Disparities in COVID-19 Vaccination Uptake by Social Vulnerability Index: A US nationwide study
Author(s)
Manuela Di Fusco, PhD1, Laura L. Lupton, MHA, MD2, Alon Yehoshua, PharmD1, Meghan Gavaghan, MPH1, Laura Puzniak, PhD1, Santiago M. Lopez, MD1, Joseph C. Cappelleri, MPH, MS, PhD1, Xiaowu Sun, PhD2;
1Pfizer Inc., New York, NY, USA, 2CVS Health, Woonsocket, RI, USA
1Pfizer Inc., New York, NY, USA, 2CVS Health, Woonsocket, RI, USA
Presentation Documents
OBJECTIVES: Vulnerable communities have been profoundly impacted by healthcare access barriers during the pandemic. This study examined differences in COVID-19 vaccination uptake by social vulnerability status.
METHODS: Symptomatic adults testing positive for SARS-CoV-2 at CVS retail pharmacies were recruited between 03/02/2023 and 05/18/2023 (CT.gov: NCT05160636). Socio-demographic characteristics and COVID-19 vaccination status (with bivalent as most up-to-date) were self-reported via an online questionnaire completed upon registration for testing. Patients were divided into quartiles of Social Vulnerability Index (SVI), a composite score developed by the CDC, with quartile 4 representing highest vulnerability. Logistic regression models estimated odds ratios (OR) for vaccine uptake based on SVI, adjusting for age, gender, region, race and ethnicity.
RESULTS: Among 640 participants, 156 (24%) were in quartile 1, 238 (37%) in quartile 2, 159 (25%) in quartile 3, and 87 (14%) in quartile 4. Their mean SVI scores were, respectively, 0.16, 0.38, 0.61, and 0.84 (p<0.001). Age, race, and geographic distribution differed: relative to quartile 1, quartile 4 participants were younger (mean age: 43.4 vs 50.4; p= 0.0004), had the highest representation of Black or Hispanic (57.5% vs 12.2%; p<0.001), and Southern or Western states (82.7% vs 50.0%; p<0.001). COVID-19 bivalent vaccination uptake was lower in vulnerable groups: 37.9% in quartile 4, 35.8% in quartile 3, 50.8% in quartile 2, and 65.4% in quartile 1 (p<0.001). Relative to quartile 1, both quartile 4 and 3 participants had significantly lower adjusted odds of being up-to-date with COVID-19 vaccination: 0.49 [95% confidence interval (CI) 0.27-0.90] and 0.34 (95% 0.21-0.56), respectively.
CONCLUSIONS: Compared with quartile 1, the most vulnerable groups (quartiles 4 and quartile 3) had 51-66% lower odds of being up-to-date with COVID-19 vaccination. These findings underscore the need to improve access and acceptance of COVID-19 vaccination, particularly among the most socially vulnerable.
METHODS: Symptomatic adults testing positive for SARS-CoV-2 at CVS retail pharmacies were recruited between 03/02/2023 and 05/18/2023 (CT.gov: NCT05160636). Socio-demographic characteristics and COVID-19 vaccination status (with bivalent as most up-to-date) were self-reported via an online questionnaire completed upon registration for testing. Patients were divided into quartiles of Social Vulnerability Index (SVI), a composite score developed by the CDC, with quartile 4 representing highest vulnerability. Logistic regression models estimated odds ratios (OR) for vaccine uptake based on SVI, adjusting for age, gender, region, race and ethnicity.
RESULTS: Among 640 participants, 156 (24%) were in quartile 1, 238 (37%) in quartile 2, 159 (25%) in quartile 3, and 87 (14%) in quartile 4. Their mean SVI scores were, respectively, 0.16, 0.38, 0.61, and 0.84 (p<0.001). Age, race, and geographic distribution differed: relative to quartile 1, quartile 4 participants were younger (mean age: 43.4 vs 50.4; p= 0.0004), had the highest representation of Black or Hispanic (57.5% vs 12.2%; p<0.001), and Southern or Western states (82.7% vs 50.0%; p<0.001). COVID-19 bivalent vaccination uptake was lower in vulnerable groups: 37.9% in quartile 4, 35.8% in quartile 3, 50.8% in quartile 2, and 65.4% in quartile 1 (p<0.001). Relative to quartile 1, both quartile 4 and 3 participants had significantly lower adjusted odds of being up-to-date with COVID-19 vaccination: 0.49 [95% confidence interval (CI) 0.27-0.90] and 0.34 (95% 0.21-0.56), respectively.
CONCLUSIONS: Compared with quartile 1, the most vulnerable groups (quartiles 4 and quartile 3) had 51-66% lower odds of being up-to-date with COVID-19 vaccination. These findings underscore the need to improve access and acceptance of COVID-19 vaccination, particularly among the most socially vulnerable.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR135
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Infectious Disease (non-vaccine), STA: Vaccines