The Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Leidos Inc., Atlanta, Georgia.
Am J Prev Med. 2022 Dec;63(6):883-893. doi: 10.1016/j.amepre.2022.06.016. Epub 2022 Jul 20.
Little is known about how the drivers of COVID-19 vaccination vary across the U.S. To inform vaccination outreach efforts, this study explores geographic variation in correlates of COVID-19 nonvaccination among adults.
Participants were a nationally representative sample of U.S. adults identified through random-digit dialing for the National Immunization Survey-Adult COVID Module. Analyses examined the geographic and temporal landscape of constructs in the Behavioral and Social Drivers of Vaccination Framework among unvaccinated respondents from May 2021 to December 2021 (n=531,798) and sociodemographic and geographic disparities and Behavioral and Social Drivers of Vaccination predictors of COVID-19 nonvaccination from October 2021 to December 2021 (n=187,756).
National coverage with at least 1 dose of COVID-19 vaccine was 79.3% by December 2021, with substantial geographic heterogeneity. Regions with the largest proportion of unvaccinated persons who would probably get a COVID-19 vaccine or were unsure resided in the Southeast and Midwest (Health and Human Services Regions 4 and 5). Both regions had similar temporal trends regarding concerns about COVID-19 and confidence in vaccine importance, although the Southeast had especially low confidence in vaccine safety in December 2021, lowest in Florida (5.5%) and highest in North Carolina (18.0%). The strongest Behavioral and Social Drivers of Vaccination correlate of not receiving a COVID-19 vaccination was lower confidence in COVID-19 vaccine importance (adjusted prevalence ratio=5.19, 95% CI=4.93, 5.47; strongest in the Northeast, Southwest, and Mountain West and weakest in the Southeast and Midwest). Other Behavioral and Social Drivers of Vaccination correlates also varied by region.
Contributors to nonvaccination showed substantial geographic heterogeneity. Strategies to improve COVID-19 vaccination uptake may need to be tailored regionally.
对于美国各地 COVID-19 疫苗接种的驱动因素知之甚少。为了为疫苗接种外展工作提供信息，本研究探讨了 COVID-19 未接种成年人中行为和社会驱动因素与疫苗接种的相关性在地理上的差异。
参与者是通过随机拨号识别的美国成年人的全国代表性样本，他们参与了全国免疫调查-成人 COVID 模块。分析检查了 2021 年 5 月至 2021 年 12 月（n=531,798）期间未接种疫苗的受访者中行为和社会驱动疫苗接种框架构建的地理和时间景观，以及 2021 年 10 月至 2021 年 12 月（n=187,756）期间 COVID-19 未接种疫苗的社会人口统计学和地理差异以及行为和社会驱动疫苗接种预测因素。
到 2021 年 12 月，COVID-19 疫苗至少接种一剂的全国覆盖率为 79.3%，存在显著的地理差异。未接种疫苗但可能接种 COVID-19 疫苗或不确定的人群比例最大的地区位于东南部和中西部（卫生和人类服务区域 4 和 5）。这两个地区在对 COVID-19 的担忧和对疫苗重要性的信心方面都有类似的时间趋势，尽管东南部在 2021 年 12 月对疫苗安全性的信心特别低，在佛罗里达州（5.5%）最低，在北卡罗来纳州（18.0%）最高。未接种 COVID-19 疫苗的最强行为和社会驱动疫苗接种相关性是对 COVID-19 疫苗重要性的信心较低（调整后患病率比=5.19，95%置信区间=4.93，5.47；在东北部、西南部和山区最强，在东南部和中西部最弱）。其他行为和社会驱动疫苗接种相关性也因地区而异。
未接种疫苗的原因存在显著的地理差异。提高 COVID-19 疫苗接种率的策略可能需要根据地区进行调整。
