Institute for Modeling Collaboration and Innovation, University of Idaho, Moscow, ID 83844, USA.
Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT 06269, USA.
J Infect Public Health. 2021 Oct;14(10):1563-1565. doi: 10.1016/j.jiph.2021.07.013. Epub 2021 Jul 22.
In the United States, distribution plans for the COVID-19 vaccination were established at the state level. However, some states, such as Connecticut, followed an age-based strategy without considering occupations or co-morbid conditions due to its simplicity in implementation. This strategy raised concerns about exacerbating health inequities because it did not prioritize vulnerable communities, specifically, minorities and low-income groups. The study aims to examine the vaccination inequities among different population groups for people aged 65+.
A cross-sectional analysis of quantile-based independent sample t-test was employed to examine the relationship between eight social vulnerability indices (SVIs, i.e., below poverty, unemployed, without high school diploma, disability, minority, speaks English less than well, no vehicle, and mobile homes) and vaccination rates at the town level in Connecticut during the second phase of the vaccine distribution plan when individuals aged 65 and over were eligible. Negative binomial regressions were employed to further justify the relationships between SVIs and vaccination rates.
The report shows that the differences in vaccination rates were statistically significant between the most vulnerable and the least vulnerable towns with respect to six SVIs (i.e., below poverty, without high school diploma, disability, minority, speaks English less than well, and no vehicle). The vaccination gap was greater for people aged 75+ than people aged 65-74. Among the selected SVIs, below poverty was negatively correlated with the vaccination rate for 75+, and without high school diploma was negatively correlated with both rates.
This report reveals the significant health inequities in COVID-19 vaccination among the elderly population at the early vaccination phase. It can shed insights into health policy initiatives to improve vaccination coverage in the elderly communities, such as promoting onsite scheduling and increasing at-home vaccination services.
在美国,COVID-19 疫苗的分发计划是在州一级制定的。然而,由于实施起来较为简单,一些州,如康涅狄格州,遵循了基于年龄的策略,而没有考虑职业或合并症等因素。由于该策略没有优先考虑弱势社区,特别是少数民族和低收入群体,因此人们担心这会加剧健康不平等。本研究旨在检查不同人群中 65 岁以上人群的疫苗接种不平等情况。
采用基于分位数的独立样本 t 检验的横断面分析方法,考察了在康涅狄格州疫苗分发计划第二阶段(65 岁及以上人群有资格接种疫苗时),8 个社会脆弱性指数(SVI,即贫困、失业、未完成高中学业、残疾、少数民族、英语水平较低、无交通工具和移动房屋)与城镇一级疫苗接种率之间的关系。采用负二项回归进一步证明 SVI 与疫苗接种率之间的关系。
报告显示,在六个 SVI(贫困、未完成高中学业、残疾、少数民族、英语水平较低、无交通工具)方面,最脆弱和最不脆弱的城镇之间的疫苗接种率存在统计学上的显著差异。75 岁以上人群的疫苗接种差距大于 65-74 岁人群。在所选择的 SVI 中,贫困与 75 岁以上人群的疫苗接种率呈负相关,而未完成高中学业与两个年龄组的疫苗接种率均呈负相关。
本报告揭示了 COVID-19 疫苗在早期接种阶段老年人群中存在显著的健康不平等现象。它可以为改善老年社区的疫苗接种覆盖率的卫生政策举措提供启示,例如促进现场预约和增加上门接种服务。