Underserved Population Brief
Overall California COVID-19 Vaccination Data
Refer to the CDPH COVID-19 Vaccination Data webpage to view current statewide vaccination data by county, age, race, ethnicity, and ZIP code.
Rural Communities
According to the CDC, residents in rural parts of the United States express concerns about vaccine safety and seem to have higher lack of governmental trust than their suburban and urban counterparts. Approximately 50.9% of adults in rural areas reported feeling confident in the safety of the COVID-19 vaccines, compared to 61.7% of urban-dwelling adults (PDF). Additionally, a study exploring barriers to COVID-19 vaccination within rural Latinx communities found fear stemming from misinformation to be the biggest barrier to vaccination.
Applicants seeking to improve vaccine confidence for residents of rural communities may wish to refer to the following resource: CDCās State of Vaccine Confidence Insights Report: Vaccination in Rural America Special Report (2023) (PDF).
Black/African Americans
Data on Black Californians indicate they are less likely to be up-to-date with their COVID vaccinations than Whites or Asians. Historic mistrust of health care systems, racism, living in communities with fewer services or other barriers may contribute to vaccine hesitancy or access gaps.
1) Determinants of Vaccine Hesitancy in African American and Black Individuals in the USA (Savoia et al., 2024); 2) A Framework for Inspiring Vaccine Confidence in African American and Latino Communities (Wiley et al., 2022); and 3) A Guide for Community Partners: Increasing COVID-19 Vaccine Uptake Among Members of Racial and Ethnic Minority Communities (PDF) (CDC, 2021).
Latinx Californians
Despite being approximately 40% of the Stateās population, far fewer Latinx Californians are up to date with COVID vaccinations than White or Asian residents. Latinx Californians may be recent immigrants or have lived in California for generations. They may speak Spanish, English, Portuguese or indigenous languages.
Native American Californians
California Native Americans may reside in rural communities on reservation or on urban areas. Native Californiansā COVID vaccination rates have lagged behind White and Asians in ages 50 and under. Even the best up-to-date rates remain well below 50%. Showing respect for cultural values is key to developing vaccine confidence with tribal communities.
Applicants seeking to improve vaccine confidence for Native Americans may wish to refer to the following resources: 1) Vaccine Confidence and uptake Strategies for Tribal Communities Toolkit (PDF) (National Indian Health Board, 2022) 2) Be a Good Relative Campaign (National Council of Urban Indian Health).
Immigrants and Refugees
Immigrants and refugees must navigate their new US health care system to find doctors or clinics that will serve them. They face language barriers and many lack trust in institutions that direct them to get vaccinated.
Applicants seeking to improve vaccine confidence for immigrants or refugees may wish to refer to the following resources: 1) Vaccine Hesitancy in the Refugee, Immigrant, and Migrant Population in the United States (Daniels et al, 2022); 2) Defining Drivers of Under-Immunization and Vaccine Hesitancy in Refugee and Migrant Populations (Deal et al, 2023); 3) Insights From Immigrant and Refugee Communities Regarding COVID-19 Need and Opportunities (PDF) (Stadnick et al., 2023).
Migrant Farmworkers
Many of Californiaās migrant farmworkers live below the poverty level and are more likely to be uninsured. Transient work, limited English, and isolated locations can also create barriers to finding basic health care including vaccinations.
Applicants seeking to improve vaccine confidence for California migrant farmworkers may wish to refer to the following resource: Lessons From the Fields: Farmworker Communities Confronting COVID-19 (PDF) (Farmworker Justice, 2022).
People with Disabilities
People with disabilities have historically faced myriad access barriers to health care including getting vaccinated. In some cases, individuals living with chronic illnesses may also be at increased risk for respiratory disease complications.
Applicants seeking to improve vaccine confidence in the disability community may wish to refer to the following resource: Stories From the Field: Building Capacity for People with Disabilities to Build Capacity in Preparedness Planning and Response.
People Experiencing Homelessness
People experiencing homelessness (PEH) are among the most vulnerable to infectious diseases. Unable to shelter at home, they may be more likely to be in contact with others in public places or in crowded shelters. PEH are unlikely to have health insurance or regular access to healthcare and may have a host of other day-to-day issues to navigate basic needs that compete with getting vaccinated.
Applicants seeking to improve vaccine confidence for PEH may wish to refer to the following resources: 1) COVID-19 Homeless System Response: Vaccine Distribution and Planning (HUD, 2021); 2) COVID-19 Booster Uptake: Best Practice (Homeless Link UK, 2023); and 3) COVID-19 Vaccine Confidence and Access among Youth Experiencing Homelessness (Gewirtz O'Brien et al., 2023).
People Living in Healthy Places Index Quartile 1
California has been tracking COVID vaccination rates by using Californiaās Healthy Places Index (HPI) quartiles 1ā4 since the beginning of the COVID-19 pandemic. Quartile 1 ZIP codes continue to have the lowest COVID-19 vaccination rates, while more affluent zip code 4 quartiles typically have the highest rates.
