scholarly journals A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice

2021 ◽  
Author(s):  
Carina Marquez ◽  
Andrew D. Kerkhoff ◽  
Jamie Naso ◽  
Maria G. Contreras ◽  
Edgar Castellanos ◽  
...  
Keyword(s):  
San Francisco ◽  
Vaccine Coverage ◽  
Family Members ◽  
Vaccination Strategy ◽  
Vaccine Uptake ◽  
Component Community ◽  
Annual Household Income ◽  
Community Based ◽  
Vaccination Site ◽  
Health Partnership

Background COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized that a community-centered vaccination strategy that included mobilization, vaccination, and "activation" components could successfully reach an underserved Latinx population, utilizing its social networks to boost vaccination coverage. Methods and Findings Our community-academic-public health partnership, "Unidos en Salud," utilized a theory-informed approach to design our "Motivate, Vaccinate, and Activate" COVID-19 vaccination strategy. Our strategy's design was guided by the PRECEDE Model and sought to address and overcome predisposing, enabling, and reinforcing barriers to COVID-19 vaccination faced by Latinx individuals in San Francisco. We evaluated our prototype outdoor, "neighborhood" vaccination program located in a central commercial and transport hub in the Mission District in San Francisco, using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework during a 16-week period from February 1, 2021 to May 19, 2021. Programmatic data, city-wide COVID-19 surveillance data, and a survey conducted between May 2, 2021 and May 19, 2021 among 997 vaccinated clients at least 16 years old were used in the evaluation. There were 20,792 COVID-19 vaccinations administered at the neighborhood site during the 16-week evaluation period. Vaccine recipients had a median age of 43 (IQR 32-56) years, 53.9% were male and 70.5% were Latinx, 14.1% white, 7.7% Asian, 2.4% Black, and 5.3% other. Latinx vaccinated clients were substantially more likely than non-Latinx clients to have an annual household income of less than $50,000 a year (76.1% vs. 33.5%), be a first-generation immigrant (60.2% vs. 30.1%), not have health insurance (47.3% vs. 16.0%), and not have access to primary care provider (62.4% vs. 36.2%). The most frequently reported reasons for choosing vaccination at the site were its neighborhood location (28.6%), easy and convenient scheduling (26.9%) and recommendation by someone they trusted (18.1%); approximately 99% reported having an overall positive experience, regardless of ethnicity. Notably, 58.3% of clients reported that they were able to get vaccinated earlier because of the neighborhood vaccination site, 98.4% of clients completed both vaccine doses, and 90.7% said that they were more likely to recommend COVID-19 vaccination to family and friends after their experience; these findings did not substantially differ according to ethnicity. There were 40.3% of vaccinated clients who said they still knew at least one unvaccinated person (64.6% knew 3 or more). Among clients who received both vaccine doses (n=729), 91.0% said that after their vaccination experience, they had personally reached out to at least one unvaccinated person they knew (61.6% reached out to 3 or more) to recommend getting vaccinated; 83.0% of clients reported that one or more friends, and/or family members got vaccinated as a result of their outreach, including 18.9% who reported 6 or more persons got vaccinated as a result of their influence. Conclusions A multi-component, "Motivate, Vaccinate, and Activate" community-based strategy addressing barriers to COVID-19 vaccination for the Latinx population reached the intended population, and vaccinated individuals served as ambassadors to recruit other friends and family members to get vaccinated.

scholarly journals A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: From theory to practice

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257111
Author(s):  
Carina Marquez ◽  
Andrew D. Kerkhoff ◽  
Jamie Naso ◽  
Maria G. Contreras ◽  
Edgar Castellanos Diaz ◽  
...  
Keyword(s):  
San Francisco ◽  
Vaccine Coverage ◽  
Family Members ◽  
Vaccination Strategy ◽  
Vaccine Uptake ◽  
Component Community ◽  
Annual Household Income ◽  
Community Based ◽  
Vaccination Site ◽  
Health Partnership

