Pennsylvania’s vaccination numbers appear to show an alarmingly low rate of coronavirus vaccination among Asian American residents, but state officials said this week that the numbers they publicly report are likely incorrect and that they believe the real rate is higher.
Asians are among the most-vaccinated racial groups in the United States, leading white, Black, and Latino residents in their uptake of the coronavirus shot. But Pennsylvania’s data for the 66 counties outside of Philadelphia indicate that only a quarter of Asian American and Pacific Islander residents have gotten one or both doses of the vaccine.
If that number were correct, it would be among the worst in the nation — and starkly different from Philadelphia’s 88% vaccination rate for Asian and Pacific Islander city residents. The reported statistic is so low that it would mean the rest of the state — which has three times as many Asian residents as Philadelphia — has vaccinated only three AAPI residents for every five vaccinated in the city, which handles vaccinations and reports data separately from the rest of the state.
That’s so anomalous that community organizers and vaccine providers, as well as the head of the governor’s commission on Asian Pacific American affairs, were puzzled to hear that number or said they don’t believe it’s correct. In response to questions from The Inquirer, the Pennsylvania Department of Health acknowledged that may be the case.
The possibility of a severe undercount of AAPI vaccinations calls into question whether the state has accurate data to guide its targeted vaccine outreach at a time when cases are rising and health officials are making a renewed push to ramp up vaccinations and beat back the rising threat of the delta variant.
Although it remains unclear to what degree half a million Pennsylvanians are undercounted or undervaccinated, community groups’ efforts to increase vaccinations continue.
The state recently launched a survey of Asian residents in an attempt to determine what is making people hesitant to get shots and whether access barriers are impeding them. Last month, officials held a virtual panel aimed at dispelling misinformation among Asian Pacific Americans.
Unclear vaccination data
A Department of Health spokesperson said Thursday that department officials believe that the true vaccination rate is higher than reported, based on what health officials have heard from Asian community members.
“We are working to make that information publicly available,” spokesperson Mark O’Neill said.
It’s not clear what information that would be or when it might be available. Asked for details, O’Neill said: “A thorough review of all the AAPI self-reported data by our extremely busy data team would be needed.”
He declined to say when the department had become aware of the possible undercount or why the department continues to publish data on its online COVID dashboard that are believed to be inaccurate.
One possible reason for an undercount, community advocates said: Some people don’t identify themselves as Asian on the vaccination form because anti-Asian harassment and hate crimes have risen during the pandemic.
The Department of Health also suggested that could explain the undercounting, although it’s not clear why that problem would affect Pennsylvania more than any other state.
More than three times as many people are listed in the unknown, multiple, or “other” race categories as self-identified as white, African American, Asian, Pacific Islander, Hawaiian, or Native American. (Latino is counted as ethnicity, not race.) That means a portion of those more than one million residents could be Asian or other people of color who aren’t visible in the racial statistics.
The self-reported AAPI vaccination data raise other questions, too. The state data show four times as many Pacific Islanders have been vaccinated than there are Pacific Islanders living in the state. The rate among Native Americans also appears as an outlier, the state’s lowest rate though Native Americans have the highest vaccination rate nationwide.
Stephanie Sun, the executive director of the Pennsylvania Governor’s Advisory Commission on Asian Pacific American Affairs, said the reported 25% vaccination rate didn’t seem “reasonable.”
“Asian community members feel Asian acceptance of the vaccine is probably the highest compared to any other communities,” Sun said.
Several community organizers and vaccine providers who spoke to The Inquirer and work at clinics outside Philadelphia, including in the city suburbs, Lancaster County, and the Lehigh Valley, said they’ve seen a high demand among their community members, too.
Vasu Singh, a primary-care physician in Bethlehem and UPMC Health Plan medical director who is on the governor’s commission, said she would estimate that 80% of the state’s Asian population is vaccinated: “Every time I speak with my patients or my community members, pretty much everybody is vaccinated.”
‘A huge challenge for our communities’
Collecting demographic data has been a key part of the pandemic response, crucial to understanding inequities, swiftly responding to case outbreaks in communities, and pinpointing where further vaccine outreach needs to be done.
It’s a task that has been a challenge for many states, including Pennsylvania, because residents don’t always report their racial data and collection is inconsistent. In Montgomery County, for instance, officials repeatedly begged residents in the spring to report their race when getting vaccinated.
Pennsylvania collects race data in the same way as Philadelphia and other jurisdictions across the country: by asking people to choose from a list of options, including Asian, native Hawaiian, or other Pacific Islander Asian, before getting vaccinated.
Out of more than 6.3 million people the state reports vaccinating, 11.4% are listed as being of unknown race, and 10.5% selected “other” or multiple races.
Without more detailed race and ethnicity data, it’s difficult to conduct specific outreach, said Mohan Seshadri, co-executive director of the Asian Pacific Islander Political Alliance, a Pennsylvania political group. Looking at the vaccination rate for Asian Americans — a broad and diverse collection of communities — doesn’t provide insight into the rates, for example, for Chinese, Afghan, or Indian Americans.
It’s a problem that advocates have seen before.
“The lack of data in general is a huge challenge for our communities across the board,” Seshadri said. “When it comes to data on our communities, we do find that, especially in places in Pennsylvania that are not Philly, data collection tends to not always be the strongest.”
Sun said she is hopeful that the governor’s commission survey will yield a “deep-dive” report about vaccine barriers and hesitancy that can help improve the state’s outreach. It also asks whether respondents have been partially or fully vaccinated, meaning it should provide an estimate of the AAPI vaccination rate, though Sun said that wasn’t the purpose of the survey.
While the questions over the data have resulted in no one being sure where Pennsylvania stands on vaccinating Asian residents, state officials and community organizers are doubling down on outreach. Statewide, 60% of all people 12 and older are fully vaccinated.
Philadelphia has seen dramatic success in vaccinating Asian Americans thanks to a collaboration between Asian advocacy groups and the city that has brought regular clinics to Chinatown and made sure multilingual resources were available throughout the city early in the rollout. City data show the Asian vaccination rate has been the highest of any racial group since March.
“It’s quite difficult to find who is not vaccinated in the Asian community in this moment.” said Wei Chen, civic engagement coordinator for Asian Americans United, which is involved in the collaborative outreach efforts in Philadelphia.
Some organizers noted that the strong nonprofit and community infrastructure that helped get AAPI Philadelphians vaccinated is lacking for the rest of the state’s spread-out Asian American population. More outreach from and funding for those trusted groups, they said, is needed to reach those who haven’t been vaccinated and to combat hesitancy, misinformation, and access barriers.
On-the-ground efforts continue through regular clinics, incentives, educational fliers, and door-to-door canvassing in Asian communities. A statewide grant program aimed at increasing racial equity in vaccination has begun funding vaccination initiatives by local organizations in under-immunized areas and will ramp up in the coming weeks.
“Whether the number is 25%, whether the number is 30%, whether or not it is 35%,” Seshadri said, “I think it’s pretty clear that it’s not high enough until it’s 100%.”