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Racial/Ethnic Minorities Underrepresented in Vaccine Trials

THURSDAY, Feb. 25, 2021 -- There is underrepresentation of racial/ethnic minorities and older patients among U.S.-based vaccine clinical trials, while female adults are overrepresented, according to a study published online Feb. 19 in JAMA Network Open.

Laura E. Flores, from the University of Nebraska Medical Center in Omaha, and colleagues examined whether racial and/or ethnic minorities, women, and older adults were underrepresented in vaccine clinical trials completed between July 1, 2011, and June 30, 2020. Data were included for 230 U.S.-based trials with 219,555 participants.

The researchers found that compared with U.S. census data, White people were overrepresented (77.9 percent), Black/African Americans and American Indian/Alaska Natives were underrepresented (10.6 and 0.4 percent, respectively), and Asian enrollment appeared to be equally represented (5.7 percent). Among the limited number of adult trials reporting ethnicity (34.3 percent), Hispanic enrollment was low (11.6 percent). Female participants were a majority (56 percent) in adult trials. For trials reporting age as a percentage, enrollment of participants aged 65 years or older was low at 12.1 percent. In pediatric trials, Black/African American and Hispanic participants were underrepresented (10.1 and 22.5 percent, respectively). Overall, 48.5 and 60.4 percent of those trials reporting race/ethnicity did not include American Indian/Alaska Native or Hawaiian/Pacific Islander participants, respectively.

"Although we have some missing data, it is clear from the large number of studies which did report this information, that racial and ethnic minorities as well as older individuals are frequently not being equitably represented," a coauthor said in a statement.

One author disclosed financial ties to the biopharmaceutical industry.

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