Background COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized that a community-centered vaccination strategy that included mobilization, vaccination, and “activation” components could successfully reach an underserved Latinx population, utilizing its social networks to boost vaccination coverage. Methods Our community-academic-public health partnership, “Unidos en Salud,” utilized a theory-informed approach to design our “Motivate, Vaccinate, and Activate” COVID-19 vaccination strategy. Our strategy’s design was guided by the PRECEDE Model and sought to address and overcome predisposing, enabling, and reinforcing barriers to COVID-19 vaccination faced by Latinx individuals in San Francisco. We evaluated our prototype outdoor, “neighborhood” vaccination program located in a central commercial and transport hub in the Mission District in San Francisco, using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework during a 16-week period from February 1, 2021 to May 19, 2021. Programmatic data, city-wide COVID-19 surveillance data, and a survey conducted between May 2, 2021 and May 19, 2021 among 997 vaccinated clients ≥16 years old were used in the evaluation. Results There were 20,792 COVID-19 vaccinations administered at the neighborhood site during the 16-week evaluation period. Vaccine recipients had a median age of 43 (IQR 32–56) years, 53.9% were male and 70.5% were Latinx, 14.1% white, 7.7% Asian, 2.4% Black, and 5.3% other. Latinx vaccinated clients were substantially more likely than non-Latinx clients to have an annual household income of less than $50,000 a year (76.1% vs. 33.5%), be a first-generation immigrant (60.2% vs. 30.1%), not have health insurance (47.3% vs. 16.0%), and not have access to primary care provider (62.4% vs. 36.2%). The most frequently reported reasons for choosing vaccination at the site were its neighborhood location (28.6%), easy and convenient scheduling (26.9%) and recommendation by someone they trusted (18.1%); approximately 99% reported having an overall positive experience, regardless of ethnicity. Notably, 58.3% of clients reported that they were able to get vaccinated earlier because of the neighborhood vaccination site, 98.4% of clients completed both vaccine doses, and 90.7% said that they were more likely to recommend COVID-19 vaccination to family and friends after their experience; these findings did not substantially differ according to ethnicity. There were 40.3% of vaccinated clients who said they still knew at least one unvaccinated person (64.6% knew ≥3). Among clients who received both vaccine doses (n = 729), 91.0% said that after their vaccination experience, they had personally reached out to at least one unvaccinated person they knew (61.6% reached out to ≥3) to recommend getting vaccinated; 83.0% of clients reported that one or more friends, and/or family members got vaccinated as a result of their outreach, including 18.9% who reported 6 or more persons got vaccinated as a result of their influence. Conclusions A multi-component, “Motivate, Vaccinate, and Activate” community-based strategy addressing barriers to COVID-19 vaccination for the Latinx population reached the intended population, and vaccinated individuals served as ambassadors to recruit other friends and family members to get vaccinated.

scholarly journals A Community-Based Management of COVID-19 in a Mobile Container Unit

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1362
Author(s):  
Elena Petrova ◽  
Timothy Farinholt ◽  
Tejas P. Joshi ◽  
Hannah Moreno ◽  
Mayar Al Mohajer ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Vaccine Coverage ◽  
The United States ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Air Filtration ◽  
Clinical Environment ◽  
Mobile Clinic ◽  
Community Based ◽  
Community Healthcare

Vaccine uptake is a multifactor measure of successful immunization outcomes that includes access to healthcare and vaccine hesitancy for both healthcare workers and communities. The present coronavirus disease (COVID-19) pandemic has highlighted the need for novel strategies to expand vaccine coverage in underserved regions. Mobile clinics hold the promise of ameliorating such inequities, although there is a paucity of studies that validate environmental infection in such facilities. Here, we describe community-based management of COVID-19 through a Smart Pod mobile clinic deployed in an underserved community area in the United States (Aldine, Harris County, TX, USA). In particular, we validate infection control and biological decontamination of the Smart Pod by testing surfaces and the air-filtration system for the COVID-19 virus and bacterial pathogens. We show the Smart Pod to be efficacious in providing a safe clinical environment for vaccine delivery. Moreover, in the Smart Pod, up-to-date education of community healthcare workers was provided to reduce vaccine hesitancy and improve COVID-19 vaccine uptake. The proposed solution has the potential to augment existing hospital capacity and combat the COVID-19 pandemic locally and globally.

