Taylor M. Fortnam, Alyssa Bilinski, Roberta DeVito, and Joseph W. Hogan are with the Department of Biostatistics, and Laura C. Chambers is with the Department of Epidemiology, Brown University School of Public Health, Providence, RI. Lisa Gargano is with the Office of Immunization, and Michelle Wilson is with the Health Equity Institute, Rhode Island Department of Health, Providence.
Am J Public Health. 2024 Oct;114(S7):S580-S589. doi: 10.2105/AJPH.2024.307741. Epub 2024 Aug 28.
To determine whether geographic prioritization of limited COVID-19 vaccine supply was effective for reducing geographic disparities in case rates. Rhode Island allocated a portion of the initial COVID-19 vaccine supply to residents of Central Falls, a community already affected by structural policies and inadequate systems that perpetuate health inequities and experiencing disproportionately high COVID-19 morbidity and mortality. The policy was implemented with a culturally and linguistically appropriate community engagement plan and was intended to reduce observed disparities. Using a Bayesian causal analysis with population surveillance data, we evaluated the impact of this prioritization policy on recorded cases over the subsequent 16 weeks. Early geographic prioritization of Central Falls accelerated vaccine uptake, averting an estimated 520 cases (95% confidence interval = 22, 1418) over 16 weeks and reducing cases by approximately 34% during this period (520 averted vs 1519 expected without early prioritization). Early geographic prioritization increased vaccine uptake and reduced cases in Central Falls, thereby reducing geographic disparities. Public health institutions should consider geographic prioritization of limited vaccine supply to reduce geographic disparities in case rates. (. 2024;114(S7):S580-S589. https://doi.org/10.2105/AJPH.2024.307741).
为了确定有限的 COVID-19 疫苗供应的地理优先排序是否有助于减少病例率方面的地域差异。罗得岛将部分初始 COVID-19 疫苗供应分配给中央瀑布市的居民，该社区已经受到结构政策和不完善系统的影响，这些政策和系统使健康不平等现象永久化，并经历不成比例的高 COVID-19 发病率和死亡率。该政策的实施有一个文化和语言适宜的社区参与计划，旨在减少观察到的差异。我们使用具有人群监测数据的贝叶斯因果分析，评估了这项优先排序政策对随后 16 周内记录病例数的影响。早期在中央瀑布市的地理优先排序加速了疫苗接种，在接下来的 16 周内避免了约 520 例病例（95%置信区间 = 22，1418），并在此期间减少了约 34%的病例（520 例避免的病例与没有早期优先排序时预计的 1519 例相比）。早期的地理优先排序增加了中央瀑布市的疫苗接种率，并减少了病例，从而减少了地域差异。公共卫生机构应考虑对有限的疫苗供应进行地理优先排序，以减少病例率方面的地域差异。（2024 年；114（S7）：S580-S589。https://doi.org/10.2105/AJPH.2024.307741）。
