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Limitations on Reporting Percentage Vaccination Status by Race and Ethnicity

Post SMC Health COVID-19 Data

Race and ethnicity data are critically important for public health. Racism and structural inequities are barriers to accessing health care and vaccinations. However, in the U.S. and California, “vaccination coverage could not be (reliably) calculated on the basis of race and ethnicity” because of data incompleteness. Most local health departments also do not report vaccine percentage by race and ethnicity because of data limitation of both the numerator and the denominator: vaccinations (e.g., individual self-report, vaccinators asking, health systems reporting, state registry) and the estimated population size of a specific group within San Mateo County (e.g., ACS-Census and Department of Finance estimates).   

In San Mateo County, we’re choosing to utilize these estimates because they provide an estimate of vaccination status by race and ethnicity. While the data may not be precisely accurate, they do suggest that racial and social inequities are still causing barriers to immunization, and this information guides further efforts in community engagement and outreach.  We are sharing this imperfect data publicly to maximize transparency and engage stakeholders in addressing the social and racial determinants of health.

Vaccine data limitations

1.  Vaccination data from California Immunization Registry (CAIR2) is incomplete, preliminary, and not final data. Data on doses administered and individuals vaccinated may fluctuate.

a.  CAIR2 may not include all vaccinations among county residents.  
b.  The data in this dashboard will also change as data reporting issues are resolved in systems that report into CAIR2 and in CAIR2.

i.  Updates are ongoing for race/ethnicity by CAIR2 staff and by Vaccine Administrators.
ii.  Updates are ongoing for address level fixes (incorrect zip code, incorrect county of residence).

2.  Demographic information such as race/ethnicity is self-reported at the time of vaccination and individuals may self-identify and report race/ethnicity differently than expected. 

3.  For many individuals, available race/ethnicity may be unreliable as it is more likely than other demographic information not to be collected, not transmitted to CAIR2 and will be missing, or it may be incorrectly noted in CAIR2.

Population data limitations

1.  Population estimates and projections may have low precision and may be unreliable for smaller communities and geographies. Populations estimates and projections are approximations of population counts and estimates/projections may not have good precision for communities with smaller populations (i.e. Native Americans, African-Americans, and Pacific Islanders) and small towns/places (i.e. Pescadero) in San Mateo County.

2.  Total population estimates for “other” or “unknown” race/ethnicity categories are not available. The percentage of not vaccinated residents in these race categories is not available​ for Department of Finance population projections.

3.  We use two different sources for population data to calculate vaccine reach. We use Department of Finance (DOF) projections for San Mateo County age, sex, and race/ethnicity breakouts, but DOF has limited or no population data for cities/towns and census tracts. We use 2019 5-year ACS-Census data (most recent year released) for San Mateo County city and census tract population estimates. Please note: ACS population data denominators for the 10 and older age population will be used for city and census tract population, as ACS age categories are limited and we are unable to provide a 12 and older age population break out using this data.