OBJECTIVES: To describe the design and application of a real-world data dashboard for illustrating COVID-19 vaccination patterns and disparities to inform progress on primary immunization gap, booster eligibility, and prioritization of a third dose among immunocompromised (IC).

METHODS: Publicly available data was sourced from the White House COVID-19 Team Community Profile Report and clinical and administrative data came from the Veradigm Health Insight Ambulatory EHR (HIAE) Database providing coverage for all 50 states and DC. In the HIAE data vaccines were identified via CPT/CVX codes and comorbidities were identified via ICD9/ICD10 codes. Public data describes vaccination rates as a percent of the total population and EHR data provides comparisons of relative vaccination rates within geographic areas using a 1-5 scale (1:< 0.5x the region, 3: 0.76 to 1.25x, and 5: >2x). Graphic and tabular data displays for 13 geographic areas highlight differences for 21 selected patient demographic and clinical characteristics including IC and those with 7 underlying health conditions.

RESULTS: EHR data included 21.6M patients ranging from 1.2 to 13% by state. Patients were 56.9% female; 5.5% age 12-17, 63.3% 18-64, 31.3% 65+; IC 9.9%. Vaccine coverage increased with age among all patients including IC with relative vaccine gaps greater in younger patients. Comorbidities were common among patients (Obesity 40.0%, CVD 32%, Diabetes 11%, IC 10%). Booster eligibility timing, based on initial booster recommendation for patients 65+ or with a comorbidity, was similar by gender (Female 86%, male 85%) and lower in blacks (78.7%) and Hispanics (76.4%). Overall, considerable variation was observed in vaccination coverage and booster eligibility across the 21 subgroups both between and within the 13 regions evaluated.