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Nguyen KH, McChesney C, Patel R, Bednarczyk RA, Vasudevan L, Corlin L. Association between COVID-19 Booster Vaccination and COVID-19 Outcomes among U.S. Adults. Vaccines (Basel) 2024; 12:503. [PMID: 38793754 DOI: 10.3390/vaccines12050503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
Understanding the association between booster vaccination and COVID-19 outcomes can help strengthen post-pandemic messaging and strategies to increase vaccination and reduce severe and long-term consequences of COVID-19. Using the Household Pulse Survey data collected from U.S. adults from 9 December 2022 to 13 February 2023 (n = 214,768), this study assessed the relationship between COVID-19 booster vaccination and COVID-19 outcomes (testing positive for COVID-19, moderate/severe COVID-19, and long COVID). Disparities were found in COVID-19 outcomes (e.g., testing positive for COVID-19, moderate/severe COVID-19, and long COVID) by sociodemographic characteristics, region of residence, food insecurity status, mental health status, disability status, and housing type. Receipt of a COVID-19 booster vaccination was negatively associated with testing positive for COVID-19 (aOR = 0.75, 95%CI: 0.72,0.79), having moderate/severe COVID-19 (aOR = 0.92, 95%CI: 0.88, 0.97), or having long COVID (aOR = 0.86 (0.80, 0.91)). Even among those who tested positive for COVID-19, those who received the booster vaccine were less likely to have moderate/severe COVID-19 and less likely to have long COVID. Communicating the benefits of COVID-19 booster vaccination, integrating vaccination in patient visits, and reducing access barriers can increase vaccination uptake and confidence for all individuals and protect them against the severe negative outcomes of COVID-19.
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Affiliation(s)
- Kimberly H Nguyen
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Cheyenne McChesney
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA 02111, USA
| | - Ruchi Patel
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA 02111, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Emory Vaccine Center, Emory University, Atlanta, GA 30322, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Laura Corlin
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA 02111, USA
- Department of Civil and Environmental Engineering, School of Engineering, Tufts University, Medford, MA 02155, USA
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Thorpe A, Fagerlin A, Drews FA, Shoemaker H, Brecha FS, Scherer LD. Predictors of COVID-19 vaccine uptake: an online three-wave survey study of US adults. BMC Infect Dis 2024; 24:304. [PMID: 38475702 DOI: 10.1186/s12879-024-09148-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND To effectively promote vaccine uptake, it is important to understand which people are most and least inclined to be vaccinated and why. In this study, we examined predictors of COVID-19 vaccine uptake and reasons for non-vaccination. METHODS We conducted an online English-language survey study in December-2020, January-2021, and March-2021. A total of 930 US respondents completed all surveys. Multiple logistic regression models were run to test whether the early vaccine eligibility, demographic factors, and psychological factors predict getting at least one dose of a COVID-19 vaccination in January-2021 and in March-2021. RESULTS The proportion of respondents who received ≥ 1-dose of a COVID-19 vaccine increased from 18% (January) to 67% (March). Older age predicted vaccine uptake in January (OR = 2.02[95%CI = 1.14-3.78], p < .001) and March (10.92[6.76-18.05], p < .001). In January, additional predictors were higher numeracy (1.48[1.20-1.86], p < .001), COVID-19 risk perceptions (1.35[1.03-1.78], p = .029), and believing it is important adults get the COVID-19 vaccine (1.66[1.05-2.66], p = .033). In March, additional predictors of uptake were believing it is important adults get the COVID-19 vaccine (1.63[1.15-2.34], p = .006), prior COVID-19 vaccine intentions (1.37[1.10-1.72], p = .006), and belief in science (0.84[0.72-0.99], p = .041). Concerns about side effects and the development process were the most common reasons for non-vaccination. Unvaccinated respondents with no interest in getting a COVID-19 vaccine were younger (0.27[0.09-0.77], p = .016), held negative views about COVID-19 vaccines for adults (0.15[0.08-0.26], p < .001), had lower trust in healthcare (0.59[0.36-0.95], p = .032), and preferred to watch and wait in clinically ambiguous medical situations (0.66[0.48-0.89], p = .007). CONCLUSIONS Evidence that attitudes and intentions towards COVID-19 vaccines were important predictors of uptake provides validation for studies using these measures and reinforces the need to develop strategies for addressing safety and development concerns which remain at the forefront of vaccine hesitancy.
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Affiliation(s)
- Alistair Thorpe
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at University of Utah, Salt Lake City, UT, USA.
- Department of Applied Health Research, University College London, London, UK.
| | - Angela Fagerlin
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at University of Utah, Salt Lake City, UT, USA
- Salt Lake City VA Informatics Decision- Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Frank A Drews
- Salt Lake City VA Informatics Decision- Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
- University of Utah College of Social and Behavioral Science, Salt Lake City, UT, USA
| | - Holly Shoemaker
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at University of Utah, Salt Lake City, UT, USA
- Salt Lake City VA Informatics Decision- Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Federica S Brecha
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Laura D Scherer
- Division of Cardiology, University of Colorado, School of Medicine, Aurora, CO, USA
- Denver VA Center of Innovation, Denver, CO, USA
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Hinson-Enslin AM, Espinoza LE. The mental health symptoms of individuals with sensory disabilities and the reasons that lead to COVID-19 vaccine refusal and hesitancy. Vaccine 2024; 42:1220-1229. [PMID: 38199922 DOI: 10.1016/j.vaccine.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
The relationship between the reasons for COVID-19 vaccine hesitancy or refusal among people with sensory disabilities and mental health conditions (MHCs) are unclear. Data from the Census Bureau's Household Pulse Survey were analyzed to examine reasons for COVID-19 vaccination refusal among persons with sensory disabilities. Multivariable logistic and polytomous regression were used to examine the relationships among sensory disability status, MHC, and reasons for vaccine refusal and hesitancy. Individuals with sensory disabilities had higher proportion of anxiety and depression than those without a sensory disability. Individuals with a sensory disability and MHCs were less likely to obtain a vaccine and have a general distrust in the COVID-19 vaccine and the government than those without a disability or a MHC. These findings can assist in tailoring messages and developing programs to increase COVID-19 vaccination trust and uptake among individuals with disabilities and MHCs.
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Affiliation(s)
- Amanda M Hinson-Enslin
- Department of Population and Public Health Sciences, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
| | - Luis Enrique Espinoza
- College of Nursing and Health Sciences, Texas A&M University-Corpus Christi, Corpus Christi, TX, USA.
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Vardavas C, Nikitara K, Aslanoglou K, Lagou I, Marou V, Phalkey R, Leonardi-Bee J, Fernandez E, Vivilaki V, Kamekis A, Symvoulakis E, Noori T, Wuerz A, Suk JE, Deogan C. Social determinants of health and vaccine uptake during the first wave of the COVID-19 pandemic: A systematic review. Prev Med Rep 2023; 35:102319. [PMID: 37564118 PMCID: PMC10410576 DOI: 10.1016/j.pmedr.2023.102319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Social determinants of health significantly impact population health status. The aim of this systematic review was to examine which social vulnerability factors or determinants of health at the individual or county level affected vaccine uptake within the first phase of the vaccination program. We performed a systematic review of peer-reviewed literature published from January 2020 until September 2021 in Medline and Embase (Bagaria et al., 2022) and complemented the review with an assessment of pre-print literature within the same period. We restricted our criteria to studies performed in the EU/UK/EEA/US that report vaccine uptake in the general population as the primary outcome and included various social determinants of health as explanatory variables. This review provides evidence of significant associations between the early phases of vaccination uptake for SARS-CoV-2 and multiple socioeconomic factors including income, poverty, deprivation, race/ethnicity, education and health insurance. The identified associations should be taken into account to increase vaccine uptake in socially vulnerable groups, and to reduce disparities in uptake, in particular within the context of public health preparedness for future pandemics. While further corroboration is needed to explore the generalizability of these findings across the European setting, these results confirm the need to consider vulnerable groups and social determinants of health in the planning and roll-out of SARS-CoV-2 vaccination programs and within the context of future respiratory pandemics.
