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Understanding Disparities: Social Determinants of Health (SDOH) & Vaccination

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Health care professionals like you play a critical role in achieving equity.¹

When it comes to certain vaccination rates, some communities continue to lag behind.2,3,4

According to data provided by the US Department of Health and Human Services:

  • In 2020, ~30% of Hispanic adults have been less likely to have received certain recommended vaccines, compared to non-Hispanic Whites.2
  • For children up to 24 months born during 2019-2020, coverage with most childhood vaccines was lower among Black, Hispanic, and American Indian or Alaska Native children living below the federal poverty level for all vaccines.5,a

Now more than ever, it’s critical to examine and address underlying SDOH that create challenges to vaccination access and acceptance.6

aThe National Immunization Survey-Child (NIS-Child) uses random-digit-dialing to identify US households with children ages 19-35 months. A telephone survey is conducted with the parent or guardian who is most knowledgeable about the child’s immunization history, and consent is requested to contact the child’s vaccination providers. If consent is granted, a questionnaire is mailed to all the child’s vaccine providers to obtain vaccination information, which is synthesized to create the child’s comprehensive vaccination history.5

The non-medical factors that influence health outcomes

SDOH are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the circumstances of daily life.7

Acting at the individual, community, and systemic levels, SDOH can contribute to a wide range of health inequities and disparities for your patients.8,9

Examples of SDOH9:

  • Access to nutritious foods and physical activity opportunities
  • Education, job opportunities, and income
  • Language and literacy skills
  • Polluted air and water
  • Racism, discrimination, and violence
  • Safe housing, transportation, and neighborhoods
Social Determinants of Health
SDOH Domains9

Learn more about SDOH

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You can make a difference

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Outside of clinical care, SDOH are estimated to account for up to 80% of the modifiable contributors to healthy outcomes for a population.7,10,b

Learn more about the impact of SDOH and how this information can help you address vaccination gaps in your practice:

More ways to help

bThe County Health Rankings (CHR) model developed by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, delineates the underlying modifiable determinants of health and groups them into four main categories (with associated weights): healthy behaviors (30%), physical environment (10%), social and economic factors (40%), and clinical care (20%).10


  1. Centers for Disease Control and Prevention. Talking with parents about vaccines for infants. Reviewed April 11, 2018. Accessed March 13, 2024.
  2. US Department of Health and Human Services Office of Minority Health. Immunizations and Hispanic Americans. Last modified December 14, 2020. Accessed March 13, 2024.
  3. US Department of Health and Human Services Office of Minority Health. Immunizations and African Americans. Last modified February 17, 2023. Accessed March 13, 2024.
  4. US Department of Health and Human Services Office of Minority Health. Immunizations and Asian Americans. Last modified December 14, 2020. Accessed March 13, 2024.
  5. Hill HA, Yankey D, Elam-Evans LD, Chen M, Singleton JA. Vaccination coverage by age 24 months among children born in 2019 and 2020 — National Immunization Survey-Child, United States, 2020–2022. MMWR Morb Mortal Wkly Rep. 2023;72(44):1190–1196. doi:
  6. Sangster AV, Barratt JM. Towards ending immunization inequity. Vaccines (Basel). 2021;9(12):1378. doi:10.3390/vaccines9121378
  7. Centers for Disease Control and Prevention. Social determinants of health at CDC. Reviewed December 8, 2022. Accessed November 27, 2023.
  8. American Hospital Association. Societal factors that influence health. Accessed March 13, 2024.
  9. Healthy People 2030. Social determinants of health. Accessed March 13, 2024.
  10. Hood, CM, Gennuso KP, Swain GR, Catlin BB. County health rankings: relationships between determinant factors and health outcomes. Am J Prev Med. 2016;50(2):129-135. doi:10.1016/j.amepre.2015.08.024