Monitoring sociodemographic inequality in COVID-19 vaccination coverage in England: a national linked data study

Background: The UK began an ambitious COVID-19 vaccination programme on 8th December 2020. This study describes variation in vaccination coverage by sociodemographic characteristics between December 2020 and August 2021. Methods: Using population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics amongst adults aged 18 years or over in England. We also present a tool to display the results interactively. Findings: Our study population included 35,223,466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18-59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged ≥80 years) and Black Caribbeans (18-79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socio-economic group, and had fewer qualifications. Interpretation: We found inequalities in COVID-19 vaccination rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socio-economic position, and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.

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P033 POPULATION-LEVEL HPV VACCINATION COVERAGE AMONG U.S. ADULT IBD PATIENTS: STILL NOT ENOUGH

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.167 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S65-S65

Author(s):

Ryan Suk ◽

Heetae Suk ◽

Keith Sigel ◽

Kalyani Sonawane ◽

Ashish Deshmukh

Keyword(s):

Vaccination Coverage ◽

Hpv Vaccine ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Age Groups ◽

Population Level ◽

Vaccine Uptake ◽

Population Estimate ◽

Age Group ◽

Old Patients

Abstract Background Evidence suggests that the inflammatory bowel disease (IBD) patients may have an elevated risk of Human papillomavirus (HPV)-associated cancers when compared with those without IBD. HPV vaccination has been recommended for 11 to 26 years old males and females. Recently, the Centers for Disease Control and Prevention (CDC) has updated the guideline to include adults aged 27 to 45 who are not adequately vaccinated. To the best of our knowledge, population-level HPV vaccine uptake rates among patients with IBD remains unknown. Methods We used 2015–2016 National Health Information Survey (NHIS) data to assess the HPV vaccination coverage among people with IBD in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. Then we stratified the patients into two age groups: HPV-vaccine eligible age group (age 18–26) and newly approved age group (age 27–45). Our outcome was vaccine coverage status assessed as vaccine initiation age and number of doses. When the initiation age was less than 15, two doses were defined as “completed” and when the age was 15 and older, three doses were defined as “completed”. When the participants had initiated the vaccine but have not completed all the required doses according to their initiation age, it was defined as “incomplete” while no dose was defined as “no vaccine”. We estimated the coverage rate by age group and sex. We used Wald chi-square test to examine differences in completion rate by sex. Results We identified 951 participants (population estimate: 3,121,387) who self-reportedly had IBD. Among those, 51 persons (population estimate: 191,830) were HPV vaccine-eligible aged and 219 persons (population estimate: 859,711) were newly approved aged. Only 3.2% men while 63.2% of eligible women completed vaccination series as recommended. Eligible men had higher rates of incompletion compared to women (13.8% vs 1.3%). A higher proportion of vaccine-eligible men (83.0%) did not initiate the HPV vaccine compared to women (35.5%) (p=0.001). Among the newly approved age group, only 0.5% of men completed vaccine and 1.3% did not complete their doses. In women, 2.3% was complete with the doses and 9.6% initiated but did not complete the vaccine (p <0.001). Conclusion IBD patients might greatly benefit from receiving HPV vaccination given the possibly high risk of HPV-associated cancers. However, the coverage for vaccine-eligible IBD patients was not enough and much lower than the goal of 80% coverage in Healthy People 2020. Moreover, according to the updated guideline, 27 to 45 years old patients who are not adequately vaccinated would be able to catch up their vaccination. Further study needs to be focused on promoting and informing HPV vaccination in IBD patients, for both currently vaccine-eligible patients and those who are aged between 27 and 45 and not adequately vaccinated.

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Association of COVID-19 mortality with COVID-19 vaccination rates in Rhineland-Palatinate (Germany) from calendar week 1 to 20 in the year 2021: a registry-based analysis

European Journal of Epidemiology ◽

10.1007/s10654-021-00825-6 ◽

2021 ◽

Author(s):

Daniel Wollschläger ◽

Emilio Gianicolo ◽

Maria Blettner ◽

Ruben Hamann ◽

Nils Herm-Stapelberg ◽

...

