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Gay and lesbian adults had significantly higher COVID-19 vaccine coverage compared with heterosexual or bisexual adults, CDC data showed.

According to survey results from late August to October 2021, 85.4% of gay or lesbian adults had at least one dose of vaccine, which was significantly higher compared with straight or bisexual adults (76.3% for each; P<0.05), reported A.D. McNaghten, PhD, of the CDC COVID-19 Emergency Response Team, and colleagues.

Transgender or nonbinary adults, meanwhile, were vaccinated at similar rates compared with those who did not identify as transgender or nonbinary (75.7% vs 76.7%, respectively), the researchers reported in the .

"The potential for low vaccine confidence and coverage among LGBT [lesbian, gay, bisexual, and transgender] populations is of concern because these persons historically experience challenges accessing, trusting, and receiving health care services," the team wrote. Since data on sexual orientation and gender identity are not usually collected by governments, vaccine coverage statistics for these groups are limited, the researchers noted.

While gay or lesbian adults had higher vaccine coverage (at least one dose) overall, results varied widely by race, as compared to their straight counterparts, respectively:

• White men: 94.1% vs 74.2%
• White women: 88.5% vs 78.6%
• Black men: 76.6% vs 72.5%
• Black women: 57.9% vs 75.6%
• Hispanic men: 82.4% vs 72.0%
• Hispanic women: 79.5% vs 80.5%

For bisexual individuals, vaccination rates were 76.4% and 81.4% for white men and women, respectively, 79.8% and 62.1% for Black men and women, and 82.4% and 79.5% for Hispanic men and women.

"Vaccination coverage was lowest among non-Hispanic Black LGBT persons across all categories of sexual orientation and gender identity," McNaghten and co-authors wrote. "Increasing availability of education about COVID-19 vaccine in local communities of color that promotes the benefits of vaccinations and provide opportunities to answer questions and receive COVID-19 vaccine might increase coverage among gay or lesbian and bisexual women."

COVID-19 vaccination rates in the Black community overall have been lower due to distrust of the health system, but data suggest the racial gap is narrowing.

When asked about the vaccine, gay or lesbian and bisexual adults reported being more confident about the vaccine in terms of both its safety and the protection it provides, the investigators noted. Transgender or nonbinary adults were more confident in the vaccine's protective effects but not in its safety.

A higher proportion of gay or lesbian and bisexual adults also reported being very or moderately concerned about COVID-19 compared with straight adults (56.8% and 51.3% vs 48.1%, P<0.05 for both), the research group wrote.

The study drew from the National Immunization Survey Adult COVID Module, which uses a random-digit-dialed sample of cellular telephone numbers. A total of 153,062 people were surveyed, and those who responded "don't know" or "refused" to the questions about sexual orientation (9,586, 6.3%) or gender identity (10,539, 6.9%) were excluded from the study. The overall response rate was 20.9%.

Less than 3% of respondents identified as gay or lesbian, 3.1% identified as bisexual, and 3.9% identified as transgender or nonbinary.

The researchers noted that the results may have been influenced by potential reporting bias and social desirability bias related to COVID-19 vaccination status. They also acknowledged that the survey looked only at LGBT people, and survey respondents who did not identify with those categories may have been excluded.

"To prevent serious illness and death, it is important that all persons in the United States, including those in the LGBT community, stay up to date with recommended COVID-19 vaccinations," the researchers said.

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