scholarly journals Factors associated with PPSV23 coverage among older adults in Japan: a nationwide community-based survey

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030197 ◽  
Author(s):  
Yoshitaka Murakami ◽  
Shinichi Kanazu ◽  
Tanaz Petigara ◽  
Mari Saito Oba ◽  
Yuji Nishiwaki ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Immunisation Programme ◽  
Nationwide Survey ◽  
Target Population ◽  
Vaccine Uptake ◽  
Community Based ◽  
National Immunisation Programme ◽  
National Immunisation ◽  
Per Capita ◽  
Out Of Pocket Costs

ObjectivesThe 23-valent pneumococcal polysaccharide vaccine (PPSV23) was included in Japan’s national immunisation programme for older adults in 2014. While vaccination coverage has increased following the implementation of the national immunisation programme, little is known about the factors that have influenced changes in PPSV23 uptake in Japan. This study aimed to investigate the effects of municipality-level activities implemented to improve vaccine uptake during the fiscal year 2015 (April 2015–March 2016).DesignCommunity-based national survey. A postal and web-based nationwide survey was sent to all municipalities in Japan in June 2016 (n=1741). The survey included questions regarding PPSV23 coverage, out-of-pocket costs by individuals for vaccination and community-level activities implemented to improve and promote PPSV23 uptake. Municipality-level and prefecture-level variables (eg, unemployment rates, average per capita income) retrieved from published sources were also incorporated to explore the impact of social determinants on vaccine uptake.SettingJapan.ParticipantsMunicipal vaccination officers.Primary and secondary outcome measuresThe primary study outcome was PPSV23 coverage among adults aged 65 years in Japanese municipalities.ResultsA total of 1010 municipalities (58.0%) responded to the survey. The median PPSV23 coverage among responding municipalities was 41.8%. Vaccine coverage increased by 18.7% (16.7%–20.7%)%) in municipalities that sent a direct mail notification to the target population of adults compared with municipalities that did not send any notification. Vaccine coverage decreased by 3.02% (2.4%–3.6%)%) for every 1000 JPY increase in out-of-pocket costs. Municipality-level unemployment rates and average per capita income were negatively associated with PPSV23 coverage.ConclusionsThis nationwide survey provides insight into factors that may influence PPSV23 coverage in Japanese municipalities. Reduced out-of-pocket costs and direct mail notifications to the target population were associated with higher PPSV23 coverage in Japanese municipalities.

scholarly journals Comparison of intradermal injection and epicutaneous laser microporation for antitumor vaccine delivery in a human skin explant model

2019 ◽  
Author(s):  
Sanne Duinkerken ◽  
Joyce Lübbers ◽  
Dorian Stolk ◽  
Jana Vree ◽  
Martino Ambrosini ◽  
...  
Keyword(s):  
T Cell ◽  
Human Skin ◽  
T Cell Activation ◽  
Cell Activation ◽  
Ex Vivo ◽  
Vaccination Strategy ◽  
Intradermal Injection ◽  
Vaccine Uptake ◽  
Vaccination Site ◽  
Cell Responses

ABSTRACTHuman skin is a prime vaccination site containing multiple antigen presenting cells (APC), including Langerhans cells (LC) and dendritic cells (DC). APC deliver antigens to lymph nodes for induction of adaptive immunity through stimulating antigen specific T- and B-cells. Since intradermal (ID) injections require specific training, easy applicable delivery systems like laser microporation are emerging. In mice, combination of laser treatment and allergen injection showed enhanced T-cell responses and skewing of B-cell responses without adjuvants. However, it remains to be elucidated whether laser microporation can alter human skin DC phenotype and function without adjuvants. In an ex-vivo human skin explant model, we compared ID injection and laser microporation as anti-tumor vaccination strategy. A melanoma specific synthetic long peptide and multivalent dendrimer with gp100 antigen were used as vaccine formulation to measure APC phenotype, emigration and ability to stimulate gp100 specific CD8+ T-cells. We show that skin APC phenotype and emigration capacity was similar after laser microporation and ID injection. However, laser microporation reduced vaccine uptake by APC, resulting in decreased induction of gp100 specific CD8+ T-cell activation. To conclude, in our human skin model ID injection remains the most potent strategy to deliver antigens to skin APC for T-cell induction.Graphical Abstract

scholarly journals High parental vaccine motivation at a neighborhood-based vaccine and testing site serving a predominantly Latinx community

