Socioeconomic Disparities and COVID-19 Vaccination Acceptance: Experience from Israel

AbstractCOVID-19 vaccination acceptance has a key role in mitigating the pandemic. Concern has been raised that vaccination rates will be limited in demographically defined areas of lower income. Israel’s rapid vaccination campaign may allow to assess these assumptions in real-world and to devise tools for effectively focusing the vaccination efforts. We analyzed the correlation between COVID-19 vaccination rates, socioeconomic status (SES) and active COVID-19 disease burden. We carried out a nationwide study, based on data provided by Ministry of Health of COVID-19 vaccination rates in all municipalities in Israel up to January 12th, 2021. Municipal Vaccination rates of population older than 60 significantly correlated with the socioeconomic status (r=0.83, 95% confidence interval [0.79 to 0.87]). Finally, we established a novel metric for focusing the vaccination efforts based on % vaccinations and active disease burden. In Israel, a case-model country for COVD-19 vaccinations, vaccination rates were strongly correlated with SES. The study findings demonstrate the need to directly target vaccination acceptance to socio-economically disadvantaged populations and suggest potential tools for policymakers to focus their efforts.

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Increased Influenza Vaccination of Healthcare Workers at a Pediatric Cancer Hospital: Results of a Comprehensive Influenza Vaccination Campaign

Infection Control and Hospital Epidemiology ◽

10.1086/500003 ◽

2006 ◽

Vol 27 (1) ◽

pp. 77-79 ◽

Cited By ~ 16

Author(s):

Jonathan A. McCullers ◽

Kathleen M. Speck ◽

Bonnie F. Williams ◽

Hua Liang ◽

Joseph Mirro

Keyword(s):

Influenza Vaccination ◽

Patient Care ◽

Nursing Staff ◽

Pediatric Cancer ◽

Healthcare Workers ◽

Influenza Season ◽

Vaccination Campaign ◽

Direct Patient Care ◽

Vaccination Rates ◽

Vaccination Acceptance

A comprehensive influenza vaccination campaign improved vaccination rates among healthcare workers with direct patient care responsibilities from 45% during the 2003-2004 influenza season to 80% during the 2004-2005 season. A strategy of weekly feedback to unvaccinated employees was the most important factor in enhancing the rate of vaccination acceptance and was particularly effective among the nursing staff.

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Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

Infection Control and Hospital Epidemiology ◽

10.1086/670992 ◽

2013 ◽

Vol 34 (7) ◽

pp. 723-729 ◽

Cited By ~ 6

Author(s):

Kayla L. Fricke ◽

Mariella M. Gastañaduy ◽

Renee Klos ◽

Rodolfo E. Bégué

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Influenza Vaccination ◽

Vaccination Campaign ◽

Vaccination Rate ◽

Healthcare Personnel ◽

Patient Contact ◽

Hospital Type ◽

Vaccination Rates ◽

Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

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COVID-19 Vaccine Acceptance in Azuay Province, Ecuador: A Cross-Sectional Online Survey

Vaccines ◽

10.3390/vaccines9060678 ◽

2021 ◽

Vol 9 (6) ◽

pp. 678

Author(s):

Julio Jaramillo-Monge ◽

Michael Obimpeh ◽

Bernardo Vega ◽

David Acurio ◽

Annelies Boven ◽

...

Keyword(s):

