Racial and Ethnic Differences in COVID-19 Infection and Vaccine Uptake Across Multiple Waves of the Pandemic in Southeast Michigan: A retrospective cohort study.

Authors

Elkhansa Sidahmed, Corewll Health East
Ramin Homayouni, Corewell Health East
Karen Childers
Chen Shen, Corewell Health West
Elie Mulhelm, Corewell Health East

Document Type

Article

Publication Date

1-2026

Publication Title

Frontiers in Public Health

Abstract

BACKGROUND: The COVID-19 pandemic revealed significant racial and ethnic disparities in the United States, yet limited data exist for Middle Eastern or Arab (MEA) ethnic group. We aimed to assess COVID-19 infection and vaccine rates among MEA and other racial and ethnic groups across multiple waves of the pandemic.

METHODS: We conducted a retrospective cohort study of adult patients who visited eight emergency departments (EDs) within a large Southeast Michigan healthcare system during the first 2 years of the pandemic. Five pandemic waves were defined: Initial (pre-October 2020), Holiday (October 2020-March 2021), Alpha (March 2021-June 2021), Delta (June 2021-December 2021), and Omicron (December 2021-June 2022). Chi-squared tests assessed infection differences, while logistic regression evaluated infection odds and Kaplan-Meier analysis for vaccine uptake.

RESULTS: Among 168,288 ED patients, 20,253 (12%) tested positive for SARS-CoV-2. MEA and Hispanic or Latino (HL) patients exhibited higher infection rates (19.1 and 20.9%, respectively) compared to Black and White patients (13.5 and 9.8%, respectively). MEA patients consistently had higher odds of infection across all waves, despite similar vaccination rates to White patients. Black and HL patients showed varying but higher likelihoods of infection across waves and lower vaccine uptake compared to White patients.

CONCLUSION: MEA patients experienced disproportionately high infection rates in the ED despite comparable vaccination uptake to White patients. Black and HL individuals had both lower vaccine uptake and elevated infection risks. These disparities underscore the need for culturally tailored interventions to address health inequities in future pandemics.

Volume

13

First Page

1646801

Last Page

1646801

Recommended Citation

Sidahmed E, Homayouni R, Childers K, Shen C, Mulhem E. Racial and ethnic differences in COVID-19 infection and vaccine uptake across multiple waves of the pandemic in Southeast Michigan: a retrospective cohort study. Front Public Health. 2026;13. doi: 10.3389/fpubh.2025.1646801. PMID: 41602013.

DOI

10.3389/fpubh.2025.1646801

ISSN

2296-2565

PubMed ID

41602013