California Department of Public Health, Richmond, CA, United States; Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, United States.
California Department of Public Health, Richmond, CA, United States.
Vaccine. 2023 Mar 3;41(10):1649-1656. doi: 10.1016/j.vaccine.2023.01.066. Epub 2023 Feb 1.
Uptake of COVID-19 vaccination remains suboptimal in the United States and other settings. Though early reports indicated that a strong majority of people were interested in receiving the COVID-19 vaccine, the association between vaccine intention and uptake is not yet fully understood. Ourobjective was todescribe predictors of vaccine uptake, and estimate the sensitivity, specificity, and predictive values of self-reported COVID-19 vaccine status compared to a comprehensive statewide COVID-19 vaccine registry.
A cohort of California residents that received a molecular test for SARS-CoV-2 infection during 24 February-5 December 2021 were enrolled in a telephone-administered survey. Survey participants were matched with records in a statewide immunization registry. Cox proportional hazards model were used to compare time to vaccination among those unvaccinated at survey enrollment by self-reported COVID-19 vaccination intention.
Among 864 participants who were unvaccinated at the time of interview, 272 (31%) had documentation of receipt of COVID-19 vaccination at a later date; including 194/423 (45.9%) who had initially reported being willing to receive vaccination, 41/185 (22.2%) who reported being unsure about vaccination, and 37/278 (13.3%) who reported unwillingness to receive vaccination.Adjusted hazard ratios (aHRs) for registry-confirmed COVID-19 vaccination were 0.49 (95% confidence interval: 0.32-0.76) and 0.21 (0.12-0.36) for participants expressing uncertainty and unwillingness to receive vaccination, respectively, as compared with participants who reported being willing to receive vaccination. Time to vaccination was shorter among participants from higher-income households (aHR = 3.30 [2.02-5.39]) and who reported co-morbidities or immunocompromising conditions (aHR = 1.54 [1.01-2.36]).Sensitivity of self-reported COVID-19 vaccination status was 82% (80-85%) overall, and 98% (97-99%) among those referencing vaccination records; specificity was 87% (86-89%).
Willingness to receive COVID-19 vaccination was an imperfect predictor of real-world vaccine uptake. Improved messaging about COVID-19 vaccination regardless of previous SARS-CoV-2 infection status may help improve uptake.
在美国和其他国家，COVID-19 疫苗的接种率仍然不理想。尽管早期报告表明，绝大多数人都有兴趣接种 COVID-19 疫苗，但疫苗接种意愿与接种率之间的关联尚未完全清楚。我们的目的是描述疫苗接种率的预测因素，并估计与全面的全州 COVID-19 疫苗登记册相比，自我报告的 COVID-19 疫苗状况的敏感性、特异性和预测值。
在 2021 年 2 月 24 日至 12 月 5 日期间，对加利福尼亚州接受 SARS-CoV-2 感染分子检测的居民进行了一项队列研究。接受了电话管理的调查。调查参与者与全州免疫登记处的记录相匹配。未接种疫苗的 Cox 比例风险模型用于比较调查登记时未接种疫苗的参与者中，按自我报告的 COVID-19 疫苗接种意愿接种疫苗的时间。
在 864 名在接受采访时未接种疫苗的参与者中，272 名（31%）后来记录了 COVID-19 疫苗接种；包括 194/423（45.9%）最初报告愿意接种疫苗，41/185（22.2%）报告对疫苗接种不确定，37/278（13.3%）报告不愿意接种疫苗。与报告愿意接种疫苗的参与者相比，登记确认为 COVID-19 疫苗接种的调整后的危险比（aHR）分别为 0.49（95%置信区间：0.32-0.76）和 0.21（0.12-0.36）。来自高收入家庭的参与者（aHR=3.30[2.02-5.39]）和报告合并症或免疫抑制状况的参与者（aHR=1.54[1.01-2.36]）接种疫苗的时间更短。自我报告的 COVID-19 疫苗接种状况的敏感性为 82%（80-85%），参考疫苗接种记录的敏感性为 98%（97-99%）；特异性为 87%（86-89%）。
愿意接种 COVID-19 疫苗是现实世界疫苗接种率的一个不完美预测因素。无论以前是否感染过 SARS-CoV-2，改善 COVID-19 疫苗接种的信息传递可能有助于提高接种率。