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Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | | | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Revati Phalkey
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de. Ellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- School of Medicine and Health Sciences, Campus of Bellvitge, Universitat de Barcelona, Spain
- Centre of Biomedical Research Network on Respiratory Diseases (CIBERES de Enfermedaes Respiratorias), Insituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Teymur Noori
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrea Wuerz
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E. Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Charlotte Deogan
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
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Oh DL, Kemper KE, Meltzer D, Canchola AJ, Bibbins-Domingo K, Lyles CR. Neighborhood-level COVID vaccination and booster disparities: A population-level analysis across California. SSM Popul Health 2023; 22:101366. [PMID: 36873265 PMCID: PMC9982676 DOI: 10.1016/j.ssmph.2023.101366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/02/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Objectives To describe vaccine and booster uptake by neighborhood-level factors in California. Methods We examined trends in COVID-19 vaccination up to September 21, 2021, and boosters up to March 29, 2022 using data from the California Department of Public Health. Quasi-Poisson regression was used to model the association between neighborhood-level factors and fully vaccinated and boosted among ZIP codes. Sub-analyses on booster rates were compared among the 10 census regions. Results In a minimally adjusted model, a higher proportion of Black residents was associated with lower vaccination (HR = 0.97; 95%CI: 0.96-0.98). However, in a fully adjusted model, proportion of Black, Hispanic/Latinx, and Asian residents were associated with higher vaccination rates (HR = 1.02; 95%CI: 1.01-1.03 for all). The strongest predictor of low vaccine coverage was disability (HR = 0.89; 95%CI: 0.86-0.91). Similar trends persisted for booster doses. Factors associated with booster coverage varied by region. Conclusions Examining neighborhood-level factors associated with COVID-19 vaccination and booster rates uncovered significant variation within the large and geographically and demographically diverse state of California. Equity-based approaches to vaccination must ensure a robust consideration of multiple social determinants of health.
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Affiliation(s)
- Debora L Oh
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States
| | - Kathryn E Kemper
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States.,UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94143, United States
| | - Dan Meltzer
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States
| | - Alison J Canchola
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States.,UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94143, United States.,Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Portrero Avenue, Bldg 10, San Francisco, CA, 94110, United States
| | - Courtney R Lyles
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States.,UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94143, United States.,Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Portrero Avenue, Bldg 10, San Francisco, CA, 94110, United States
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Lillebråten A, Todd M, Dimka J, Bakkeli NZ, Mamelund SE. Socioeconomic status and disparities in COVID-19 vaccine uptake in Eastern Oslo, Norway. Public Health Pract (Oxf) 2023; 5:100391. [PMID: 37293528 PMCID: PMC10225062 DOI: 10.1016/j.puhip.2023.100391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/04/2023] [Accepted: 04/20/2023] [Indexed: 06/10/2023] Open
Abstract
Objective The objective of this study was to assess whether socioeconomic status still remain a barrier to COVID-19 vaccination in eastern Oslo, Norway. Study design A cross-section study. Methods We conducted a web-based survey among the residents of six eastern parishes in Oslo, Norway. Text (SMS) messages were sent to 59978 potential participants. 5447 surveys were completed for a response rate of 9.1%. After removing participants who had not been offered the COVID-19 vaccine, we ended up with a valid sample of 4000. Results We find a significant association between education and the likelihood of taking the COVID-19 vaccine in bivariate logistic regression. Further, we find a significant higher likelihood of taking the vaccine in the above-low-income group compared to the low-income group. However, when we add control variables to the regression, the significant results concerning both income and education are eliminated. In further analysis, we found that age worked as a moderator between socioeconomic status and vaccine uptake: In the youngest age group (18-29), we found a significant higher likelihood of taking the vaccine in the above-low-income group compared to the low-income group, and in the higher education group compared to the primary education group. Conclusion Socioeconomic status remains a barrier to COVID-19 vaccination in the eastern parishes of Oslo, Norway. Indicating that Norwegians of lower socioeconomic status still disproportionately face barriers such as transportation, language, flexible work hours, and paid sick time. However, our analysis shows that this association is only found in the age group 18-29.
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Affiliation(s)
| | - Megan Todd
- Department of Public Health, City of Philadelphia, United States
| | - Jessica Dimka
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Nan Zou Bakkeli
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
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Cole A, Andrilla CHA, Patterson D, Davidson S, Mendoza J. Measuring the Impact of the COVID-19 Pandemic on Health Behaviors and Health Care Utilization in Rural and Urban Patients with Cancer and Cancer Survivors. Cancer Res Commun 2023; 3:215-222. [PMID: 36817949 PMCID: PMC9934461 DOI: 10.1158/2767-9764.crc-22-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/06/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
Healthcare access and health behaviors differ between those living in urban and rural communities and contribute to inequitable cancer health outcomes. The COVID-19 pandemic led to significant disruptions in daily life and healthcare delivery. This cross-sectional survey aimed to measure the impact of the COVID-19 pandemic on the health behaviors of cancer patients and survivors, comparing outcomes for urban and rural respondents. Survey was administered from January 2021-June 2021 to cancer patients or survivors (treated within the last 5 years) at one of six cancer centers in Washington and Idaho. Respondent ZIP code was used to assess rurality using Rural-Urban Commuting Area designation. 515 rural (43.5% of those contacted) and 146 urban (40% of those contacted) cancer patients and survivors participated. Few differences between urban and rural cancer patients and cancer survivors were noted. Rural residents were older (69.2 years vs. 66.9 years). Rural respondents had higher mean alcohol consumption than urban respondents (4.4 drinks per week vs. 2.7 drinks per week). 12.2% of those who reported drinking in the last 30 days also reported increased alcohol consumption since the start of the pandemic, with no difference in reported increased alcohol consumption in rural vs. urban respondents. 38.5% reported decreased physical activity. 20.5% reported cancelling or delaying cancer care due to the COVID-19 pandemic. Delays in cancer healthcare services and worsening health behaviors due to the COVID-19 pandemic may contribute to poorer health outcomes, with few differences between rural and urban cancer patients and cancer survivors.
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Affiliation(s)
- Allison Cole
- Department of Family Medicine, University of Washington, Seattle, Washington
| | | | - Davis Patterson
- Department of Family Medicine, University of Washington, Seattle, Washington
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Liao CY, Ford JH 2nd, Mott DA, Hayney MS, Look KA. Characteristics of U.S. older adult medicare beneficiaries receiving the influenza vaccination at retail pharmacies. Explor Res Clin Soc Pharm 2023; 9:100220. [PMID: 36691454 DOI: 10.1016/j.rcsop.2023.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/04/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023] Open
Abstract
Background Pharmacy-provided influenza vaccination services have become more prevalent among the older adult population. However, little is known about the characteristics of older adults associated with receiving the influenza vaccination at retail pharmacies and how these associated characteristics have changed. Objective To examine characteristics of older adults associated with use of retail pharmacy-provided influenza vaccination services and how the characteristics changed between 2009 and 2015. Methods The study used a retrospective, cross-sectional design with data from the 2009 and 2015 Medicare Current Beneficiary Survey. Older adults aged 65 and older who completed a community questionnaire and received the influenza vaccination during the previous winter were identified. Andersen's Behavioral Model of Health Services Use was the conceptual framework for inclusion of the population characteristics. A multivariable log-binomial regression was performed to estimate the association between the population characteristics and use of pharmacy-provided vaccination service, and the relative change in associations between 2009 and 2015. Survey weights were applied in all analyses. Results The results showed older adults who were non-Hispanic black (compared to non-Hispanic white), who did not have secondary private insurance (compared to those who had), who did not have physician office visit (compared to those who had) and who lived in non-metro area (compared to those who lived in metro area) had become more likely to use pharmacy-provided influenza vaccination services in 2015 than in 2009. Conclusions Pharmacy-provided influenza vaccination services appear to reduce access barriers for racially and socioeconomically disadvantaged older adults. Findings could help inform not only the retail pharmacies that provide vaccination services to better outreach to potential target populations but also policy makers about the disadvantaged populations that would benefit from the vaccination services provided by retail pharmacies.
