Even in highly vaccinated states like Massachusetts, vaccine disparities abound, Dr. Ashish Jha says

Dr. Ashish Jha is one of the most quoted experts in his field.Jonathan Wiggs/Globe Staff

By all accounts, Massachusetts is faring well in its vaccination campaign — more than 3.5 million residents have been fully vaccinated, and like several other New England states, it is a national leader when it comes to the percent of the population that is immunized.

Still, there are significant vaccine disparities even in states like Massachusetts, regarded as “a super high vaccination state,” Dr. Ashish Jha, the dean of Brown University’s School of Public Health, wrote on Twitter Saturday evening.

In the past month, a divide in vaccination rates between historically red and blue states and the emergence of vaccine hesitancy have been a major issue in rural areas throughout the country.

It’s “tempting to look at vaccinations in [the United States] by states,” Jha wrote. “And it makes sense: states have a lot of control over vaccination sites, outreach, etc.”

But, he added, “there’s [a] ton of variation within states.”

To illustrate his point — and how factors such as education, income, and race all play a role in vaccine access — Jha presented a breakdown of two of Massachusetts’ larger cities: Newton and Springfield.

“It’s a tale of two cities,” Jha wrote.

Newton is the 11th largest city in the state with a population of 91,000, while Springfield is the 3rd largest with a population of 150,000, Jha wrote.

“Difference in vaccination rates between them?” Jha wrote. “Stunning.”

Springfield:

12% of kids aged 12-15 with at least 1 shot
55% of people over 20
64% of people over 30

Newton:

64% of kids aged 12-15
93% of people over 20
99% of people over 30

That's not a typo. 99% of people over 30!!

3/6

— Ashish K. Jha, MD, MPH (@ashishkjha) May 29, 2021

Jha outlined three categories of age breakdowns — children 12 to 15, people over 20, and people over 30 — to compare the vaccination numbers in the cities.

While 64 percent of people over 30 in Springfield, for instance, have been inoculated with at least one shot, 99 percent of those in the same demographic have been in Newton.

“That’s not a typo. 99% of people over 30!!” Jha wrote.

Springfield’s vaccine distribution numbers, Jha wrote, place the city below the national average. It has about the same vaccination rate as Oklahoma — “ranked 39th in the nation,” he added.

Meanwhile, “Newton’s numbers are through the roof” — and the only reason why they are not higher among those age 20 to 29, Jha wrote, is that there are a lot of surrounding colleges “where students are remote.”

Jha then hammered home how the difference in demographics between the two cities highlights the larger topic of vaccine disparities — or who does and does not have ready access to the shots — not only in Massachusetts but nationwide.

So what explains the difference?

Springfield:
19% with a bachelor's degree or more
$21K per capita income
27% poverty
60% Black or Latino

Newton:

79% with bachelor's or more
$73K per capita income
4% poverty
8% Black or Latino

5/7

— Ashish K. Jha, MD, MPH (@ashishkjha) May 29, 2021

For instance, only 19 percent of Springfield residents have attained a bachelor’s degree or higher compared to 79 percent of Newton residents.

Additionally, the average per capita income in Springfield is $21,000, while it is $73,000 in Newton, Jha wrote. More than half of the population in Springfield is Black or Latino — approximately 60 percent, he wrote — and only 8 percent of Newton residents are.

The differences between the two cities, Jha reiterated, “are stunning.”

“Within Massachusetts, we have communities with vaccination rates comparable to Oklahoma. And communities that far exceed Vermont,” he wrote. “It’s NOT random which communities.”

Such contrasts among communities, Jha wrote, are “largely driven” by race, income, and education — which in turn, are all “related to access.”

As a result, he concluded that while it’s “good to look at vaccinations by states,” one will not get the whole picture of how vaccines have been distributed that way — and therefore will miss seeing how much work remains to be done.

“There are a TON of within-state variations,” Jha wrote. “So if you are in a high vaccination state, your job is not done because across America there are too many people and communities for whom vaccines still remain out of reach.”

Thank you Mr. Mayor! While Massachusetts is doing great overall, we have real pockets of inequities that have to address

We cannot yet rest because our work is not anywhere near done

— Ashish K. Jha, MD, MPH (@ashishkjha) May 30, 2021

Somerville Mayor Joseph Curtatone called the thread from Jha “essential.”

“We see this problem locally too [and] we finally have mobile clinics starting next week, which should help close the gap along [with] walk-in clinics,” Curtatone wrote on Twitter. “Takes different approaches to reach different populations.”

In response, Jha added that while “Massachusetts is doing great overall, we have real pockets of inequities that [we] have to address.”

“We cannot yet rest because our work is not anywhere near done,” he wrote.