Keyword(s):

Vaccination Coverage ◽

Vaccination Campaign ◽

Population Level ◽

Federal State ◽

Age Group ◽

Vaccination Rates ◽

Percentage Points ◽

Real World Evidence ◽

Vaccination Campaigns ◽

Positive Results

AbstractVaccination is among the measures implemented by authorities to control the spread of the COVID-19 pandemic. However, real-world evidence of population-level effects of vaccination campaigns against COVID-19 are required to confirm that positive results from clinical trials translate into positive public health outcomes. Since the age group 80 + years is most at risk for severe COVID-19 disease progression, this group was prioritized during vaccine rollout in Germany. Based on comprehensive vaccination data from the German federal state of Rhineland-Palatinate for calendar week 1–20 in the year 2021, we calculated sex- and age-specific vaccination coverage. Furthermore, we calculated the proportion of weekly COVID-19 fatalities and reported SARS-CoV-2 infections formed by each age group. Vaccination coverage in the age group 80 + years increased to a level of 80% (men) and 75% (women). Increasing vaccination coverage coincided with a reduction in the age group’s proportion of COVID-19 fatalities. In multivariable logistic regression, vaccination coverage was associated both with a reduction in an age-group’s proportion of COVID-19 fatalities [odds ratio (OR) per 5 percentage points = 0.89, 95% confidence interval (CI) = 0.82–0.96, p = 0.0013] and of reported SARS-CoV-2 infections (OR per 5 percentage points = 0.82, 95% CI 0.76–0.88, p < 0.0001). The results are consistent with a protective effect afforded by the vaccination campaign against severe COVID-19 disease in the oldest age group.

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Sociodemographic Analysis of Neural Tuberculosis in Brazil from 2010 to 2020

10.5327/1516-3180.501 ◽

2021 ◽

Author(s):

Raissa Barreto Lima ◽

Thaís Machado Belitardo de Carvalho ◽

Matheus Campos Ribeiro de Souza ◽

Lara Teixeira de Oliveira ◽

Ana Carolina Pachêco de Menezes Rios ◽

...

Keyword(s):

Information System ◽

Extrapulmonary Tuberculosis ◽

Age Groups ◽

Severe Form ◽

Sociodemographic Characteristics ◽

Age Group ◽

The South ◽

Cross Sectional ◽

Prevention And Health Promotion ◽

Using Data

Background: Neural tuberculosis is an infection of the central nervous system caused by the bacterium Mycobacterium tuberculosis. Bearing in mind that neural tuberculosis is the most severe form of extrapulmonary tuberculosis and results in significant morbidity and mortality rates, it is important to analyze its sociodemographic characteristics in Brazil. Objectives: To describe the sociodemographic characteristics of neural tuberculosis cases in Brazil in the period from 2010 to 2020. Design and Setting: Cross-sectional, retrospective, and descriptive study, carried out using data collected from the Notifiable Diseases Information System (SINAN) and the Hospital Information System (SIH / SUS) of confirmed cases and hospitalizations for neural tuberculosis. Methods: Variables used: region, sex, age group, color/race and year of service. Results: In the period from 2010 to 2020, the number of notified cases of meningoencephalic tuberculosis was 7.451, with mean cases per year of 677.36. The Southeast region was the most affected with 43.8% of the total cases, followed by the South and Northeast regions, with 24.1% and 20.1%, respectively. There was a wide predominance in individuals aged 30-39 years (42.8%) and in the age group 40-59 years (35.9%). The male sex was the most affected with 63.3% of the total. Conclusions: The study shows a predominance of cases in the South and Southeast regions, with a significant prevalence of males and age groups of 20- 59. This could be an alert for new prevention and health promotion strategies for the most affected groups.

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Character introductions in oral narratives of Swedish–German bilingual preschoolers

First Language ◽

10.1177/0142723719897440 ◽

2020 ◽

pp. 014272371989744

Author(s):

Josefin Lindgren ◽

Valerie Reichardt ◽

Ute Bohnacker

Keyword(s):

Language Proficiency ◽

Language Skills ◽

Age Groups ◽

Age Group ◽

Morphological Form ◽

Information Status ◽

Significant Difference ◽

Old Swedish ◽

As Effects ◽

Two Age Groups

Closely related Swedish and German both mark information status of referents morphologically, though little is known about its acquisition. This study investigates character introductions in the narratives of 4- and 6-year-old Swedish–German bilinguals ( N = 40) in both languages, elicited with MAIN Cat/Dog. We analyse effects of age group, language and animacy (human vs nonhuman characters) on the type of referring expression (indefinite NP and pronoun), as well as effects of language proficiency and exposure on the use of indefinite NPs for each language. We also explore which syntactic constructions indefinite NPs occur in. A significant difference was found between the two age groups, but not between languages. No effect was found of language skills or exposure. Four-year-olds used more pronouns and a lower proportion of indefinite NPs than 6-year-olds. Pronouns were more frequent for the human character than for nonhuman animate characters. Whilst animacy (humanness) promoted the use of pronouns, it did not affect the choice of morphological form for lexical NPs (indefinite/definite). The age groups differed in how indefinite NPs were used. Four-year-olds produced fewer narrative presentations (where a character is introduced as part of a typical story opening, e.g. Once upon a time there was a cat) than 6-year-olds, and more labellings (with only an NP, or a clausal predicative, e.g. That’s a cat). Qualitative analyses suggest that the children’s indefinite NPs in labelling constructions can be both referential (when setting the narrative scene), and type-denoting (when naming referents in individual pictures). Whilst the children’s abilities to introduce story characters develop measurably from 4 to 6 years in Swedish and German, appropriateness of character introductions not only depends on whether an indefinite NP is chosen, but also on the syntactic construction this indefinite NP is used in.

