tetano
Editor, Senior Moderator
SSM Popul Health
. 2023 Feb 21;22:101366.
doi: 10.1016/j.ssmph.2023.101366. eCollection 2023 Jun.
Neighborhood-level COVID vaccination and booster disparities: A population-level analysis across California
Debora L Oh[SUP] 1 [/SUP], Kathryn E Kemper[SUP] 1 2 [/SUP], Dan Meltzer[SUP] 1 [/SUP], Alison J Canchola[SUP] 1 [/SUP], Kirsten Bibbins-Domingo[SUP] 1 2 3 [/SUP], Courtney R Lyles[SUP] 1 2 3 [/SUP]
Affiliations
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.
Keywords: ACS, American Community Survey; CDPH, California Department of Public Health; COVID-19; COVID-19, Coronavirus Disease 2019; Health disparities; LEP, Limited English Proficiency; Neighborhood; Population health; SDOH, Social Determinants of Health; Social determinants of health; UCSF, University of California, San Francisco; VEM, Vaccine Equity Metric; Vaccination; ZCTA, Zip Code Tabulation Area.
. 2023 Feb 21;22:101366.
doi: 10.1016/j.ssmph.2023.101366. eCollection 2023 Jun.
Neighborhood-level COVID vaccination and booster disparities: A population-level analysis across California
Debora L Oh[SUP] 1 [/SUP], Kathryn E Kemper[SUP] 1 2 [/SUP], Dan Meltzer[SUP] 1 [/SUP], Alison J Canchola[SUP] 1 [/SUP], Kirsten Bibbins-Domingo[SUP] 1 2 3 [/SUP], Courtney R Lyles[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 36873265
- PMCID: PMC9982676
- DOI: 10.1016/j.ssmph.2023.101366
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.
Keywords: ACS, American Community Survey; CDPH, California Department of Public Health; COVID-19; COVID-19, Coronavirus Disease 2019; Health disparities; LEP, Limited English Proficiency; Neighborhood; Population health; SDOH, Social Determinants of Health; Social determinants of health; UCSF, University of California, San Francisco; VEM, Vaccine Equity Metric; Vaccination; ZCTA, Zip Code Tabulation Area.