2019冠状病毒病疫苗接种与社会经济不平等：厄瓜多尔的一项横断面研究
Vaccination against COVID-19 and socioeconomic inequalities: A cross-sectional study in Ecuador.
作者信息
Torres Eulalia C, Moreno Maribel, Rivadeneira María F
机构信息
Facultad de Medicina, Maestría en Epidemiología para la Salud Pública, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
Coordinación de Auditoria Médica, Hospital de Especialidades "José Carrasco Arteaga", Cuenca, Ecuador.
出版信息
Vaccine X. 2023 Sep 20;15:100393. doi: 10.1016/j.jvacx.2023.100393. eCollection 2023 Dec.
BACKGROUND
Equity in vaccination against COVID-19 is a public health concern. The objective of this study was to analyze socioeconomic inequalities related to vaccination for the first and second doses from primary series against COVID-19 in Ecuador.
METHODS
Secondary database study in 12,743,507 respondents from 15 years and over. The COVID-19 section of the National Survey of Employment, Unemployment and Underemployment (ENEMDU) was analyzed. Socioeconomic characteristics and vaccination against COVID-19 were associated with the at least one dose and second dose. Poisson regressions for complex samples were obtained.
RESULTS
As of the date of the survey, 87.3% of the sample (95% CI 86.7%-87.8%) had received at least one vaccine against COVID-19. A lower probability of having received at least one vaccine against COVID-19 was found in rural areas (PR 0.82, 95% CI 0.74-0.91), indigenous population (PR 0.43, 95% CI 0.29-0.64), no level of education (PR 0.25, 95% CI 0.14-0.43), and the lowest economic income (PR 0.42, 95% CI 0.35-0.52). A significantly lower probability of vaccination with two or more doses was found in rural vs urban area (PR 0.88, 95% CI 0.80-0.96), women vs men (PR 0.85, 95% CI 0.77-0.91), indigenous population vs white (PR 0.44, 95% CI 0.33-0.59) and individuals in the lowest income quartile vs highest income quartile (PR 0.48, 95% CI 0.42-0.55). Underemployment, population economically inactive (PR 0.77, 95% CI 0.67-0.88 and PR 0.71, 95% CI 0.61-0.83) and individuals with no level of education (PR 0.39, 95% CI 0.27-0.58) also were less likely to complete the primary phase of vaccination compared with individuals in the highest income quartile, employment and postgraduate level of education.
CONCLUSIONS
There were socioeconomic inequalities with the primary series of vaccine against COVID-19, with a greater disadvantage for rural residents, women, indigenous populations, lower economic income and lower levels of education.
背景
2019冠状病毒病（COVID-19）疫苗接种的公平性是一个公共卫生问题。本研究的目的是分析厄瓜多尔与COVID-19初级系列疫苗第一剂和第二剂接种相关的社会经济不平等情况。
方法
对12743507名15岁及以上的受访者进行二次数据库研究。分析了全国就业、失业和就业不足调查（ENEMDU）中的COVID-19部分。社会经济特征和COVID-19疫苗接种与至少一剂和第二剂疫苗接种相关。获得了复杂样本的泊松回归。
结果
截至调查日期，87.3%的样本（95%置信区间86.7%-87.8%）接种了至少一剂COVID-19疫苗。在农村地区（PR 0.82，95%置信区间0.74-0.91）、土著人口（PR 0.43，95%置信区间0.29-0.64）、未接受教育者（PR 0.25，95%置信区间0.14-0.43）以及经济收入最低者（PR 0.42，95%置信区间0.35-0.52）中，接种至少一剂COVID-19疫苗的可能性较低。与城市地区相比，农村地区接种两剂或更多剂疫苗的可能性显著较低（PR 0.88，95%置信区间0.80-0.96）；与男性相比，女性接种两剂或更多剂疫苗的可能性较低（PR 0.85，95%置信区间0.77-0.91）；与白人相比，土著人口接种两剂或更多剂疫苗的可能性较低（PR 0.44，95%置信区间0.33-0.59）；与收入最高四分位数的个体相比，收入最低四分位数的个体接种两剂或更多剂疫苗的可能性较低（PR 0.48，95%置信区间0.42-0.55）。与收入最高四分位数、就业且接受研究生教育的个体相比，就业不足者、经济不活跃人口（PR 0.77，95%置信区间0.67-0.88和PR 0.71，95%置信区间0.61-0.83）以及未接受教育者（PR 0.39，95%置信区间0.27-0.58）完成疫苗接种初级阶段的可能性也较低。
结论
在COVID-19初级系列疫苗接种方面存在社会经济不平等，农村居民、女性、土著人口、经济收入较低者和教育水平较低者处于更不利地位。
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