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Assessing disparities in engagement in a post-discharge virtual visit follow-up program.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.100 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 100-100

Author(s):

Abdullateef Abdulkareem ◽

Nathan Handley ◽

Samantha Burdette ◽

Adam Binder

Keyword(s):

Socioeconomic Status ◽

Language Proficiency ◽

English Language ◽

Urban Setting ◽

Transitions Of Care ◽

Area Deprivation ◽

Patient Portal ◽

Post Discharge ◽

The Impact

100 Background: Transitions of care are a frequent focus of quality improvement initiatives. In attempt to improve upon the transitions of care for oncology patients, our institution implemented a post discharge virtual visit follow-up program. Previous studies have suggested that socioeconomic status impacts engagement in technology based interventions. Herein, we report the impact of socio-economic status based on area deprivation index (ADI) on engagement with the program. Methods: All patients admitted to the elective chemotherapy service were included. Retrospective analysis of characteristics of each participant was conducted. Data included eligibility (access to the internet, appropriate device, English language proficiency, ability to set up video visit and a patient portal account) for video visit, interest in participating, completion of the visit and any interventions performed during the visit. In addition, ADI was calculated for each individual. Patients were classified into quartiles based on ADI (quartiles increased with ADI). Chi squared testing was performed to assess whether socioeconomic status affected enrollment in video visits. Simple descriptive analysis was also performed. Results: One hundred seven unique patients were included for review. Of these, 33 (31%), 39 (36%), 16 (15%) and 19 (18%) were in quartile(Q) 1, 2, 3 and 4 respectively. Eligibility per quartile was 29 (88%), 34(87%), 13(81%), and 15(83%). ADI quartile did not significantly affect virtual visit eligibility (p = .50). A total of 91 patients (85%) were eligible for video visits; of these, 46 patients declined. Of the 46 patients that declined 9 (19%), 20 (43%), 8 (17%), and 9 (19%) were in Q1, Q2, Q3 and Q4 respectively. Fifteen patients cited technology issues as reasons for declining telehealth visits - 10 (67%) from Q1 and Q2 and 5 (33%) from Q3 and Q4. The vast majority cited lack of interest as reason for declining. Conclusions: ADI as a measure of socioeconomic status did not significantly affect eligibility for or enrollment in video visits. This may be explained by more ubiquitous access to internet services in a large urban setting. Current research is currently being conducted to understand patient barriers to engagement in virtual visits.

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Measles elimination and immunisation: national surveillance trends in Japan, 2008–2015

Epidemiology and Infection ◽

10.1017/s0950268817001248 ◽

2017 ◽

Vol 145 (11) ◽

pp. 2374-2381 ◽

Cited By ~ 7

Author(s):

S. INAIDA ◽

S. MATSUNO ◽

F. KOBUNE

Keyword(s):

Incidence Rate ◽

Vaccination Coverage ◽

Age Groups ◽

Incidence Rates ◽

Natural Immunity ◽

Age Group ◽

Virus Genotype ◽

Measles Elimination ◽

Major Outbreak ◽

Catch Up

SUMMARYMeasles elimination relies on vaccination programmes. In Japan, a major outbreak started in 2007. In response, 5-year two-dose catch-up vaccination programme was initiated in April 2008 for children 13–16-years-old. In this study, we analysed the epidemic curves, incidence rates for each age group, virus genotype, vaccination coverage and ratio of measles gelatin particle agglutination (PA) antibody using surveillance data for 2008–2015.Monthly case counts markedly decreased as vaccination coverage increased. D5, which is the endemic virus type, disappeared after 2011, with the following epidemic caused by imported viruses. Most cases were confirmed to have a no-dose or single-dose vaccination status. Although the incidence rate among all age groups ⩾5-years-old decreased during the study period, for children <5-years-old, the incidence rate remained relatively high and increased in 2014. The ratio of PA antibody (⩾1:128 titres) increased for the majority of age groups, but with a decrease for specific age groups: the 0–5 months and the 2–4, 14, 19 and most of the 26–55- and the 60-year-old groups (−1 to −9%). This seems to be the result of higher vaccination coverage, which would result in decreasing natural immunity booster along with decreasing passive immunity in infants whose mothers did not have the natural immunity booster. The 20–29- and 30–39-year-old age groups had higher number of cases, suggesting that vaccination within these age groups might be important for eliminating imported viruses.