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Abstract
PURPOSE Anchor institutions ("anchors") are large employers, rooted in a community by reason of mission, capital, or relationships. Many anchors have encouraged coronavirus vaccination for employees and their families. Our objective was to determine whether the presence of an anchor was associated with a higher county-level vaccination rate. METHODS A cross-sectional study focused on 745 small- and mid-sized US counties. We used data from the Centers for Disease Control and Prevention, Reference USA's US Business Database, Economic Innovation Group's Distressed Communities Index database, 2021 County Health Ratings and Rankings, 2020 US Presidential Election popular vote data, and National Center for Health Statistics urban-rural classification data. We constructed 3 explanatory variables of interest: a binary variable indicating whether the county had an anchor; a continuous variable representing the number of anchors within a county; and the percent of all workers in the county who were employed by an anchor. Multivariable linear regression models were adjusted for race/ethnicity, political party allegiance, rurality, economic distress, and prevalence of smoking and adult obesity. FINDINGS Counties with an anchor had vaccination rates 2.31 (P<.01) percentage points higher than those without an anchor. The number of anchors in a county was also significantly associated with higher vaccination rates. CONCLUSIONS Efforts by anchors to encourage vaccination may have been successful, and that anchors may be well positioned to amplify public health messages. However, the influence and efforts of anchors to increase vaccination did not fully mitigate disparities in vaccination rates by race, ethnicity, and political party allegiance.
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Affiliation(s)
- Alexandra Harris
- Health Sciences Integrated PhD Program, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Jane L Holl
- Department of Neurology, University of Chicago, Chicago, Illinois, USA
| | - Megan McHugh
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Cheng Y, Li T, Zheng Y, Xu B, Bi Y, Hu Y, Zhou YH. Self-Reported adverse events among Chinese healthcare workers immunized with COVID-19 vaccines composed of inactivated SARS-CoV-2. Hum Vaccin Immunother 2022; 18:2064134. [PMID: 35452357 PMCID: PMC9897645 DOI: 10.1080/21645515.2022.2064134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mass vaccination is critical to control the pandemic of coronavirus disease 2019 (COVID-19). Fear of adverse events (AEs) after COVID-19 vaccination is a main factor associated with vaccination hesitancy. We aimed to analyze AEs in healthcare workers (HCWs) vaccinated with COVID-19 vaccines (Aikewei or CoronaVac) composed of inactivated virus. We used a structured self-administered questionnaire to conduct two surveys on COVID-19 vaccination among HCWs in perinatal medicine and obstetrics/gynecology from April 5 to April 21, 2021. In total, 1392 HCWs who had received at least one vaccine dose were included. Of them, 1264 (90.8%) were females and 1047 (75.2%) received two doses. The overall incidence of any AEs after the first and second dose was 38.2% (532/1392) and 31.0% (325/1047) respectively (χ2 = 13.506, P = .0002). Female and HCWs aged 18-30 y were more likely to report AEs. The most common AEs were local reaction, accounting for 48.1% and 67.4% of all AEs after the first and second dose respectively. The systemic AEs were mainly neurological (9.8% and 4.8% after the first and second injection respectively) and flu-like symptoms (6.3% and 3.2%). Overall, most of AEs were mild, only 5.1% (after the first dose) and 2.8% (after the second dose) of individuals with AEs received symptomatic treatment or sick leaves, and none of them required hospitalization. Our data added more evidence that inactivated COVID-19 vaccines are highly safe. The data are valuable to overcome vaccine hesitancy associated with concerns about the safety of COVID-19 vaccines.
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Affiliation(s)
- Yandong Cheng
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Taishun Li
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yaning Zheng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Biyun Xu
- Department of Biomedicine Statistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,CONTACT Yali Hu Department of Obstetrics and Gynecology, NanjingDrum Tower Hospital, Nanjing University Medical SchoolNanjing, Jiangsu, China
| | - Yi-Hua Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China,Yi-Hua Zhou Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing210008, China
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Jefferson C, Watson E, Certa JM, Gordon KS, Park LS, D’Souza G, Benning L, Abraham AG, Agil D, Napravnik S, Silverberg MJ, Leyden WA, Skarbinski J, Williams C, Althoff KN, Horberg MA. Differences in COVID-19 testing and adverse outcomes by race, ethnicity, sex, and health system setting in a large diverse US cohort. PLoS One 2022; 17:e0276742. [PMID: 36417366 PMCID: PMC9683575 DOI: 10.1371/journal.pone.0276742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Racial/ethnic disparities during the first six months of the COVID-19 pandemic led to differences in COVID-19 testing and adverse outcomes. We examine differences in testing and adverse outcomes by race/ethnicity and sex across a geographically diverse and system-based COVID-19 cohort collaboration. METHODS Observational study among adults (≥18 years) within six US cohorts from March 1, 2020 to August 31, 2020 using data from electronic health record and patient reporting. Race/ethnicity and sex as risk factors were primary exposures, with health system type (integrated health system, academic health system, or interval cohort) as secondary. Proportions measured SARS-CoV-2 testing and positivity; attributed hospitalization and death related to COVID-19. Relative risk ratios (RR) with 95% confidence intervals quantified associations between exposures and main outcomes. RESULTS 5,958,908 patients were included. Hispanic patients had the highest proportions of SARS-CoV-2 testing (16%) and positivity (18%), while Asian/Pacific Islander patients had the lowest portions tested (11%) and White patients had the lowest positivity rates (5%). Men had a lower likelihood of testing (RR = 0.90 [0.89-0.90]) and a higher positivity risk (RR = 1.16 [1.14-1.18]) compared to women. Black patients were more likely to have COVID-19-related hospitalizations (RR = 1.36 [1.28-1.44]) and death (RR = 1.17 [1.03-1.32]) compared with White patients. Men were more likely to be hospitalized (RR = 1.30 [1.16-1.22]) or die (RR = 1.70 [1.53-1.89]) compared to women. These racial/ethnic and sex differences were reflected in both health system types. CONCLUSIONS This study supports evidence of disparities by race/ethnicity and sex during the COVID-19 pandemic that persisted even in healthcare settings with reduced barriers to accessing care. Further research is needed to understand and prevent the drivers that resulted in higher burdens of morbidity among certain Black patients and men.
