scholarly journals Vaccination as an Alternative to Non-Drug Interventions to Prevent Local Resurgence of COVID-19

2021 ◽  
Author(s):  
Jinhua Pan ◽  
Wenlong Zhu ◽  
Jie Tian ◽  
Zhixi Liu ◽  
Ao Xu ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Transmission Rate ◽  
Vaccination Strategy ◽  
Risk Groups ◽  
Vaccine Effectiveness ◽  
Sensitivity Analyses ◽  
Random Fluctuation ◽  
Epidemic Curve ◽  
Fluctuation Effects ◽  
Drug Interventions

Abstract Background While a COVID-19 vaccine protects people from serious illness and death, it remains concern when and how to relax from the high cost strict non-pharmaceutical interventions (NPIs). Methods We developed a stochastic calculus model to identify the level of vaccine coverage that would allow safe relaxation of NPIs, and the vaccination strategies that can best achieve this level of coverage. We applied Monto Carlo simulations more than 10,000 times to remove random fluctuation effects and obtain fitted/predicted epidemic curve based on various parameters with 95% confidence interval (95% CI) at each time point. Results We found that a vaccination coverage of 50.42% was needed for the safe relaxation of NPIs, if the vaccine effectiveness was 79.34%. However, with the increasing of variants transmissibility and the decline of vaccine effectiveness for variants, the threshold for lifting NPIs would be higher. We estimated that more than 8 months were needed to achieve the vaccine coverage threshold in the combination of accelerated vaccination strategy and key groups firstly strategy. Conclusion If there are sufficient doses of vaccine then an accelerated vaccination strategy should be used, and if vaccine supply is insufficient then high-risk groups should be targeted for vaccination first. Sensitivity analyses results shown that the higher the transmission rate of the virus and the lower annual vaccine supply, the more difficult the epidemic could be under control. In conclusion, as vaccine coverage improves, the NPIs can be gradually relaxed. Until that threshold is reached, however, strict NPIs are still needed to contain the epidemic. The more transmissible SARS-CoV-2 variant lead to higher resurgence probability, which indicates the importance of accelerated vaccination and achieving the vaccine coverage earlier. Trial registration We did not involve clinical trial.

scholarly journals Dynamics of the COVID-19 epidemic in Ireland under mitigation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernard Cazelles ◽  
Benjamin Nguyen-Van-Yen ◽  
Clara Champagne ◽  
Catherine Comiskey
Keyword(s):  
Transmission Rate ◽  
Vaccination Campaign ◽  
Virus Transmission ◽  
Reporting Rate ◽  
Mitigation Measures ◽  
Third Wave ◽  
The European Union ◽  
Hospital Data ◽  
Prevalence Survey ◽  
Epidemic Curve

Abstract Background In Ireland and across the European Union the COVID-19 epidemic waves, driven mainly by the emergence of new variants of the SARS-CoV-2 have continued their course, despite various interventions from governments. Public health interventions continue in their attempts to control the spread as they wait for the planned significant effect of vaccination. Methods To tackle this challenge and the observed non-stationary aspect of the epidemic we used a modified SEIR stochastic model with time-varying parameters, following Brownian process. This enabled us to reconstruct the temporal evolution of the transmission rate of COVID-19 with the non-specific hypothesis that it follows a basic stochastic process constrained by the available data. This model is coupled with Bayesian inference (particle Markov Chain Monte Carlo method) for parameter estimation and utilized mainly well-documented Irish hospital data. Results In Ireland, mitigation measures provided a 78–86% reduction in transmission during the first wave between March and May 2020. For the second wave in October 2020, our reduction estimation was around 20% while it was 70% for the third wave in January 2021. This third wave was partly due to the UK variant appearing in Ireland. In June 2020 we estimated that sero-prevalence was 2.0% (95% CI: 1.2–3.5%) in complete accordance with a sero-prevalence survey. By the end of April 2021, the sero-prevalence was greater than 17% due in part to the vaccination campaign. Finally we demonstrate that the available observed confirmed cases are not reliable for analysis owing to the fact that their reporting rate has as expected greatly evolved. Conclusion We provide the first estimations of the dynamics of the COVID-19 epidemic in Ireland and its key parameters. We also quantify the effects of mitigation measures on the virus transmission during and after mitigation for the three waves. Our results demonstrate that Ireland has significantly reduced transmission by employing mitigation measures, physical distancing and lockdown. This has to date avoided the saturation of healthcare infrastructures, flattened the epidemic curve and likely reduced mortality. However, as we await for a full roll out of a vaccination programme and as new variants potentially more transmissible and/or more infectious could continue to emerge and mitigation measures change silent transmission, challenges remain.

scholarly journals Impact of public health interventions to curb SARS-CoV-2 spread assessed by an evidence-educated Delphi panel and tailored SEIR model

2021 ◽  
Author(s):  
Bernd Brüggenjürgen ◽  
Hans-Peter Stricker ◽  
Lilian Krist ◽  
Miriam Ortiz ◽  
Thomas Reinhold ◽  
...  
Keyword(s):  
Public Health ◽  
Transmission Rate ◽  
Latency Period ◽  
Policy Decision ◽  
Sensitivity Analyses ◽  
Delphi Panel ◽  
Time Step ◽  
Seir Model ◽  
Health Policy Decision ◽  
The Impact

Abstract Aim To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). Methods We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. Conclusion Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures.