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Context-specific complementary feeding recommendations developed using Optifood could improve the diets of breast-fed infants and young children from diverse livelihood groups in northern Kenya

Public Health Nutrition ◽

10.1017/s1368980016003116 ◽

2016 ◽

Vol 20 (6) ◽

pp. 971-983 ◽

Cited By ~ 11

Author(s):

Marieke Vossenaar ◽

Frances A Knight ◽

Alison Tumilowicz ◽

Christine Hotz ◽

Peter Chege ◽

...

Keyword(s):

Young Children ◽

Complementary Feeding ◽

Age Groups ◽

Population Level ◽

Age Group ◽

Northern Kenya ◽

Pastoralist Communities ◽

Context Specific ◽

Breast Fed ◽

Infants And Young Children

AbstractObjectiveTo formulate age- and context-specific complementary feeding recommendations (CFR) for infants and young children (IYC) and to compare the potential of filling population-level nutrient gaps using common sets of CFR across age groups.DesignLinear programming was used to develop CFR using locally available and acceptable foods based on livelihood- and age-group-specific dietary patterns observed through 24 h dietary recalls. Within each livelihood group, the nutrient potential of age-group-specific v. consolidated CFR across the three age groups was tested.SettingThree food-insecure counties in northern Kenya; namely, settled communities from Isiolo (n 300), pastoralist communities from Marsabit (n 283) and agro-pastoralist communities from Turkana (n 299).SubjectsBreast-fed IYC aged 6–23 months (n 882).ResultsAge-specific CFR could achieve adequacy for seven to nine of eleven modelled micronutrients, except among 12–23-month-old children in agro-pastoralist communities. Contribution of Fe, Zn and niacin remained low for most groups, and thiamin, vitamin B6 and folate for some groups. Age-group-consolidated CFR could not reach the same level of nutrient adequacy as age-specific sets among the settled and pastoralist communities.ConclusionsContext- and age-specific CFR could ensure adequate levels of more modelled nutrients among settled and pastoralist IYC than among agro-pastoralist communities where use of nutrient-dense foods was limited. Adequacy of all eleven modelled micronutrients was not achievable and additional approaches to ensure adequate diets are required. Consolidated messages should be easier to implement as part of a behaviour change strategy; however, they would likely not achieve the same improvements in population-level dietary adequacy as age-specific CFR.

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Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1258 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Marrella ◽

A Casuccio ◽

E Amodio ◽

F Vitale

Keyword(s):

Vaccination Coverage ◽

Age Groups ◽

Incidence Rates ◽

Varicella Vaccination ◽

Age Group ◽

Annual Percent Change ◽

High Coverage ◽

Joint Point ◽

Hospitalization Rates ◽

The Impact

Abstract Introduction The present study summarizes evidences of the impact of varicella vaccination (VV) on hospitalization rates attributable to this infectious disease in Italy. Methods We have carried out a retrospective observational study that analysed hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Health Ministry. All hospitalizations with the presence of an ICD-9 CM 059.X code in the principal diagnosis or in any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis. Results Hospitalization rates showed a decreasing risk by age: children aged <1 year were the most affected age group in each region (42.56/100,000 per year), whereas lower incidence rates were found in older age groups (23.76/100,000 in 1 to 5 years age group and <4/100,000 in the following groups). Varicella hospitalization rates decreased significantly after the introduction of VV (3.42 vs. 2.67 per 100,000; P < 0.001). During the first five years after vaccination introduction hospitalization rates showed a statistically significant decrease especially for infants aged <1 year (AAPC -34.98%; p < 0.001) and 1 to 5 years old (AAPC -35.22%; P < 0.01). VV coverage was strongly correlated with hospitalization rates decrease over each paediatric age group (R-squared 0.38 in aged <1 year, p < 0.001; 0.71 in 1 to 5 years old, p < 0.001; 0.93 in 6 to 14 years old, p < 0.0001). Conclusions All the previously reported findings confirm that hospitalization rates are strictly related to both the number of years since vaccination introduction and the vaccination coverage. VV confirms to be an important step in public health strategies and the introduction of universal vaccination, with high vaccination coverage, should be considered as an extremely powerful tool for reducing the risk of complications. Key messages This study adds update findings to the literature and shows that varicella hospitalizations in Italy, from 2003 to 2018, have reduced their burden, that was high in years before varicella vaccination. Varicella vaccination introduction and high coverage are powerful tools for reducing the risk of varicella complications and related hospitalizations in the general population.