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Affiliation(s)
- Celeena Jefferson
- Kaiser Permanente Mid-Atlantic Permanente Medical Group, Mid-Atlantic Permanente Research Institute, Rockville, Maryland, United States of America
| | - Eric Watson
- Kaiser Permanente Mid-Atlantic Permanente Medical Group, Mid-Atlantic Permanente Research Institute, Rockville, Maryland, United States of America
- * E-mail:
| | - Julia M. Certa
- United Health Group, Fredrick, Maryland, United States of America
| | - Kirsha S. Gordon
- Yale School of Medicine, Department of General Internal Medicine, New Haven, Connecticut, United States of America
- VA Connecticut Healthcare System, West Haven, Connecticut, United States of America
| | - Lesley S. Park
- Stanford Center for Population Health Sciences, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Gypsyamber D’Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Lorie Benning
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Alison G. Abraham
- Department of Epidemiology, Anschutz Medical Campus, University of Colorado, Aurora, Colorado, United States of America
| | - Deana Agil
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Sonia Napravnik
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Michael J. Silverberg
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Wendy A. Leyden
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Carolyn Williams
- Division of AIDS, National Institute of Allergy and Infectious Diseases, Rockville, Maryland, United States of America
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Michael A. Horberg
- Kaiser Permanente Mid-Atlantic Permanente Medical Group, Mid-Atlantic Permanente Research Institute, Rockville, Maryland, United States of America
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12
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Chen Y, Zhang L, Li T, Li L. Amplified effect of social vulnerability on health inequality regarding COVID-19 mortality in the USA: the mediating role of vaccination allocation. BMC Public Health 2022; 22:2131. [PMID: 36402963 PMCID: PMC9675971 DOI: 10.1186/s12889-022-14592-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/10/2022] [Indexed: 11/20/2022] Open
Abstract
Background Vaccination reduces the overall burden of COVID-19, while its allocation procedure may introduce additional health inequality, since populations characterized with certain social vulnerabilities have received less vaccination and been affected more by COVID-19. We used structural equation modeling to quantitatively evaluate the extent to which vaccination disparity would amplify health inequality, where it functioned as a mediator in the effect pathways from social vulnerabilities to COVID-19 mortality. Methods We used USA nationwide county (n = 3112, 99% of the total) level data during 2021 in an ecological study design. Theme-specific rankings of social vulnerability index published by CDC (latest data of 2018, including socioeconomic status, household composition & disability, minority status & language, and housing type & transportation) were the exposure variables. Vaccination coverage rate (VCR) during 2021 published by CDC was the mediator variable, while COVID-19 case fatality rate (CFR) during 2021 published by John Hopkinson University, the outcome variable. Results Greater vulnerabilities in socioeconomic status, household composition & disability, and minority status & language were inversely associated with VCR, together explaining 11.3% of the variance of VCR. Greater vulnerabilities in socioeconomic status and household composition & disability were positively associated with CFR, while VCR was inversely associated with CFR, together explaining 10.4% of the variance of CFR. Our mediation analysis, based on the mid-year data (30th June 2021), found that 37.6% (mediation/total effect, 0.0014/0.0037), 10% (0.0003/0.0030) and 100% (0.0005/0.0005) of the effects in the pathways involving socioeconomic status, household composition & disability and minority status & language, respectively, were mediated by VCR. As a whole, the mediation effect significantly counted for 30.6% of COVID-19 CFR disparity. Such a mediation effect was seen throughout 2021, with proportions ranging from 12 to 32%. Conclusions Allocation of COVID-19 vaccination in the USA during 2021 led to additional inequality with respect to COVID-19 mortality. Viable public health interventions should be taken to guarantee an equitable deployment of healthcare recourses across different population groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14592-w.
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13
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Lane J, Palacio A, Chen LE, McCarter D, Tamariz L, Chen CJ, Ghany R. Access to Health Care Improves COVID-19 Vaccination and Mitigates Health Disparities Among Medicare Beneficiaries. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01343-1. [PMID: 36171495 PMCID: PMC9518942 DOI: 10.1007/s40615-022-01343-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
Abstract
Background COVID-19 disproportionately impacts the elderly, particularly racial/ethnic minorities and those with low socioeconomic status (SES). These latter groups may also have higher vaccine hesitancy. We aim to evaluate if access to care improves COVID-19 vaccination rates and improves health disparities. Methods We conducted a retrospective cohort study of Medicare patients receiving care in a high-touch capitated network across ten states. We collected type and date of COVID-19 vaccine and demographic and clinical data from the inpatient and outpatient electronic health records and socioeconomic status from the US census. Our primary outcome was completing vaccination using logistic regression. Results Our cohort included 93,224 patients enrolled in the network during the study period. Sixty nine percent of all enrolled patients completed full vaccination. Those who completed vaccination did it with Pfizer (46%), Moderna (49%), and Jannsen (4.6%) vaccines. In adjusted models, we found that the following characteristics increased the odds of being vaccinated: being male, increasing age, BMI, and comorbidities, being Black or Hispanic, having had the flu vaccine in 2020, and increasing number of office primary care visits. Living in a neighborhood with higher social deprivation and having dual Medicaid/Medicare enrollment decreased the odds of completing full vaccination. Conclusions Increasing office visit in a high-touch primary care model is associated with higher vaccination rates among elderly populations who belong to racial/ethnic minorities or have low socioeconomic status. However, lower SES and Medicaid populations continue to have difficulty in completing vaccination. Key points • High COVID-19 vaccination rates of minorities enrolled in Medicare can be achieved. • Lower socioeconomic status is associated with completing vaccination. • Increasing office visits can lead to higher vaccination rates. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-022-01343-1.
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Affiliation(s)
- Jason Lane
- Department of Medicine, Miller School of Medicine at the University of Miami, Miami, FL, USA
| | - Ana Palacio
- Chen Neighborhood Medical Centers, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Suite 1124, Miami, FL, 33136, USA.,The Geriatric Research and Education Center, Veterans Affairs Medical Center, Miami, FL, USA
| | - Li Ern Chen
- Department of Medicine, Miller School of Medicine at the University of Miami, Miami, FL, USA
| | - Daniel McCarter
- Department of Medicine, Miller School of Medicine at the University of Miami, Miami, FL, USA
| | - Leonardo Tamariz
- Chen Neighborhood Medical Centers, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Suite 1124, Miami, FL, 33136, USA. .,The Geriatric Research and Education Center, Veterans Affairs Medical Center, Miami, FL, USA.
| | - Christopher James Chen
- Chen Neighborhood Medical Centers, Miller School of Medicine at the University of Miami, 1120 NW 14th St, Suite 1124, Miami, FL, 33136, USA
| | - Reyan Ghany
- Department of Medicine, Miller School of Medicine at the University of Miami, Miami, FL, USA
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14
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Bilal U, Mullachery PH, Schnake-Mahl A, Rollins H, McCulley E, Kolker J, Barber S, Diez Roux AV. Heterogeneity in Spatial Inequities in COVID-19 Vaccination Across 16 Large US Cities. Am J Epidemiol 2022; 191:1546-1556. [PMID: 35452081 PMCID: PMC9047229 DOI: 10.1093/aje/kwac076] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/02/2022] [Accepted: 04/14/2022] [Indexed: 01/29/2023] Open
Abstract
Differences in vaccination coverage can perpetuate coronavirus disease 2019 (COVID-19) disparities. We explored the association between neighborhood-level social vulnerability and COVID-19 vaccination coverage in 16 large US cities from the beginning of the vaccination campaign in December 2020 through September 2021. We calculated the proportion of fully vaccinated adults in 866 zip code tabulation areas (ZCTAs) of 16 large US cities: Long Beach, Los Angeles, Oakland, San Diego, San Francisco, and San Jose, all in California; Chicago, Illinois; Indianapolis, Indiana; Minneapolis, Minnesota; New York, New York; Philadelphia, Pennsylvania; and Austin, Dallas, Fort Worth, Houston, and San Antonio, all in Texas. We computed absolute and relative total and Social Vulnerability Index-related inequities by city. COVID-19 vaccination coverage was 0.75 times (95% confidence interval: 0.69, 0.81) or 16 percentage points (95% confidence interval: 12.1, 20.3) lower in neighborhoods with the highest social vulnerability as compared with those with the lowest. These inequities were heterogeneous, with cities in the West generally displaying narrower inequities in both the absolute and relative scales. The Social Vulnerability Index domains of socioeconomic status and of household composition and disability showed the strongest associations with vaccination coverage. Inequities in COVID-19 vaccinations hamper efforts to achieve health equity, as they mirror and could lead to even wider inequities in other COVID-19 outcomes.