Rural Areas ◽

Online Survey ◽

Vaccination Campaign ◽

Postgraduate Education ◽

Effective Vaccine ◽

Cross Sectional ◽

Lower Education Level ◽

Vaccination Acceptance ◽

History Of ◽

High Level

We investigated the COVID-19 vaccination acceptance level in Azuay province, Ecuador through an online survey from 12th to 26th February (before the start of the COVID-19 vaccination campaign in Ecuador). Overall, 1219 respondents participated in the survey. The mean age was 32 ± 13 years; 693 participants (57%) were female. In total, 1109 (91%) of the participants indicated they were willing to be vaccinated with a COVID-19 vaccine, if the vaccine is at least 95% effective; 835 (68.5%) if it is 90% effective and 493 (40.5%) if it is 70% effective; 676 (55.5%) participants indicated they feared side effects and 237 (19.4%) thought the vaccine was not effective. Older age, having had a postgraduate education, a history of a negative COVID-19 test, a high level of worry of contracting COVID-19, believing that COVID-19 infection can be prevented with a vaccine and understanding there is currently an effective vaccine against COVID-19 were associated with higher vaccination acceptance. A vaccination education campaign will be needed to increase the knowledge of Ecuadorians about the COVID-19 vaccine and to increase their trust in the vaccine. People with a lower education level and living in rural areas may need to be targeted during such a campaign.

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Do quality improvement initiatives for diabetes care address social inequities? Secondary analysis of a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-018826 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018826 ◽

Cited By ~ 5

Author(s):

Jacquie Boyang Lu ◽

Kristin J Danko ◽

Michael D Elfassy ◽

Vivian Welch ◽

Jeremy M Grimshaw ◽

...

Keyword(s):

Systematic Review ◽

Socioeconomic Status ◽

Quality Improvement ◽

Diabetes Care ◽

Secondary Analysis ◽

Place Of Residence ◽

Disadvantaged Groups ◽

Disadvantaged Populations ◽

Patients With Diabetes ◽

Race Ethnicity

BackgroundSocially disadvantaged populations carry a disproportionate burden of diabetes-related morbidity and mortality. There is an emerging interest in quality improvement (QI) strategies in the care of patients with diabetes, however, the effect of these interventions on disadvantaged groups remains unclear.ObjectiveThis is a secondary analysis of a systematic review that seeks to examine the extent of equity considerations in diabetes QI studies, specifically quantifying the proportion of studies that target interventions toward disadvantaged populations and conduct analyses on the impact of interventions on disadvantaged groups.Research design and methodsStudies were identified using Medline, HealthStar and the Cochrane Effective Practice and Organisation of Care database. Randomised controlled trials assessing 12 QI strategies targeting health systems, healthcare professionals and/or patients for the management of adult outpatients with diabetes were eligible. The place of residence, race/ethnicity/culture/language, occupational status, gender/sexual identity, religious affiliations, education level, socioeconomic status, social capital, plus age, disability, sexual preferences and relationships (PROGRESS-Plus) framework was used to identify trials that focused on disadvantaged patient populations, to examine the types of equity-relevant factors that are being considered and to explore temporal trends in equity-relevant diabetes QI trials.ResultsOf the 278 trials that met the inclusion criteria, 95 trials had equity-relevant considerations. These include 64 targeted trials that focused on a disadvantaged population with the aim to improve the health status of that population and 31 general trials that undertook subgroup analyses to assess the extent to which their interventions may have had differential impacts on disadvantaged subgroups. Trials predominantly focused on race/ethnicity, socioeconomic status and place of residence as potential factors for disadvantage in patients receiving diabetes care.ConclusionsLess than one-third of diabetes QI trials included equity-relevant considerations, limiting the relevance and applicability of their data to disadvantaged populations. There is a need for better data collection, reporting, analysis and interventions on the social determinants of health that may influence the health outcomes of patients with diabetes.PROSPERO registration numberCRD42013005165.

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Seroprevalence ofBordetella pertussisin the Mexican population: a cross-sectional study

Epidemiology and Infection ◽

10.1017/s0950268813001313 ◽

2013 ◽

Vol 142 (4) ◽

pp. 706-713 ◽

Cited By ~ 7

Author(s):

C. CONDE-GLEZ ◽

E. LAZCANO-PONCE ◽

R. ROJAS ◽

R. DeANTONIO ◽

L. ROMANO-MAZZOTTI ◽

...