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Change in age distribution of COVID-19 deaths with the introduction of COVID-19 vaccination

10.1101/2021.07.20.21260842 ◽

2021 ◽

Author(s):

Roberta Pastorino ◽

Angelo Maria Pezzullo ◽

Leonardo Villani ◽

Francesco Andrea Causio ◽

Cathrine Axfors ◽

...

Keyword(s):

Age Distribution ◽

Age Groups ◽

Prevalence Ratio ◽

Population Level ◽

Vaccination Programs ◽

Vaccination Rates ◽

Elderly Populations ◽

The Difference ◽

Age Independent ◽

Vaccination Period

Background. Most countries initially deployed COVID-19 vaccines preferentially in elderly populations. Population-level vaccine effectiveness may be heralded by an increase in the proportion of deaths among non-elderly populations that were less covered by vaccination programs. Methods. We collected data from 40 countries on age-stratified COVID-19 deaths during the vaccination period (1/14/2021-5/31/2021) and two control periods (entire pre-vaccination period and excluding the first wave). We meta-analyzed the proportion of deaths in different age groups in vaccination versus control periods in countries with low vaccination rates; (2) countries with age-independent vaccination policies; and (3) countries with standard age-dependent vaccination policies. Findings. Countries that prioritized vaccination among older people saw an increasing share of deaths among 0-69 year old people in the vaccination versus the two control periods (summary prevalence ratio 1.32 [95 CI% 1.24-1.41] and 1.35 [95 CI% 1.26-1.44)]. No such change was seen on average in countries with age-independent vaccination policies (1.05 [95 CI% 0.78-1.41 and 0.97 [95 CI% 0.95- 1.00], respectively) and limited vaccination (0.93 [95 CI% 0.85-1.01] and 0.95 [95 CI% 0.87-1.03], respectively). Prevalence ratios were associated with the difference of vaccination rates in elderly versus non-elderly people. No significant changes occurred in the share of deaths in age 0-49 among all 0-69 deaths in the vaccination versus pre-vaccination periods. Interpretation. The substantial shift in the age distribution of COVID-19 deaths in countries that rapidly implemented vaccination predominantly among elderly may herald the population level-effectiveness of COVID-19 vaccination and a favorable evolution of the pandemic towards endemicity with fewer elderly deaths. Funding. This study received no specific funding.

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Massive diphtheria outbreak in South Asia: an epidemiological evidence review and lesson learnt

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20205734 ◽

2020 ◽

Vol 8 (1) ◽

pp. 439

Author(s):

Shamsal M. Islam ◽

Salim M. Chowdhury ◽

Mahfuz A. ◽

Bimal C. Das ◽

Reza M. ◽

...

Keyword(s):

South Asia ◽

Vaccination Coverage ◽

Large Scale ◽

English Language ◽

Age Groups ◽

Living Environment ◽

Refugee Camps ◽

Evidence Review ◽

Low Coverage ◽

And Control

Vaccination is to be considerd as one of the most well-known economically viable medical procedures to prevent massive diphtheria outbreaks happening in recent times. Under this circumstance, the available data on diphtheria and vaccination coverage of three South Asian countries is warranted. The published English-language literature between January 2007 and January 2019 was retrieved from search results in eight highly resourceful journal databases using the specific terms. A massive diphtheria outbreak was occurred in refugee camps in Cox Bazar, a harbour city in Bangladesh, between November 2017 and March 2019. A total of 8641 diphtheria case-patients were reported including 45 deaths in the refugee camps. Our synthesis data shows that there is a gap of immunity which creates a large scale of potentiality for a new pandemic for adult couples along with children. The DTP3 coverage in India and Myanmar is less than 90% and these two countries had no standard coverage of DTP3 dose. We concluded that the massive outbreak of diphtheria in South Asia normally occurred due to low coverage of vaccination or incomplete vaccination. Crowded living environment, low socio-economic conditions, cultural belief, and importation of microorganisms are considered for massive outbreak of diphtheria outbreaks. Community-based awareness program and vaccinating individuals and some cases revaccination of older age groups are needed to stop further transmission and control the diphtheria outbreaks in South Asia. Further research is required to fully assess the vaccination coverage in the stateless populations in this region.

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