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Affiliation(s)
- Usama Bilal
- Correspondence to Dr. Usama Bilal, 3600 Market Street, Suite 730, Philadelphia, PA, 19104 (e-mail: )
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15
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Fattahi H, Seproo FG, Fattahi A. Effective factors in people's preventive behaviors during covid-19 pandemic: a systematic review and meta-synthesis. BMC Public Health 2022; 22:1218. [PMID: 35717144 PMCID: PMC9206506 DOI: 10.1186/s12889-022-13621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background The overwhelming outbreak of covid-19 has forced governments all over the world to consider different measures to face this challenging situation. A vitally important element to the declining transmission of viruses is changing behaviors based on reliable information. This study was designed and implemented to identify factors affecting the preventive behaviors during the covid-19 pandemic. Methods This thematic synthesis was carried out in order to create a set of central themes that summarize all of the issues raised in the articles reviewed in this study. We used PRISMA 2020 guidelines to direct this systematic review and meta synthesis. The process of analyzing data includes three different stages: 1) creating codes; 2) production of descriptive themes; 3) and finally, the creation of analytical themes. The Standards for Reporting Qualitative Research checklist was used to evaluate the articles' quality. Results Five central themes emerged from 8 included articles, (1) Social factors (subthemes: environmental context, political leadership, multimedia), (2) Cultural factors (subthemes: national culture, religious culture, the family beliefs, work culture, foreign culture), (3) Economic factors (subthemes: economic situation of the individual, the government supports, infrastructures), (4) Personal factors (subthemes: people experiences, cognitive ability, physical factors, different motivational level, sense of responsibility, risk management, and self-management skills), and (5) Knowledge and Education factors (subthemes: access to information, skill training). Furthermore, SRQR items that were weakly reported were “researcher characteristics and reflexivity”, “Sampling strategy”, “Data collection methods”, “Data analysis”, and “techniques to enhance trustworthiness. Conclusion Health policymakers and other public health officials in various countries can use the factors listed to develop appropriate, evidence-based policies. They should investigate behavioral characteristics in their community based on their abilities, and then design and implement appropriate executive actions.
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Affiliation(s)
- Hamed Fattahi
- Center for Primary Health Care Network Management, Deputy for Public Health, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Faeze Ghasemi Seproo
- Center for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Arash Fattahi
- Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Iran.
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16
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Rich JA, Miech EJ, Bilal U, Corbin TJ. How education and racial segregation intersect in neighborhoods with persistently low COVID-19 vaccination rates in Philadelphia. BMC Public Health 2022; 22:1044. [PMID: 35614426 PMCID: PMC9130689 DOI: 10.1186/s12889-022-13414-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND COVID-19 infection has disproportionately affected socially disadvantaged neighborhoods. Despite this disproportionate burden of infection, these neighborhoods have also lagged in COVID-19 vaccinations. To date, we have little understanding of the ways that various types of social conditions intersect to explain the complex causes of lower COVID-19 vaccination rates in neighborhoods. METHODS We used configurational comparative methods (CCMs) to study COVID-19 vaccination rates in Philadelphia by neighborhood (proxied by zip code tabulation areas). Specifically, we identified neighborhoods where COVID-19 vaccination rates (per 10,000) were persistently low from March 2021 - May 2021. We then assessed how different combinations of social conditions (pathways) uniquely distinguished neighborhoods with persistently low vaccination rates from the other neighborhoods in the city. Social conditions included measures of economic inequities, racial segregation, education, overcrowding, service employment, public transit use, health insurance and limited English proficiency. RESULTS Two factors consistently distinguished neighborhoods with persistently low COVID-19 vaccination rates from the others: college education and concentrated racial privilege. Two factor values together - low college education AND low/medium concentrated racial privilege - identified persistently low COVID-19 vaccination rates in neighborhoods, with high consistency (0.92) and high coverage (0.86). Different values for education and concentrated racial privilege - medium/high college education OR high concentrated racial privilege - were each sufficient by themselves to explain neighborhoods where COVID-19 vaccination rates were not persistently low, likewise with high consistency (0.93) and high coverage (0.97). CONCLUSIONS Pairing CCMs with geospatial mapping can help identify complex relationships between social conditions linked to low COVID-19 vaccination rates. Understanding how neighborhood conditions combine to create inequities in communities could inform the design of interventions tailored to address COVID-19 vaccination disparities.
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Affiliation(s)
- John A Rich
- Department of Health Management and Policy, Center for Nonviolence and Social Justice, Dornsife School of Public Health, Drexel University, 1505 Race Street, MS 1047, 6th floor, Philadelphia, PA, 19102, USA.
| | - Edward J Miech
- Regenstrief Institute, Center for Health Services Research, 1101 West 10th Street, Indianapolis, IN, 46202, USA
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
| | - Theodore J Corbin
- Department of Emergency Medicine, Rush University Medical Center, 1750 W. Harrison Street, Suite 108 Kellogg, Chicago, IL, 60612, USA
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17
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Moreira RDS, Costa EG, Dos Santos LFR, Miranda LHL, de Oliveira RR, Romão RF, Cozer RF, Guedes SC. The assistance gaps in combating COVID-19 in Brazil: for whom, where and when vaccination occurs. BMC Infect Dis 2022; 22:473. [PMID: 35581560 PMCID: PMC9110943 DOI: 10.1186/s12879-022-07449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/06/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Following the emergence of the COVID-19 pandemic, the number of infected Brazilian people has increased dramatically since February 2020, with Brazil being amongst the countries with the highest number of cases and deaths. Brazilian vaccination began in January 2021, aimed at priority groups. This study analysed the spatial and temporal evolution of vaccination in Brazil between the 3rd and 21st epidemiological weeks (EW) of 2021. METHODS Spatial and temporal analyses were performed comprising 19 EW. Cases were structured into priority groups-elderly population (EP); healthcare workers (HW); indigenous and quilombola populations (I/Q), dose, vaccine (CoronaVac or AstraZeneca), and place of vaccination. A sweep test was performed to identify vaccination rate clusters. Vaccination rates (VR) were calculated according to a spatial window for each Health Region, indicating clusters above/below expected VR. Based on the discrete Poisson probability model, spatial analysis was performed to detect high/low VR clusters, which were converted into Kernel maps. Points were generated from SaTScan analyses associated with Health Region centroids. Temporal analysis of VR was carried out to identify significant trends, and results were converted into temporal cluster graphs. P-value ≤ 0.05 was adopted. RESULTS Southeast region concentrated most of the vaccines of EP and HW, followed by the Northeast. The latter region had the largest contingent of I/Q vaccinated. In all priority age groups and all regions, a higher percentage of complete CoronaVac vaccination schedules were observed compared with AstraZeneca. The temporal analysis identified high VR clusters of CoronaVac first and second dose in the early weeks, except for the EP; of AstraZeneca first dose, only for HW in the early weeks, and for EP and I/Q in the final weeks; of AstraZeneca second dose for all priority groups in the final weeks. I/Q populations had the lowest general VR. The spatial profile of VR indicated significant regional cluster differences between the priority groups. CONCLUSION This study highlights the importance of establishing vaccination priority groups, considering the asymmetries that a pandemic can trigger, notably in vast geographic areas, to contemplate the main objective of vaccination: to prevent casualties.
