tetano
Editor, Senior Moderator
Chest
. 2024 Feb 9:S0012-3692(24)00145-4.
doi: 10.1016/j.chest.2024.01.049. Online ahead of print. Disparities in Influenza, Pneumococcal, COVID-19 Vaccine Coverage in High-Risk Adults 19-64 Years of Age in Southeastern Minnesota, 2010-2021
Jamie R Felzer[SUP] 1 [/SUP], Amy Montgomery[SUP] 2 [/SUP], Allison M LeMahieu[SUP] 3 [/SUP], Lila J Finney Rutten[SUP] 4 [/SUP], Young J Juhn[SUP] 5 [/SUP], Chung-Il Wi[SUP] 5 [/SUP], Robert M Jacobson[SUP] 6 [/SUP], Cassie C Kennedy[SUP] 7 [/SUP]
Affiliations
Background: Despite effective vaccines against influenza, pneumococcus and COVID-19, uptake has been suboptimal.
Research question: While disparities in vaccination by race and ethnicity have been observed, what is the role of other sociodemographic in US vaccine uptake?
Study design and methods: We conducted a population-based study using Rochester Epidemiology Project (REP), a comprehensive medical records linkage system, to assess effects of sociodemographic factors including race, ethnicity, individual-level socioeconomic status (SES) via HOUSES index, education, population density (urban or non-urban) and marital status with uptake of influenza, pneumococcal, and COVID-19 vaccination in high-risk adults. Adults at high-risk for invasive pneumococcal disease residing in four counties of southeastern Minnesota aged 19-64-years-old were identified. Vaccination data was obtained from Minnesota Immunization Information Connection and REP from January 1, 2010 - December 31, 2021.
Results: We identified 45,755 residents. A majority were White (82%), non-Hispanic (94%), married (56%), living in an urban setting (81%) with three-quarters obtaining at least some college (74%). 45.1% were up-to-date on pneumococcal vaccines while 60.1% completed their primary COVID-19 series. For influenza and COVID-19, higher SES, living in an urban setting, older age and higher education positively correlated with vaccination. Magnitude of differences in race, education and SES widened with booster vaccine.
Interpretation: This high-risk population is undervaccinated against preventable respiratory diseases, especially influenza and pneumococcus. While national data reported improvement of disparities in COVID-19 vaccination uptake observed early in the pandemic, our data demonstrated gaps related to race, education level, SES and age widened with booster vaccines. Communities with high social vulnerabilities often have increased risk of severe disease outcomes yet demonstrate lower uptake of preventive services. This highlights the need to better understand vaccine compliance and access in rural, lower SES, less-educated, Black, Hispanic, and younger populations - each of which were independently associated with decreased vaccination.
Keywords: Adult; Healthcare Disparities; Respiratory Tract Infections; Risk Factors; Sociodemographic Factors; Vaccines.
. 2024 Feb 9:S0012-3692(24)00145-4.
doi: 10.1016/j.chest.2024.01.049. Online ahead of print. Disparities in Influenza, Pneumococcal, COVID-19 Vaccine Coverage in High-Risk Adults 19-64 Years of Age in Southeastern Minnesota, 2010-2021
Jamie R Felzer[SUP] 1 [/SUP], Amy Montgomery[SUP] 2 [/SUP], Allison M LeMahieu[SUP] 3 [/SUP], Lila J Finney Rutten[SUP] 4 [/SUP], Young J Juhn[SUP] 5 [/SUP], Chung-Il Wi[SUP] 5 [/SUP], Robert M Jacobson[SUP] 6 [/SUP], Cassie C Kennedy[SUP] 7 [/SUP]
Affiliations
- PMID: 38342164
- DOI: 10.1016/j.chest.2024.01.049
Background: Despite effective vaccines against influenza, pneumococcus and COVID-19, uptake has been suboptimal.
Research question: While disparities in vaccination by race and ethnicity have been observed, what is the role of other sociodemographic in US vaccine uptake?
Study design and methods: We conducted a population-based study using Rochester Epidemiology Project (REP), a comprehensive medical records linkage system, to assess effects of sociodemographic factors including race, ethnicity, individual-level socioeconomic status (SES) via HOUSES index, education, population density (urban or non-urban) and marital status with uptake of influenza, pneumococcal, and COVID-19 vaccination in high-risk adults. Adults at high-risk for invasive pneumococcal disease residing in four counties of southeastern Minnesota aged 19-64-years-old were identified. Vaccination data was obtained from Minnesota Immunization Information Connection and REP from January 1, 2010 - December 31, 2021.
Results: We identified 45,755 residents. A majority were White (82%), non-Hispanic (94%), married (56%), living in an urban setting (81%) with three-quarters obtaining at least some college (74%). 45.1% were up-to-date on pneumococcal vaccines while 60.1% completed their primary COVID-19 series. For influenza and COVID-19, higher SES, living in an urban setting, older age and higher education positively correlated with vaccination. Magnitude of differences in race, education and SES widened with booster vaccine.
Interpretation: This high-risk population is undervaccinated against preventable respiratory diseases, especially influenza and pneumococcus. While national data reported improvement of disparities in COVID-19 vaccination uptake observed early in the pandemic, our data demonstrated gaps related to race, education level, SES and age widened with booster vaccines. Communities with high social vulnerabilities often have increased risk of severe disease outcomes yet demonstrate lower uptake of preventive services. This highlights the need to better understand vaccine compliance and access in rural, lower SES, less-educated, Black, Hispanic, and younger populations - each of which were independently associated with decreased vaccination.
Keywords: Adult; Healthcare Disparities; Respiratory Tract Infections; Risk Factors; Sociodemographic Factors; Vaccines.