Keyword(s):

Socioeconomic Status ◽

Disease Burden ◽

Public Health Intervention ◽

Booster Vaccination ◽

Cross Sectional Study ◽

Serum Samples ◽

Nutrition Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Sources Of Infection

SUMMARYSerum samples collected during the National Health and Nutrition survey (ENSANUT 2006) were obtained from subjects aged 1–95 years (January–October 2010) and analysed to assess the seroprevalence ofBordetella pertussis(BP) in Mexico. Subjects' gender, age, geographical region and socioeconomic status were extracted from the survey and compiled into a subset database. A total of 3344 subjects (median age 29 years, range 1–95 years) were included in the analysis. Overall, BP seroprevalence was 47·4%. BP seroprevalence was significantly higher in males (53·4%,P = 0·0007) and highest in children (59·3%) decreasing with advancing age (P = 0·0008). BP seroprevalence was not significantly different between regions (P = 0·1918) and between subjects of socioeconomic status (P = 0·0808). Women, adolescents and young adults were identified as potential sources of infection to infants. Booster vaccination for adolescents and primary contacts (including mothers) for newborns and infants may provide an important public health intervention to reduce the disease burden.

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School and Community Socioeconomic Status and Access to Athletic Trainer Services in Wisconsin Secondary Schools

Journal of Athletic Training ◽

10.4085/1062-6050-440-17 ◽

2019 ◽

Vol 54 (2) ◽

pp. 177-181 ◽

Cited By ~ 8

Author(s):

Eric Post ◽

Andrew P. Winterstein ◽

Scott J. Hetzel ◽

Blaire Lutes ◽

Timothy A. McGuine

Keyword(s):

Socioeconomic Status ◽

Secondary Schools ◽

Student Athletes ◽

Athletic Directors ◽

Cross Sectional Study ◽

Socioeconomic Disparities ◽

Athletic Trainer ◽

Cross Sectional ◽

High School Athletic ◽

High Level

Context Secondary schools have made significant progress in providing athletic trainer (AT) coverage to their student-athletes, but the levels of access at schools with ATs may vary widely. Socioeconomic disparities in medical coverage and access have been noted in other health care fields, but such disparities in the level of access to AT services have not been thoroughly examined. Objective To determine if (1) access to AT services or (2) the level of access (AT hours per week and athletes per AT hour) differed based on the socioeconomic characteristics of secondary schools. Design Cross-sectional study. Setting Mailed and e-mailed surveys. Patients or Other Participants High school athletic directors and ATs from 402 Wisconsin high schools. Main Outcome Measure(s) Respondents provided information as to whether their school used the services of an AT and the number of hours per week that their school had an AT on-site. The number of athletes per AT hour was calculated by dividing the total number of athletes at the school by the number of hours of AT coverage per week. The socioeconomic status of each school was determined using the percentage of students with free or reduced-cost lunch and the county median household income (MHI). Results Schools without an AT on-site were in lower MHI counties (P < .001) and had more students eligible for a free or reduced-cost lunch (P < .001). Lower levels of AT access (fewer hours of AT access per week and more athletes per AT hour) were observed at schools in the lowest third of the county MHI and with the highest third of students eligible for a free or reduced-cost lunch (P < .001). Conclusions Socioeconomic disparities were present in access to AT services. New models are needed to focus on providing a high level of AT access for all student-athletes, regardless of socioeconomic status.

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Socioeconomic Disparities in eHealth Literacy and Preventive Behaviors During the COVID-19 Pandemic in Hong Kong: Cross-sectional Study (Preprint)

10.2196/preprints.24577 ◽

2020 ◽

Author(s):

Ziqiu Guo ◽

Sheng Zhi Zhao ◽

Ningyuan Guo ◽

Yongda Wu ◽

Xue Weng ◽

...