Applicants seeking to improve vaccine confidence for residents in HPI Quartile 1 regions may wish to refer to the following resources: 1) a map of Californiaās HPI Index, and 2) notes about the HPI Index methodology.rove
vaccine confidence for residents of rural communities may wish to refer to the following resource:
CDCās State of Vaccine Confidence Insights Report: Vaccination in Rural America Special Report (2023) (PDF).
Black/African Americans
Data on Black Californians indicate they are less likely to be up-to-date with their COVID vaccinations than Whites or Asians. Historic mistrust of health care systems, racism, living in communities with fewer services or other barriers may contribute to vaccine hesitancy or access gaps.
1)
Determinants of Vaccine Hesitancy in African American and Black Individuals in the USA (Savoia et al., 2024); 2)
A Framework for Inspiring Vaccine Confidence in African American and Latino Communities (Wiley et al., 2022); and 3)
A Guide for Community Partners: Increasing COVID-19 Vaccine Uptake Among Members of Racial and Ethnic Minority Communities (PDF) (CDC, 2021).
Latinx Californians
Despite being approximately 40% of the Stateās population, far fewer Latinx Californians are up to date with COVID vaccinations
than White or Asian residents. Latinx Californians may be recent immigrants or have lived in California for generations. They may speak Spanish, English, Portuguese or indigenous languages.
Native American Californians
California Native Americans may reside in rural communities on reservation or on urban areas.
Native Californiansā COVID vaccination rates have lagged behind White and Asians in ages 50 and under. Even the best up-to-date rates remain well below 50%. Showing respect for cultural values is key to developing vaccine confidence with tribal communities.
Applicants seeking to improve vaccine confidence for Native Americans may wish to refer to the following resources: 1)
Vaccine Confidence and uptake Strategies for Tribal Communities Toolkit (PDF) (National Indian Health Board, 2022) 2)
Be a Good Relative Campaign (National Council of Urban Indian Health).
Immigrants and Refugees
Immigrants and refugees must navigate their new US health care system to find doctors or clinics that will serve them. They face language barriers and many lack trust in institutions that direct them to get vaccinated.
Applicants seeking to improve vaccine confidence for immigrants or refugees may wish to refer to the following resources: 1)
Vaccine Hesitancy in the Refugee, Immigrant, and Migrant Population in the United States (Daniels et al, 2022); 2)
Defining Drivers of Under-Immunization and Vaccine Hesitancy in Refugee and Migrant Populations (Deal et al, 2023); 3)
Insights From Immigrant and Refugee Communities Regarding COVID-19 Need and Opportunities (PDF) (Stadnick et al., 2023).
Migrant Farmworkers
Many of Californiaās migrant farmworkers live below the poverty level and are more likely to be uninsured. Transient work, limited English, and isolated locations can also create barriers to finding basic health care including vaccinations.
Applicants seeking to improve vaccine confidence for California migrant farmworkers may wish to refer to the following resource:
Lessons From the Fields: Farmworker Communities Confronting COVID-19 (PDF) (Farmworker Justice, 2022).
People
with Disabilities
People with disabilities have historically faced myriad access barriers to health care including getting vaccinated. In some cases, individuals living with chronic illnesses may also be at increased risk for respiratory disease complications.
Applicants seeking to improve vaccine confidence in the disability community may wish to refer to the following resource:
Stories From the Field: Building Capacity for People with Disabilities to Build Capacity in Preparedness Planning and Response.
People Experiencing Homelessness
People experiencing homelessness (PEH) are among the most vulnerable to infectious diseases. Unable to shelter at home, they may be more likely to be in contact with others in public places or in crowded shelters. PEH are unlikely to have health insurance or regular access to healthcare and may have a host of other day-to-day issues to navigate basic needs that compete with getting vaccinated.
Applicants seeking to improve vaccine confidence for PEH may wish to refer to the following resources: 1)
COVID-19 Homeless System Response: Vaccine Distribution and PlanningāÆ(HUD, 2021); 2)
COVID-19 Booster Uptake: Best Practice (Homeless Link UK, 2023); and 3)
COVID-19 Vaccine Confidence and Access among Youth Experiencing HomelessnessāÆ(Gewirtz O'Brien et al., 2023).
People Living in Healthy Places Index Quartile 1
California has been tracking COVID vaccination rates by using Californiaās Healthy Places Index (HPI) quartiles 1ā4 since the beginning of the COVID-19 pandemic. Quartile 1 ZIP codes continue to have the lowest COVID-19 vaccination rates, while more affluent zip code 4 quartiles typically have the highest rates.
Applicants seeking to improve vaccine confidence for residents in HPI Quartile 1 regions may wish to refer to the following resources: 1) a map of Californiaās HPI Index, and 2) notes about the
HPI Index methodology.ā