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Affiliation(s)
- Rafael da Silveira Moreira
- Public Health Department, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil.
- Centre for Medical Sciences, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
| | - Emilly Guaris Costa
- Centre for Medical Sciences, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | | | | | - Ricardo Fusano Romão
- Centre for Medical Sciences, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Rodolfo Ferreira Cozer
- Centre for Medical Sciences, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Qiao S, Li Z, Zhang J, Sun X, Garrett C, Li X. Social Capital, Urbanization Level, and COVID-19 Vaccination Uptake in the United States: A National Level Analysis. Vaccines (Basel) 2022; 10:vaccines10040625. [PMID: 35455373 PMCID: PMC9025929 DOI: 10.3390/vaccines10040625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022] Open
Abstract
Vaccination remains the most promising mitigation strategy for the COVID-19 pandemic. However, existing literature shows significant disparities in vaccination uptake in the United States. Using publicly available national-level data, we aimed to explore if county-level social capital can further explain disparities in vaccination uptake rates when adjusting for demographic and social determinants of health (SDOH) variables, and if association between social capital and vaccination uptake may vary by urbanization level. Bivariate analyses and a hierarchical multivariable quasi-binomial regression analysis were conducted, where the regression analysis was stratified by urban–rural status. The current study suggests that social capital contributes significantly to the disparities of vaccination uptake in the US. The results of the stratification analysis show common predictors of vaccine uptake but also suggest various patterns based on urbanization level regarding the associations of COVID-19 vaccination uptake with SDOH and social capital factors. The study provides a new perspective to address disparities in vaccination uptake through fostering social capital within communities; which may inform tailored public health intervention efforts to enhance social capital and promote vaccination uptake.
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Affiliation(s)
- Shan Qiao
- Department of Health Promotion, Education and Behavior, Smartstate Center of Healthcare Quality, Arnold School of Public Health, The University of South Carolina, Columbia, SC 29208, USA; (C.G.); (X.L.)
- Correspondence: ; Tel.: +1-(803)777-6844
| | - Zhenlong Li
- Department of Geography, The University of South Carolina, Columbia, SC 29208, USA;
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina, Columbia, SC 29208, USA; (J.Z.); (X.S.)
| | - Xiaowen Sun
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina, Columbia, SC 29208, USA; (J.Z.); (X.S.)
| | - Camryn Garrett
- Department of Health Promotion, Education and Behavior, Smartstate Center of Healthcare Quality, Arnold School of Public Health, The University of South Carolina, Columbia, SC 29208, USA; (C.G.); (X.L.)
| | - Xiaoming Li
- Department of Health Promotion, Education and Behavior, Smartstate Center of Healthcare Quality, Arnold School of Public Health, The University of South Carolina, Columbia, SC 29208, USA; (C.G.); (X.L.)
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Inoue Y. Relationship Between High Organ Donation Rates and COVID-19 Vaccination Coverage. Front Public Health 2022; 10:855051. [PMID: 35480588 PMCID: PMC9038079 DOI: 10.3389/fpubh.2022.855051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Besides attaining the goal of self-protection, the rollout of vaccination programs also encourages altruistic practices. Therefore, the progress in vaccination against coronavirus disease (COVID-19) in each country may be related to the prevalence of cooperative and altruistic practices in health care. I hypothesized that in countries where organ donation is popular, individuals would exhibit a greater tendency to become vaccinated. Methods I examined the correlation between the level of progress of COVID-19 vaccination and the status of organ donation just before the pandemic in Organization for Economic Co-operation and Development (OECD) countries. Publicly available statistical information on the progress of immunization and organ donation was used. Univariate and multivariate analyses were conducted to examine common drivers of immunization and organ donation. Results In OECD countries, progress in vaccination was found to be significantly correlated with the status of organ donation in each country. This relationship was stable after the summer (September 1: Pearson's r = 0.442, October 1: 0.457, November 1: 0.366). The results of the univariate and multivariate analyses showed that high trust in medical professionals was significantly correlated with both the “progress of vaccinations” and “organ donations.” Conclusions Progress in COVID-19 vaccination and organ donation status for transplantation have similar trends, and both may involve people's trust in medical personnel and public health systems. Similar to the efforts to obtain organ donors, governments around the world need to take further steps to ensure that vaccination programs are supported by people's trust and sense of solidarity.
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Mofleh D, Almohamad M, Osaghae I, Bempah S, Zhang Q, Tortolero G, Ebeidat A, Ramphul R, Sharma SV. Spatial Patterns of COVID-19 Vaccination Coverage by Social Vulnerability Index and Designated COVID-19 Vaccine Sites in Texas. Vaccines (Basel) 2022; 10. [PMID: 35455323 DOI: 10.3390/vaccines10040574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023] Open
Abstract
Equitable access to the COVID-19 vaccine remains a public health priority. This study explores the association between ZIP Code−Tabulation Area level Social Vulnerability Indices (SVI) and COVID-19 vaccine coverage in Texas. A mixed-effects, multivariable, random-intercept negative binomial model was used to explore the association between ZIP Code−Tabulation Area level SVI and COVID-19 vaccination coverage stratified by the availability of a designated vaccine access site. Lower COVID-19 vaccine coverage was observed in ZIP codes with the highest overall SVIs (adjusted mean difference (aMD) = −13, 95% CI, −23.8 to −2.1, p < 0.01), socioeconomic characteristics theme (aMD = −16.6, 95% CI, −27.3 to −5.7, p = 0.01) and housing and transportation theme (aMD = −18.3, 95% CI, −29.6 to −7.1, p < 0.01) compared with the ZIP codes with the lowest SVI scores. The vaccine coverage was lower in ZIP Code−Tabulation Areas with higher median percentages of Hispanics (aMD = −3.3, 95% CI, −6.5 to −0.1, p = 0.04) and Blacks (aMD = −3.7, 95% CI, −6.4 to −1, p = 0.01). SVI negatively impacted COVID-19 vaccine coverage in Texas. Access to vaccine sites did not address disparities related to vaccine coverage among minority populations. These findings are relevant to guide the distribution of COVID-19 vaccines in regions with similar demographic and geospatial characteristics.
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Wyte-Lake T, Manheim C, Gillespie SM, Dobalian A, Haverhals LM. COVID-19 Vaccination in VA Home Based Primary Care: Experience of Interdisciplinary Team Members. J Am Med Dir Assoc 2022; 23:917-922. [PMID: 35443215 PMCID: PMC8977493 DOI: 10.1016/j.jamda.2022.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/15/2022] [Accepted: 03/26/2022] [Indexed: 11/19/2022]
Abstract
Objectives Describe how Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) team members discussed the COVID-19 vaccine with Veteran patients and their caregivers; describe HBPC team members' experiences providing care during the pandemic; identify facilitators and barriers to vaccinating HBPC Veterans during the COVID-19 pandemic. Design Online survey that included 3 open-ended COVID-19 vaccine-related questions. Setting and Participants HBPC Program Directors from 145 VA Medical Centers were invited to participate and share the survey invitation with team members. The survey was open from March to May 2021. We collected N = 573 surveys from 73 sites. Methods We analyzed demographic data using descriptive frequencies and open-ended questions using thematic analysis. Results Respondents from all HBPC roles were included in the study: Registered Nurses, Psychologists, Advanced Registered Nurse Practitioners, Social Workers, Dieticians, Occupational Therapists, Pharmacists, Physical Therapists, HBPC Program Directors, HBPC Medical Directors, MDs, Physician Assistants, Other. Qualitative thematic analysis revealed 3 themes describing VA HBPC team members' experiences discussing and administering the COVID-19 vaccine: communication and education, advocating for prioritization of HBPC Veterans to receive the vaccine, and logistics of delivering and administering the vaccine. Conclusions and Implications Our study findings highlight the multifaceted experiences of VA HBPC team members discussing and administering initial doses of the COVID-19 vaccine to primarily homebound Veterans. Although the VA's HBPC program offers an example of a singular health care system, insights from more than 70 sites from across the United States reveal key lessons around the internal and external structures required to successfully support programs and their staff in providing these key activities. These lessons include proactively addressing the needs of homebound populations in national vaccine rollouts and developing vaccine education and training programs for HBPC team members specifically aligned to HBPC program needs. These lessons can extend to non-VA organizations who care for similar homebound populations.