Keyword(s):

Socioeconomic Status ◽

Hong Kong ◽

Drainage System ◽

Socioeconomic Disparities ◽

Preventive Behaviors ◽

Web Based ◽

Social Distancing ◽

Ehealth Literacy ◽

Surgical Masks ◽

High Adherence

BACKGROUND eHealth literacy can potentially facilitate web-based information seeking and taking informed measures. OBJECTIVE This study aimed to evaluate socioeconomic disparities in eHealth literacy and seeking of web-based information on COVID-19, and their associations with COVID-19 preventive behaviors. METHODS The COVID-19 Health Information Survey (CoVHIns), using telephonic (n=500) and web-based surveys (n=1001), was conducted among adults in Hong Kong in April 2020. The Chinese eHealth literacy scale (eHEALS; score range 8-40) was used to measure eHealth literacy. COVID-19 preventive behaviors included wearing surgical masks, wearing fabric masks, washing hands, social distancing, and adding water or bleach to the household drainage system. Adjusted beta coefficients and the slope indices of inequality for the eHEALS score by socioeconomic status, adjusted odds ratios (aORs) for seeking of web-based information on COVID-19 by socioeconomic status, and aORs for the high adherence to preventive behaviors by the eHEALS score and seeking of web-based information on COVID-19 were calculated. RESULTS The mean eHEALS score was 26.10 (SD 7.70). Age was inversely associated with the eHEALS score, but education and personal income were positively associated with the eHEALS score and seeking of web-based information on COVID-19 (for all, <i>P</i> for trend<.05). Participants who sought web-based information on COVID-19 showed high adherence to the practice of wearing surgical masks (aOR 1.56, 95% CI 1.15-2.13), washing hands (aOR 1.33, 95% CI 1.05-1.71), social distancing (aOR 1.48, 95% CI 1.14-1.93), and adding water or bleach to the household drainage system (aOR 1.67, 95% CI 1.28-2.18). Those with the highest eHEALS score displayed high adherence to the practice of wearing surgical masks (aOR 3.84, 95% CI 1.63-9.05), washing hands (aOR 4.14, 95% CI 2.46-6.96), social distancing (aOR 2.25, 95% CI 1.39-3.65), and adding water or bleach to the household drainage system (aOR 1.94, 95% CI 1.19-3.16), compared to those with the lowest eHEALS score. CONCLUSIONS Chinese adults with a higher socioeconomic status had higher eHealth literacy and sought more web-based information on COVID-19; both these factors were associated with a high adherence to the guidelines for preventive behaviors during the COVID-19 pandemic.

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Seroprevalence of anti-SARS-CoV-2 antibodies six months into the vaccination campaign in Geneva, Switzerland

10.1101/2021.08.12.21261929 ◽

2021 ◽

Author(s):

Silvia Stringhini ◽

María-Eugenia Zaballa ◽

Nick Pullen ◽

Javier Perez-Saez ◽

Carlos de Mestral ◽

...

Keyword(s):

Vaccination Campaign ◽

Age Groups ◽

Credible Interval ◽

Population Based ◽

Vaccine Hesitancy ◽

Socioeconomically Disadvantaged ◽

Cross Sectional ◽

Vaccination Rates ◽

Health Measures ◽

Random Samples

Background: Up-to-date seroprevalence estimates are critical to describe the SARS-CoV-2 immune landscape in the population and guide public health measures. We aimed to estimate the seroprevalence of anti-SARS-CoV-2 antibodies 15 months into the COVID-19 pandemic and six months into the vaccination campaign. Methods: We conducted a population-based cross-sectional serosurvey between June 1 and July 7, 2021, recruiting participants from age- and sex-stratified random samples of the general population. We tested participants for anti-SARS-CoV-2 antibodies targeting the spike (S) or nucleocapsid (N) proteins (Roche Elecsys immunoassays). We estimated the anti-SARS-CoV-2 antibodies seroprevalence following vaccination and/or infection (anti-S antibodies), or infection only (anti-N antibodies). Results: We included 3355 individuals, of which 1814 (54.1%) were women, 697 (20.8%) were aged <18 years and 449 (13.4%) were aged ≥65 years, 2161 (64.4%) tested positive for anti-S antibodies, and 906 (27.0%) tested positive for anti-N antibodies. The total seroprevalence of anti-SARS-CoV-2 antibodies was 66.1% (95% credible interval, 64.1-68.0). Considering the presence of anti-N antibodies, we estimated that 29.9% (28.0-31.9) of the population developed antibodies after infection; the rest having developed antibodies only via vaccination. Seroprevalence estimates were similar across sexes, but differed markedly across age groups, being lowest among children aged 0-5 years (20.8% [15.5-26.7]) and highest among older adults aged ≥75 years (93.1% [89.6-96.0]). Seroprevalence of antibodies developed via infection and/or vaccination was higher among participants with a higher educational level. Conclusions: Most adults have developed anti-SARS-CoV-2 antibodies, while most teenagers and children remain vulnerable to infection. As the SARS-CoV-2 Delta variant spreads and vaccination rates stagnate, efforts are needed to address vaccine hesitancy, particularly among younger individuals and socioeconomically disadvantaged groups, and to minimize spread among children.

