Program in Ecology, Evolution, and Conservation Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
Department of Statistics, University of Illinois Urbana-Champaign, Urbana, IL, USA.
Sci Adv. 2023 Aug 2;9(31):eadh9920. doi: 10.1126/sciadv.adh9920.
SARS-CoV-2 vaccines have been distributed at unprecedented speed. Still, little is known about temporal vaccination trends, their association with socioeconomic inequality, and their consequences for disease control. Using data from 161 countries/territories and 58 states, we examined vaccination rates across high and low socioeconomic status (SES), showing that disparities in coverage exist at national and subnational levels. We also identified two distinct vaccination trends: a rapid initial rollout, quickly reaching a plateau, or sigmoidal and slow to begin. Informed by these patterns, we implemented an SES-stratified mechanistic model, finding profound differences in mortality and incidence across these two vaccination types. Timing of initial rollout affects disease outcomes more substantially than final coverage or degree of SES disparity. Unexpectedly, timing is not associated with wealth inequality or GDP per capita. While socioeconomic disparity should be addressed, accelerating initial rollout for all over focusing on increasing coverage is an accessible intervention that could minimize the burden of disease across socioeconomic groups.
SARS-CoV-2 疫苗的分发速度前所未有。尽管如此，人们对时间性的疫苗接种趋势、它们与社会经济不平等的关系以及它们对疾病控制的影响知之甚少。利用来自 161 个国家/地区和 58 个州的数据，我们检查了高和低社会经济地位（SES）的疫苗接种率，表明在国家和次国家层面上存在覆盖范围的差距。我们还确定了两种不同的疫苗接种趋势：快速初始推出，迅速达到平台期，或呈 S 型缓慢开始。根据这些模式，我们实施了 SES 分层的机制模型，发现这两种疫苗接种类型在死亡率和发病率方面存在显著差异。初始推出的时间比最终覆盖率或 SES 差距程度对疾病结果的影响更大。出乎意料的是，时间与财富不平等或人均 GDP 无关。虽然应该解决社会经济差距问题，但加快所有人群的初始推广而不是专注于提高覆盖率是一种可行的干预措施，可以最大限度地减少各社会经济群体的疾病负担。