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Affiliation(s)
- Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center, North Hills, CA, USA; Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
| | - Chelsea Manheim
- VA Eastern Colorado Health Care System Denver-Seattle Center of Innovation, Aurora, CO, USA
| | - Suzanne M Gillespie
- VA Finger Lakes Healthcare System, Canandaigua, NY, USA; Division of Geriatrics/Aging, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, North Hills, CA, USA; Health Services Management and Policy, College of Public Health, The Ohio State University, Colombus, OH, USA
| | - Leah M Haverhals
- VA Eastern Colorado Health Care System Denver-Seattle Center of Innovation, Aurora, CO, USA; Health Care Policy & Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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22
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Li J, Wang X, Yuan B. Population distribution by ethnicities and the disparities in health risk and coping in the United States during the pandemic: the spatial and time dynamics. Arch Public Health 2022; 80:93. [PMID: 35337382 PMCID: PMC8948454 DOI: 10.1186/s13690-022-00858-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background As a multi-ethnic country, the US is increasingly concerned about ethnic minorities facing disproportionate health risks of the coronavirus disease 2019 (COVID-19) pandemic. This study attempted to provide a macro picture of the associations between population distribution by ethnicity and the vulnerability to COVID-19 in terms of infection risk and vaccination coverage in the US. Methods This study used multi-source data from New York Times, County Health Rankings & Roadmap Program (2020), and the Center for Disease Control and Prevention. Multiple linear regressions were performed at equidistant time points (May 2020-Jan 2021, with one-month interval between each time point) to reveal the association between population distribution by ethnicities and the infection risk and the dynamics over time. Besides, multiple linear regressions were also conducted at equidistant time points (Jan 2021-Aug 2021) to reveal whether health disparities between ethnicities would hold true for the COVID-19 vaccination coverage (in total population, and among those > 12, > 18, and > 65 years of age). Results Both the COVID-19 confirmed cases (population standardized) and the vaccination coverage (in total population, and among those > 12, > 18, and > 65 years of age) were significantly associated with the population distribution by ethnicity (e.g., population percentage of ethnic minorities). Above associations were statistically significant for non-Hispanic blacks and Hispanics, but not for Asian Americans. Conclusions A proportion of socioeconomically-disadvantageous population could be a key intuitive reflection of the risk level of this public health crisis. The policy focusing on the vulnerable population is important in this pandemic.
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Affiliation(s)
- Jiannan Li
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Xinmeng Wang
- School of Tourism Management, Sun Yat-Sen University, West Xingang Rd. 135, Guangzhou, 510275, China
| | - Bocong Yuan
- School of Tourism Management, Sun Yat-Sen University, West Xingang Rd. 135, Guangzhou, 510275, China.
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23
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Ku L. The Association of Social Factors and Health Insurance Coverage with COVID-19 Vaccinations and Hesitancy, July 2021. J Gen Intern Med 2022; 37:409-414. [PMID: 34845582 PMCID: PMC8629592 DOI: 10.1007/s11606-021-07213-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/08/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND There are racial differences in COVID-19 vaccination rates, but social factors, such as lack of health insurance or food insecurity, may explain some of the racial disparities. OBJECTIVE To assess social factors, including insurance coverage, that may affect COVID-19 vaccination as of June-July 2021 and vaccine hesitancy among those not yet vaccinated, and how these may affect racial equity in vaccinations. DESIGN Cross-sectional analysis of nationally representative survey data. PARTICIPANTS Adults 18 to 64 participating in the Census Bureau's Household Pulse Survey for June 23 to July 5, 2021. MAIN MEASURES Vaccination: receipt of at least one dose of a COVID-19 vaccine. Vaccine hesitancy: among those not yet vaccinated, intent to definitely or probably not get vaccinated. KEY RESULTS In unadjusted analyses, black adults were less likely to be vaccinated than other respondents, but, after social factors were included, including health insurance status, food sufficiency, income and education, and state-level political preferences, differences between black and white adults were no longer significant and Hispanics were more likely to be vaccinated (OR = 1.87, p < .001). Among those not yet vaccinated, black and Hispanic adults were vaccine hesitant than white adults (ORs = .37 and .45, respectively, both p < .001) and insurance status and food insufficiency were not significantly associated with vaccine hesitancy. The percent of state voters for former President Trump in 2020 was significantly associated with lower vaccination rates and with increased vaccine hesitancy. DISCUSSION The results indicate that much of the gap in COVID vaccination rates for minority adults are due to social barriers, rather than differences in racial attitudes. Unvaccinated minority adults expressed less vaccine hesitancy than white adults. Social barriers like food insecurity and insurance coverage could have deterred prompt COVID-19 vaccinations. Reducing these problems might help increase vaccination rates.
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Affiliation(s)
- Leighton Ku
- Dept of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
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24
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Gertz A, Rader B, Sewalk K, Brownstein JS. Emerging Socioeconomic Disparities in COVID-19 Vaccine Second-Dose Completion Rates in the United States. Vaccines (Basel) 2022; 10:121. [PMID: 35062782 PMCID: PMC8780621 DOI: 10.3390/vaccines10010121] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/30/2021] [Accepted: 01/11/2022] [Indexed: 11/16/2022] Open
Abstract
Although COVID-19 vaccination plans acknowledge a need for equity, disparities in two-dose vaccine initiation have been observed in the United States. We aim to assess if disparity patterns are emerging in COVID-19 vaccination completion. We gathered (n = 843,985) responses between February and November 2021 from a web survey. Individuals self-reported demographics and COVID-19 vaccination status. Dose initiation and completion rates were calculated incorporating survey weights. A multi-variate logistic regression assessed the association between income and completing vaccination, accounting for other demographics. Overall, 57.4% initiated COVID-19 vaccination, with 84.5% completing vaccination. Initiation varied by income, and we observed disparities in completion by occupation, race, age, and insurance. Accounting for demographics, higher incomes are more likely to complete vaccination than lower incomes. We observe disparities in completion across annual income. Differences in COVID-19 vaccination completion may lead to two tiers of protection in the population, with certain sub-groups being better protected from future infection.
