Kim Yun, Iachan Ronaldo, Boyle John, Deng Yangyang
ICF International, Rockville, MD 20850, USA.
Vaccines (Basel). 2024 Dec 3;12(12):1368. doi: 10.3390/vaccines12121368.
BACKGROUND/OBJECTIVES: Understanding attitudes and behaviors related to vaccination is critical for enhancing COVID-19 vaccination acceptance and reducing disparities in vaccination coverage. This study examines disparities in vaccine-related attitudes and COVID-19 vaccine hesitancy in the United States in relation to community-level social vulnerability.
This study analyzed cross-sectional national surveys conducted repeatedly between July 2020 and August 2021 ( = 6716). We assessed the association between county-level social vulnerability and general vaccine-related attitudes, as well as COVID-19 vaccine hesitancy. We developed Poisson models with robust variance estimation. The analysis also included the association of county social vulnerability with parental COVID-19 vaccine hesitancy.
Living in counties with high Socioeconomic Status vulnerability was associated with less vaccine support (adjusted Prevalence Ratio (aPR) 1.10; 95% CI 1.05-1.14) and residing in counties with high Household Characteristics vulnerability was associated with higher likelihood of COVID-19 vaccine hesitancy (aPR 1.13; 95% CI 1.07-1.20). In contrast, high vulnerability in the Racial and Ethnic Minority was associated with more positive attitudes toward vaccines (aPR 0.91; 95% CI 0.88-0.94) and lower COVID-19 vaccine hesitancy for both themselves (aPR 0.81; 95% CI 0.76-0.87) and children (aPR 0.84; 95% CI 0.75-0.94), after adjusting for sociodemographic factors.
Our study highlights the importance of addressing vulnerabilities related to socioeconomic status and household characteristics to reduce disparities in vaccine perceptions and hesitancy in socially vulnerable populations. The findings provide evidence for targeted public health interventions at the community level. They also demonstrate that the relationship between social vulnerability and vaccine attitudes varies across different vulnerability components.
背景/目的：了解与疫苗接种相关的态度和行为对于提高新冠疫苗接种率以及缩小疫苗接种覆盖率的差距至关重要。本研究调查了美国在社区层面社会脆弱性方面与疫苗相关态度及新冠疫苗犹豫情况的差异。
本研究分析了2020年7月至2021年8月期间多次进行的全国性横断面调查（n = 6716）。我们评估了县级社会脆弱性与一般疫苗相关态度以及新冠疫苗犹豫之间的关联。我们构建了具有稳健方差估计的泊松模型。分析还包括县级社会脆弱性与父母对新冠疫苗犹豫情况的关联。
生活在社会经济地位脆弱性高的县与对疫苗的支持度较低相关（调整后的患病率比（aPR）为1.10；95%置信区间为1.05 - 1.14），居住在家庭特征脆弱性高的县与新冠疫苗犹豫的可能性较高相关（aPR为1.13；95%置信区间为1.07 - 1.20）。相比之下，在调整社会人口统计学因素后，种族和族裔少数群体的高脆弱性与对疫苗更积极的态度相关（aPR为0.91；95%置信区间为0.88 - 0.94），并且他们自己（aPR为0.81；95%置信区间为0.76 - 0.87）和儿童（aPR为0.84；95%置信区间为0.75 - 0.94）的新冠疫苗犹豫程度较低。
我们的研究强调了解决与社会经济地位和家庭特征相关的脆弱性对于减少社会脆弱人群在疫苗认知和犹豫方面的差距的重要性。研究结果为社区层面有针对性的公共卫生干预措施提供了证据。它们还表明社会脆弱性与疫苗态度之间的关系在不同的脆弱性组成部分中有所不同。