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Ensuring COVID-19 Vaccines for Migrant and Immigrant Farmworkers

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0199 ◽

2021 ◽

Author(s):

Christine M. Thomas ◽

Amy K. Liebman ◽

Alma Galván ◽

Jonathan D. Kirsch ◽

William M. Stauffer

Keyword(s):

Public Health ◽

Disease Burden ◽

Vaccination Campaign ◽

Geographic Location ◽

The United States ◽

Health Centers ◽

Coordination Of Care ◽

Faith Based ◽

Food And Agriculture ◽

Health Authorities

Migrant and immigrant farmworkers are cornerstones to food security and production in many nations. In the United States, farmworkers have been disproportionately impacted by COVID-19. Because they are considered essential workers, vaccines may be made imminently available to them and offer an opportunity to reduce these COVID-19–related impacts. It is essential for a successful vaccination campaign to address the unique challenges arising from this workforce’s inherently mobile nature and limited access to healthcare. Proposed strategies to overcome these challenges include ensuring farmworkers are prioritized in vaccine allocation and provided cost-free vaccines at convenient locations through partnerships among health authorities, community- and faith-based groups, and health centers with trusted community relationships. Further, a portable immunization record should be used, and coordination of care continued when a farmworker moves to a new geographic location. If implemented well, vaccinating farmworkers can reduce the COVID-19 disease burden among these essential workers, improve public health, and protect food and agriculture production.

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Use Of A Mobile Cart Influenza Program For Vaccination Of Hospital Employees

Infection Control and Hospital Epidemiology ◽

10.1086/502320 ◽

2004 ◽

Vol 25 (11) ◽

pp. 918-922 ◽

Cited By ~ 99

Author(s):

Catherine Sartor ◽

Herve Tissot-Dupont ◽

Christine Zandotti ◽

Francoise Martin ◽

Pierre Roques ◽

...

Keyword(s):

Influenza Vaccination ◽

Vaccination Rate ◽

Associate Professor ◽

University Hospital ◽

Vaccination Program ◽

Vaccination Rates ◽

Vaccination Acceptance ◽

The Impact ◽

Haenszel Test

AbstractObjective:Rates of annual influenza vaccination of healthcare workers (HCWs) remained low in our university hospital. This study was conducted to evaluate the impact of a mobile cart influenza vaccination program on HCW vaccination.Methods:From 2000 to 2002, the employee health service continued its annual influenza vaccination program and the mobile cart program was implemented throughout the institution. This program offered influenza vaccination to all employees directly on the units. Each employee completed a questionnaire. Vaccination rates were analyzed using the Mantel–Haenszel test.Results:The program proposed vaccination to 50% to 56% of the employees. Among the nonvaccinated employees, 52% to 53% agreed to be vaccinated. The compliance with vaccination varied from 61% to 77% among physicians and medical students and from 38% to 55% among nurses and other employees. Vaccination of the chief or associate professor of the unit was associated with a higher vaccination rate of the medical staff (P < .01). Altogether, the vaccination program led to an increase in influenza vaccination among employees from 6% in 1998 and 7% in 1999 before the mobile cart program to 32% in 2000, 35% in 2001, and 32% in 2002 (P < .001).Conclusions:The mobile cart program was associated with a significantly increased vaccination acceptance. Our study was able to identify HCW groups for which the mobile cart was effective and highlight the role of the unit head in its success.

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