were female. There were disparities in COVID-19 vaccine and booster uptake by income groups. All other income groups were less likely to receive COVID-19 vaccines and booster shot than those in the high-income group. Those in the poor income group had 55% lower odds of being vaccinated for COVID-19 (aOR=0.45, p<0.01). Considering the female population only, women with lower incomes may have greater disparities in access to COVID-19 vaccines than do males with lower incomes. Disparities in COVID-19 vaccination by income may have even greater implications as the updated vaccines are rolled out in the US without the government covering the cost as before.