Trends in disparities in COVID hospitalizations among community‐dwelling residents of two counties in Connecticut, before and after vaccine introduction, March 2020–September 2021

BACKGROUND: Prior to the introduction of vaccines, COVID‐19 hospitalizations of non‐institutionalized persons in Connecticut disproportionately affected communities of color and individuals of low socioeconomic status (SES). Whether the magnitude of these disparities changed 7–9 months after vaccine rollout during the Delta wave is not well documented. METHODS: All initially hospitalized patients with laboratory‐confirmed COVID‐19 during July–September 2021 were obtained from the Connecticut COVID‐19‐Associated Hospitalization Surveillance Network database, including patients' geocoded residential addresses. Census tract measures of poverty and crowding were determined by linking geocoded residential addresses to the 2014–2018 American Community Survey. Age‐adjusted incidence and relative rates of COVID‐19 hospitalization were calculated and compared with those from July to December 2020. Vaccination levels by age and race/ethnicity at the beginning and end of the study period were obtained from Connecticut's COVID vaccine registry, and age‐adjusted average values were determined. RESULTS: There were 708 COVID‐19 hospitalizations among community residents of the two counties, July–September 2021. Age‐adjusted incidence was the highest among non‐Hispanic Blacks and Hispanic/Latinx compared with non‐Hispanic Whites (RR 4.10 [95% CI 3.41–4.94] and 3.47 [95% CI 2.89–4.16]). Although RR decreased significantly among Hispanic/Latinx and among the lowest SES groups, it increased among non‐Hispanic Blacks (from RR 3.2 [95% CI 2.83–3.32] to RR 4.10). Average age‐adjusted vaccination rates among those ≥12 years were the lowest among non‐Hispanic Blacks compared with Hispanic/Latinx and non‐Hispanic Whites (50.6% vs. 64.7% and 66.6%). CONCLUSIONS: Although racial/ethnic and SES disparities in COVID‐19 hospitalization have mostly decreased over time, disparities among non‐Hispanic Blacks increased, possibly due to differences in vaccination rates.