Kaiser Permanente Center for Health Research, Portland, OR, USA.
OCHIN, Inc., Portland, OR, USA.
Vaccine. 2024 Oct 24;42(24):126288. doi: 10.1016/j.vaccine.2024.126288. Epub 2024 Sep 5.
There are known disparities in U.S. COVID-19 vaccination but there is limited information on national vaccine uptake in a large, racially diverse, all-age population. Here, we describe COVID-19 vaccination coverage in a large U.S. population accessing care in OCHIN (not an acronym), a national network of community-based healthcare organizations.
Within OCHIN, we identified patients aged 6 months and older with ≥1 completed clinical encounter since becoming age-eligible for the COVID-19 vaccine between December 13, 2020 and December 31, 2022. Patients' COVID-19 vaccination status was assessed from OCHIN's Epic® electronic health record which includes data from state immunization information systems. Patients were considered vaccinated if they received ≥1 dose of a monovalent vaccine product; coverage was categorized by age groups (6 months-4 years; 5-11 years, 12-15 years, 16+ years). Multivariate analyses assessed factors associated with COVID-19 vaccination across age groups.
The cohort included 3.3 million Hispanic (37 %), non-Hispanic (NH) White (31 %), NH Black (15 %), and NH Asian (7 %) patients; 45 % of whom were Medicaid-enrolled, 19 % uninsured, and 53 % with a household income below 100 % of the federal poverty level. The proportion with ≥1 COVID-19 vaccine dose increased with age, from 11.7 % (6 months through 4 years) to 72.3 % (65 years and older). The only factors associated with significantly higher COVID-19 vaccine coverage across age groups were prior receipt of an influenza vaccine and having private insurance. In adjusted modeling, when compared to NH whites, COVID-19 vaccine coverage was significantly higher among Hispanic, NH Asian, and NH multiple-race patients aged ≥5 years and significantly lower among NH Black and NH Native Hawaiian/Other Pacific Islander patients aged 6 months-4 years old.
We identified disparities in primary series COVID-19 vaccine coverage by age, race and ethnicity, household income, insurance status, and prior influenza vaccination within this large, diverse population accessing care in community-based healthcare organizations.
在美国，新冠疫苗的接种情况存在差异，但在一个以种族多样性为主的全年龄段人群中，关于全国疫苗接种率的信息有限。在这里，我们描述了在美国大型医疗组织 OCHIN（非缩写）中接受治疗的大量人群中新冠疫苗的接种情况。
在 OCHIN 中，我们确定了自 2020 年 12 月 13 日至 2022 年 12 月 31 日年满 6 个月且至少有一次完成临床就诊的≥6 个月龄患者，这些患者有资格接种新冠疫苗。从 OCHIN 的 Epic®电子健康记录中评估患者的新冠疫苗接种情况，该记录包含来自州免疫信息系统的数据。如果患者接种了≥1 剂单价疫苗产品，则认为其已接种疫苗；根据年龄组（6 个月至 4 岁；5-11 岁，12-15 岁，16 岁及以上）对疫苗接种情况进行分类。多元分析评估了各年龄组与新冠疫苗接种相关的因素。
队列包括 330 万西班牙裔（37%）、非西班牙裔白人（31%）、非西班牙裔黑人（15%）和非西班牙裔亚裔（7%）患者；其中 45%的人参加了医疗补助计划，19%的人没有保险，53%的人家庭收入低于联邦贫困线的 100%。≥1 剂新冠疫苗接种比例随年龄增长而增加，从 6 个月至 4 岁的 11.7%增加到 65 岁及以上的 72.3%。唯一与各年龄组新冠疫苗接种率显著升高相关的因素是之前接种过流感疫苗和有私人保险。在调整后的模型中，与非西班牙裔白人相比，≥5 岁的西班牙裔、非西班牙裔亚裔和多种族患者的新冠疫苗接种率显著较高，而 6 个月至 4 岁的非西班牙裔黑人以及非西班牙裔夏威夷/其他太平洋岛民患者的新冠疫苗接种率显著较低。
在这个由社区医疗组织提供治疗的大型多样化人群中，我们根据年龄、种族和民族、家庭收入、保险状况和之前的流感疫苗接种情况，发现了新冠疫苗基础系列接种率的差异。