2021 ◽  
Author(s):  
Jamie Naso ◽  
Susy Rojas ◽  
James Peng ◽  
Carina Marquez ◽  
Maria Contreras ◽  
...  
Keyword(s):  
Side Effects ◽  
San Francisco ◽  
Low Income ◽  
Community Organizations ◽  
Vaccine Hesitancy ◽  
Sources Of Information ◽  
Community Based ◽  
Vaccination Site ◽  
Testing Site

Purpose. To understand vaccine attitudes of Latinx parents highly impacted by COVID-19. Methods. In April 2021, we surveyed parents about their attitudes for COVID-19 vaccination of their children at a community-based outdoor testing/vaccination site serving predominantly low-income, Latinx persons in San Francisco. Results. Among 1,033 parents (75% Latinx), 92% would 'definitely' or 'probably' vaccinate their children. Vaccine hesitancy was higher for younger children; concerns included side effects and impacts on fertility. Doctors and community organizations were noted as trusted sources of information, including among vaccine-hesitant parents. Conclusion. Latinx parents accessing neighborhood-based COVID-19 testing/vaccination services are highly motivated to vaccinate their children for COVID-19.

Influenza vaccination coverage in a population-based cohort of Australian-born Aboriginal and non-Indigenous older adults

2019 ◽  
Vol 43 ◽  
Author(s):  
Amalie Dyda ◽  
Surendra Karki ◽  
Marlene Kong ◽  
Heather F Gidding ◽  
John M Kaldor ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Torres Strait Islander ◽  
Vaccine Coverage ◽  
Vaccine Uptake ◽  
P Value ◽  
Healthy Weight ◽  
Medical Risk ◽  
Torres Strait

Background: There is limited information on vaccination coverage and characteristics associated with vaccine uptake in Aboriginal and/or Torres Strait Islander adults. We aimed to provide more current estimates of influenza vaccination coverage in Aboriginal adults. Methods: Self-reported vaccination status (n=559 Aboriginal and/or Torres Strait Islander participants, n=80,655 non-Indigenous participants) from the 45 and Up Study, a large cohort of adults aged 45 years or older, was used to compare influenza vaccination coverage in Aboriginal and/or Torres Strait Islander adults with coverage in non-Indigenous adults. Results: Of Aboriginal and non-Indigenous respondents aged 49 to <65 years, age-standardised influenza coverage was respectively 45.2% (95% CI 39.5–50.9%) and 38.5%, (37.9–39.0%), p-value for heterogeneity=0.02. Coverage for Aboriginal and non-Indigenous respondents aged ≥65 years was respectively 67.3% (59.9–74.7%) and 72.6% (72.2–73.0%), p-heterogeneity=0.16. Among Aboriginal adults, coverage was higher in obese than in healthy weight participants (adjusted odds ratio (aOR)=2.38, 95%CI 1.44–3.94); in those aged <65 years with a medical risk factor than in those without medical risk factors (aOR=2.13, 1.37–3.30); and in those who rated their health as fair/poor compared to those who rated it excellent (aOR=2.57, 1.26–5.20). Similar associations were found among non-Indigenous adults. Conclusions: In this sample of adults ≥65 years, self-reported influenza vaccine coverage was not significantly different between Aboriginal and non-Indigenous adults whereas in those <65 years, coverage was higher among Aboriginal adults. Overall, coverage in the whole cohort was suboptimal. If these findings are replicated in other samples and in the Australian Immunisation Register, it suggests that measures to improve uptake, such as communication about the importance of influenza vaccine and more effective reminder systems, are needed among adults.