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Affiliation(s)
- Autumn Gertz
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
| | - Benjamin Rader
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Kara Sewalk
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
| | - John S. Brownstein
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
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25
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Kaim A, Siman-Tov M, Jaffe E, Adini B. Effect of a Concise Educational Program on COVID-19 Vaccination Attitudes. Front Public Health 2021; 9:767447. [PMID: 34917578 PMCID: PMC8669390 DOI: 10.3389/fpubh.2021.767447] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Vaccination has been recognized as a vital step for containing the COVID-19 outbreak. To ensure the success of immunization efforts as a public health containment measure, a high level of public vaccination compliance is essential. Targeted educational programs can be utilized to improve attitudes toward vaccination and improve the public's uptake of protective measures. Methods: In this cross-sectional study, we aimed to evaluate the impact of a concise educational program on perceived knowledge regarding the COVID-19 vaccine, vaccine importance and trust, protection and fear from COVID-19, trust in authorities, as well as individual resilience. Results: The study evaluated 503 participants that completed the questionnaire before and after viewing a concise video tutorial on vaccination. Following the educational program, scores of five variables increased significantly compared to their pre-viewing level: knowledge, personal resilience, trust in authorities, vaccine importance, as well as perceived protection. Those that were vaccinated and/or intend to be vaccinated (N = 394) report higher levels of knowledge, trust in authorities, vaccine importance, vaccine trust, and fear of being infected as compared to those that are unwilling to get vaccinated. Positive significant correlations were found between resilience and trust in authorities (r = 0.169, p < 0.001), vaccine importance (r = 0.098, p = 0.028), and feeling protected (r = 0.310, p < 0.001). Trust in authorities was positively correlated with vaccine importance (r = 0.589, p < 0.001) and vaccine trust (r = 0.177, p < 0.001). Vaccine importance was positively correlated with vaccine trust (r = 0.149, p = 0.001), but not correlated with knowledge score. Conclusion: The findings of the study demonstrate the benefits of educational programs on improving attitudes toward vaccination acceptability. Incorporation of such concise educational programs by authorities may improve uptake of COVID-19 vaccination and help overcome public vaccine hesitancy. We recommend that such a concise and easily implementable educational program be incorporated as a response component to the current and future outbreaks.
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Affiliation(s)
- Arielle Kaim
- Department of Emergency and Disaster Management, Faculty of Medicine, School of Public Health, Sackler Tel Aviv University, Tel Aviv, Israel.,Israel National Center for Trauma and Emergency Medicine Research, Sheba Medical Center, The Gertner Institute for Epidemiology and Health Policy Research, Ramat-Gan, Israel
| | - Maya Siman-Tov
- Department of Emergency and Disaster Management, Faculty of Medicine, School of Public Health, Sackler Tel Aviv University, Tel Aviv, Israel.,Public Relations, Training and Volunteers Division, Magen David Adom, Tel Aviv, Israel
| | - Eli Jaffe
- Public Relations, Training and Volunteers Division, Magen David Adom, Tel Aviv, Israel
| | - Bruria Adini
- Department of Emergency and Disaster Management, Faculty of Medicine, School of Public Health, Sackler Tel Aviv University, Tel Aviv, Israel
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26
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Gharpure R, Yi SH, Li R, Jacobs Slifka KM, Tippins A, Jaffe A, Guo A, Kent AG, Gouin KA, Whitworth JC, Vlachos N, Patel A, Stuckey MJ, Link-Gelles R. COVID-19 Vaccine Uptake Among Residents and Staff Members of Assisted Living and Residential Care Communities-Pharmacy Partnership for Long-Term Care Program, December 2020-April 2021. J Am Med Dir Assoc 2021; 22:2016-2020.e2. [PMID: 34508695 PMCID: PMC8384582 DOI: 10.1016/j.jamda.2021.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES In December 2020, CDC launched the Pharmacy Partnership for Long-Term Care Program to facilitate COVID-19 vaccination of residents and staff in long-term care facilities (LTCFs), including assisted living (AL) and other residential care (RC) communities. We aimed to assess vaccine uptake in these communities and identify characteristics that might impact uptake. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS AL/RC communities in the Pharmacy Partnership for Long-Term Care Program that had ≥1 on-site vaccination clinic during December 18, 2020-April 21, 2021. METHODS We estimated uptake using the cumulative number of doses of COVID-19 vaccine administered and normalizing by the number of AL/RC community beds. We estimated the percentage of residents vaccinated in 3 states using AL census counts. We linked community vaccine administration data with county-level social vulnerability index (SVI) measures to calculate median vaccine uptake by SVI tertile. RESULTS In AL communities, a median of 67 residents [interquartile range (IQR): 48-90] and 32 staff members (IQR: 15-60) per 100 beds received a first dose of COVID-19 vaccine at the first on-site clinic; in RC, a median of 8 residents (IQR: 5-10) and 5 staff members (IQR: 2-12) per 10 beds received a first dose. Among 3 states with available AL resident census data, median resident first-dose uptake at the first clinic was 93% (IQR: 85-108) in Connecticut, 85% in Georgia (IQR: 70-102), and 78% (IQR: 56-91) in Tennessee. Among both residents and staff, cumulative first-dose vaccine uptake increased with increasing social vulnerability related to housing type and transportation. CONCLUSIONS AND IMPLICATIONS COVID-19 vaccination of residents and staff in LTCFs is a public health priority. On-site clinics may help to increase vaccine uptake, particularly when transportation may be a barrier. Ensuring steady access to COVID-19 vaccine in LTCFs following the conclusion of the Pharmacy Partnership is critical to maintaining high vaccination coverage among residents and staff.
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Affiliation(s)
- Radhika Gharpure
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sarah H Yi
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruoran Li
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kara M Jacobs Slifka
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; United States Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Ashley Tippins
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Angela Guo
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alyssa G Kent
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katryna A Gouin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Carrie Whitworth
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; United States Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Nicholas Vlachos
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anita Patel
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew J Stuckey
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; United States Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Ruth Link-Gelles
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; United States Public Health Service Commissioned Corps, Rockville, MD, USA
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27
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Ala A, Wilder J, Jonassaint NL, Coffin CS, Brady C, Reynolds A, Schilsky ML. COVID-19 and the Uncovering of Health Care Disparities in the United States, United Kingdom and Canada: Call to Action. Hepatol Commun 2021; 5:1791-1800. [PMID: 34558861 PMCID: PMC8426700 DOI: 10.1002/hep4.1790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 12/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic created a crisis that disproportionately affected populations already disadvantaged with respect to access to health care systems and adequate medical care and treatments. Understanding how and where health care disparities are most widespread is an important starting point for exploring opportunities to mitigate such disparities, especially within our patient population with liver disease. In a webinar in LiverLearning, we discussed the impact of the pandemic on the United States, United Kingdom and Canada, highlighting the disproportionate effects on infection rates and death for certain ethnic minorities, those socioeconomically disadvantaged and living in higher density areas, and those working in health care and other essential jobs. We set forth a "call to action" for members of the American Association for the Study of Liver Diseases and the larger community of providers of liver disease care to generate viable solutions to improve access to care and vaccination rates of our patients against COVID-19, and in general help reduce health care disparities and improve the health of disadvantaged populations within their communities. Solutions will likely involve personalized interventions and messaging for communities that honor local leaders and embrace the diverse needs and different cultural sensitivities of our unique patient populations.
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Affiliation(s)
- Aftab Ala
- Institute of Liver StudiesKings College HospitalLondonUnited Kingdom.,Department of Gastroenterology and HepatologyRoyal Surrey NHS Foundation TrustGuildfordUnited Kingdom.,Department of Clinical and Experimental MedicineFHMSUniversity of SurreyGuildfordUnited Kingdom
| | - Julius Wilder
- Department of MedicineDivision of GastroenterologyDuke UniversityDurhamNCUSA
| | | | - Carla S Coffin
- Department of MedicineCumming School of MedicineUniversity of CalgaryCalgaryALCanada
| | - Carla Brady
- Department of MedicineDivision of GastroenterologyDuke UniversityDurhamNCUSA
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28
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Diesel J, Sterrett N, Dasgupta S, Kriss JL, Barry V, Vanden Esschert K, Whiteman A, Cadwell BL, Weller D, Qualters JR, Harris L, Bhatt A, Williams C, Fox LM, Meaney Delman D, Black CL, Barbour KE. COVID-19 Vaccination Coverage Among Adults - United States, December 14, 2020-May 22, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:922-927. [PMID: 34166331 PMCID: PMC8224863 DOI: 10.15585/mmwr.mm7025e1] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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