How the Social Vulnerability Index (SVI) Provides Insights into Vaccination Coverage Inequities

Posted on by Mariama S. Tounkara, MPH

Vaccines are one of the greatest advancements in public health in the United States, and integral in keeping community safe from certain diseases. Since the start of the COVID-19 pandemic, people in racial and ethnic minoritized groups have experienced challenges accessing and accepting vaccinations. Existing research measures the success of vaccination programs by focusing largely on demographic coverage rates, often overlooking other systems shaping uptake. Research has shown that social disadvantage, and by extension social vulnerability, increase health disparities for many populations. Therefore, understanding social vulnerability or a community’s ability to respond and “bounce back” is imperative.

What is the Social Vulnerability Index (SVI)?

Overall vulnerability. SVI index

The Social Vulnerability Index (SVI) is a tool that can identify and quantify social needs of vulnerable communities at the county level, in each state, during public health emergencies. The SVI tool ranks counties on their social determinant factors which are grouped into four related themes: socioeconomic status, household characteristics, racial and ethnic minority status, and housing type and transportation.

What has CDC been doing?

CDC continues to work with communities and partners to create tools and resources to increase vaccination opportunities across all demographic groups. Of note, is the application of the health equity science approach with the SVI tool. Combining COVID-19 vaccine administration data from the Tiberius platform with SVI highlights the underlying social determinants and drivers of health inequities. In a 2023 report, CDC assessed vaccination coverage for persons who completed a primary series of the COVID-19 vaccine by SVI themes at the county level. Key results from the analysis indicated the following:

  • COVID-19 vaccine primary series completion was lower in high SVI areas compared to low SVI areas
  • There was high vaccination coverage for counties with high levels of vulnerability for racial and ethnic minority status, housing type and transportation themes; and
  • Following the expansion of vaccine eligibility in April 2021, disparities among high and moderate vulnerability counties widened for all themes except socioeconomic status.

The full report can be accessed here.

What Can Public Health Practitioners Do?

Social determinants of health are important elements for vaccination programs to improve population level health. Employing a health equity science approach may help practitioners better understand contributors to community level vaccination coverage across the social vulnerability spectrum. Achieving vaccine equity also requires building vaccine confidence which is the belief that vaccines work, are safe, and are part of a trusted healthcare system. For communities with high social vulnerability and limited faith in the health infrastructure establishing a rapport and trust is imperative. Engaging communities in a sustainable, equitable, and inclusive way is important to limit harms from historical and contemporary social disadvantage. Lastly, designing and employing robust hyperlocal initiatives with communities may help to further advance equity-centered practice for optimal vaccination coverage.

For National Immunization Awareness Month, held annually in August, CDC is promoting vaccinations across the lifespan. With many adults and children missing routine immunizations, it is imperative to stay up to date with the recommended vaccinations. Getting routine immunizations back on track and vaccine equity are achievable goals when strong science supports effective strategies and interventions for those groups that experience disparities in immunization.

What are you doing to support vaccine equity in your community? What are some effective best practices that can be implemented to advance vaccine equity in your community?

Posted on by Mariama S. Tounkara, MPHTags , , ,

2 comments on “How the Social Vulnerability Index (SVI) Provides Insights into Vaccination Coverage Inequities”

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    Per the CDC website, the “Social Vulnerability Index (SVI) is a tool that can identify and quantify social needs of vulnerable communities at the county level, in each state, during public health emergencies.”

    It is unclear whether the SVI was developed to identify groups with low immunization rates (i.e., those which require additional vaccination efforts) or groups at risk for greater morbidity/mortality from highly contagious infectious diseases impacting elderly, immune compromised individuals. Some SVI factors seem more linked to illness risk, although some are more linked to poor vaccination rates. Given some uncertainty regarding what the SVI represents and also lacking greater clarity regarding the planned application of the SVI, the value of this tool is unclear.

    It would be valuable to more clearly identify the potential application of the SVI, such that the components could be verified as appropriate for the intended usage. Is the SVI intended for use outside of vaccination campaigns? How well do the racial/ethnic categories in isolation reflect unique PH risk when other factors are addressed?

    Thank you for proposing such a tool to characterize communities. I anticipate that the tool itself could be greatly strengthened with a better understanding of the anticipated applications and related justification of specific individual risk factors those those anticipated applications.

    Hi Mariama S.Tonakara,
    I thoroughly enjoyed reading your article on Health. Your insights about Health Equity were particularly enlightening and provided a fresh perspective. It’s evident that you have a deep understanding of this subject matter. I appreciate the effort you put into creating such valuable content. As someone who’s passionate about Health, I found your article to be both informative and thought-provoking. I’m looking forward to more of your work in the future. Keep up the great writing!
    Best regards,
    Muhammad Qasim

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Page last reviewed: August 31, 2023
Page last updated: August 31, 2023