scholarly journals Estimation of secondary household attack rates for emergent spike L452R SARS-CoV-2 variants detected by genomic surveillance at a community-based testing site in San Francisco

2021 ◽  
Author(s):  
James Peng ◽  
Jamin Liu ◽  
Sabrina A Mann ◽  
Anthea M Mitchell ◽  
Matthew T Laurie ◽  
...  
Keyword(s):  
San Francisco ◽  
West Coast ◽  
Reproductive Number ◽  
Community Based ◽  
Viral Loads ◽  
Mission District ◽  
Household Contacts ◽  
Epidemiological Tool ◽  
Testing Site ◽  
New Mutations

Abstract Background Sequencing of the SARS-CoV-2 viral genome from patient samples is an important epidemiological tool for monitoring and responding to the pandemic, including the emergence of new mutations in specific communities. Methods SARS-CoV-2genomicsequencesweregeneratedfrompositivesamplescollected,alongwithepidemiologicalmetadata,atawalk-up, rapid testing site in the Mission District of San Francisco, California during November 22-December 1, 2020 and January 10-29, 2021. Secondary household attack rates and mean sample viral load were estimated and compared across observed variants. Results A total of 12,124 tests were performed yielding 1,099 positives. From these, 928 high quality genomes were generated. Certain viral lineages bearing spike mutations, defined in part by L452R, S13I, and W152C, comprised 54.4% of the total sequences from January, compared to 15.7% in November. Household contacts exposed to the “California” or “West Coast” variants (B.1.427 and B.1.429) were at higher risk of infection compared to household contacts exposed to lineages lacking these variants (0.36 vs 0.29, RR=1.28; 95% CI:1.00-1.64). The reproductive number was estimated to be modestly higher than other lineages spreading in California during the second half of 2020. Viral loads were similar among persons infected with West Coast versus non-West Coast strains, as was the proportion of individuals with symptoms (60.9% vs 64.3%). Conclusions The increase in prevalence, relative household attack rates, and reproductive number are consistent with a modest transmissibility increase of the West Coast variants.

scholarly journals Impact of national influenza vaccination strategy in severe influenza outcomes among the high-risk Portuguese population

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ausenda Machado ◽  
Irina Kislaya ◽  
Amparo Larrauri ◽  
Carlos Matias Dias ◽  
Baltazar Nunes
Keyword(s):  
High Risk ◽  
Influenza Vaccination ◽  
Seasonal Influenza ◽  
Vaccine Coverage ◽  
Vaccination Strategy ◽  
High Risk Population ◽  
Risk Population ◽  
Seasonal Influenza Vaccination ◽  
Severe Influenza ◽  
The Impact

Abstract Background All aged individuals with a chronic condition and those with 65 and more years are at increased risk of severe influenza post-infection complications. There is limited research on cases averted by the yearly vaccination programs in high-risk individuals. The objective was to estimate the impact of trivalent seasonal influenza vaccination on averted hospitalizations and death among the high-risk population in Portugal. Methods The impact of trivalent seasonal influenza vaccination was estimated using vaccine coverage, vaccine effectiveness and the number of influenza-related hospitalizations and deaths. The number of averted events (NAE), prevented fraction (PF) and number needed to vaccinate (NVN) were estimated for seasons 2014/15 to 2016/17. Results The vaccination strategy averted on average approximately 1833 hospitalizations and 383 deaths per season. Highest NAE was observed in the ≥65 years population (85% of hospitalizations and 95% deaths) and in the 2016/17 season (1957 hospitalizations and 439 deaths). On average, seasonal vaccination prevented 21% of hospitalizations in the population aged 65 and more, and 18.5% in the population with chronic conditions. The vaccination also prevented 29% and 19.5% of deaths in each group of the high-risk population. It would be needed to vaccinate 3360 high-risk individuals, to prevent one hospitalization and 60,471 high-risk individuals to prevent one death. Conclusion The yearly influenza vaccination campaigns had a sustained positive benefit for the high-risk population, reducing hospitalizations and deaths. These results can support public health plans toward increased vaccine coverage in high-risk groups.

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