Racial disparities in Phase 1 COVID-19 vaccine shipments to Neighborhood sites in Pennsylvania by the Federal Retail Pharmacy Program

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Abstract

Early racial disparities in COVID-19 vaccination rates have been attributed primarily to personal vaccine attitudes and behavior. Little attention has been paid to the possibility that inequitable vaccine distribution may have contributed to racial disparities in vaccine uptake when supplies were most scarce. We test the hypothesis that scarce vaccines were distributed inequitably using the shipping addresses of 385,930 COVID-19 vaccine doses distributed in the first 17 weeks of Pennsylvania’s Phase 1 rollout (December 14, 2020 through April 12, 2021). All shipments we analyze were allocated via the Federal Retail Pharmacy Program, a public-private partnership coordinated by the Centers for Disease Control and Prevention.

Overall, White people had an average of 81.4% more retail pharmacy program doses shipped to their neighborhoods than did Black people. Regression models reveal that weekly vaccine allocations determined by pharmacy chains—rather than initial shipment and administration site decisions requiring state and federal approval—drove these effects. All findings remained consistent after controlling for neighborhood differences in income, population density, insurance coverage, number of pharmacies, and other social determinants of health.

Our findings suggest that the private distribution of scarce public resources should be assessed for racial impact, regulated as public resources, and monitored continuously.

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  1. SciScore for 10.1101/2022.03.12.22272300: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsField Sample Permit: Study design: The setting, location, time period, and data collection for this research were determined by the considerations described in the introduction.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.