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.

scholarly journals Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study

BMJ ◽  
2021 ◽  
pp. n1087
Author(s):  
Santiago Romero-Brufau ◽  
Ayush Chopra ◽  
Alex J Ryu ◽  
Esma Gel ◽  
Ramesh Raskar ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Vaccination Strategy ◽  
Population Based ◽  
Agent Based Modeling ◽  
Sensitivity Analyses ◽  
Agent Based ◽  
Cumulative Mortality ◽  
Vaccination Rates ◽  
Dose Strategy ◽  
Modeling Study

AbstractObjectiveTo estimate population health outcomes with delayed second dose versus standard schedule of SARS-CoV-2 mRNA vaccination.DesignSimulation agent based modeling study.SettingSimulated population based on real world US county.ParticipantsThe simulation included 100 000 agents, with a representative distribution of demographics and occupations. Networks of contacts were established to simulate potentially infectious interactions though occupation, household, and random interactions.InterventionsSimulation of standard covid-19 vaccination versus delayed second dose vaccination prioritizing the first dose. The simulation runs were replicated 10 times. Sensitivity analyses included first dose vaccine efficacy of 50%, 60%, 70%, 80%, and 90% after day 12 post-vaccination; vaccination rate of 0.1%, 0.3%, and 1% of population per day; assuming the vaccine prevents only symptoms but not asymptomatic spread (that is, non-sterilizing vaccine); and an alternative vaccination strategy that implements delayed second dose for people under 65 years of age, but not until all those above this age have been vaccinated.Main outcome measuresCumulative covid-19 mortality, cumulative SARS-CoV-2 infections, and cumulative hospital admissions due to covid-19 over 180 days.ResultsOver all simulation replications, the median cumulative mortality per 100 000 for standard dosing versus delayed second dose was 226 v 179, 233 v 207, and 235 v 236 for 90%, 80%, and 70% first dose efficacy, respectively. The delayed second dose strategy was optimal for vaccine efficacies at or above 80% and vaccination rates at or below 0.3% of the population per day, under both sterilizing and non-sterilizing vaccine assumptions, resulting in absolute cumulative mortality reductions between 26 and 47 per 100 000. The delayed second dose strategy for people under 65 performed consistently well under all vaccination rates tested.ConclusionsA delayed second dose vaccination strategy, at least for people aged under 65, could result in reduced cumulative mortality under certain conditions.

Vaccine effectiveness of Pfizer-BioNTech and Oxford-AstraZeneca to prevent severe COVID-19 in Costa Rica: A nationwide, observational study of hospitalizations prevalence (Preprint)

2021 ◽  
Author(s):  
Luis Rosero-Bixby
Keyword(s):  
Single Dose ◽  
Costa Rica ◽  
Observational Study ◽  
Real World ◽  
Vaccine Coverage ◽  
Secondary Analysis ◽  
Vaccine Effectiveness ◽  
Costa Rican ◽  
Vaccination Program ◽  
Severe Illness

BACKGROUND The Costa Rican vaccination program uses Pfizer-BioNTech and Oxford-AstraZeneca vaccines. Real-world estimates of these vaccines effectiveness to prevent hospitalizations range from 90% to 98% for two doses and from 70% to 91% for a single dose. Almost all of these estimates predate the Delta variant. OBJECTIVE To estimate the dose-dependent effectiveness of coronavirus disease (COVID-19) vaccines to prevent severe illness in real-world conditions of Costa Rica, after the Delta variant became dominant. METHODS This observational study is a secondary analysis of hospitalizations prevalence. The participants are all 3.67 million adults residents in Costa Rica by mid-2021. The study is based on public aggregated data of 5978 COVID-19-related hospital records from 14th September to 20th October, 2021 and 6.1 million vaccination doses administered to determine hospitalization prevalence by dose-specific vaccination status. The intervention retrospectively evaluated is vaccination with Pfizer-BioNTech (78%) and Oxford-AstraZeneca (22%). The main outcome studied is being hospitalized. RESULTS Vaccine effectiveness to prevent hospitalization (VEH) was estimated as 93.4% (95% confidence interval [CI]: 93.0 to 93.9) for complete vaccination and 76.7% (CI: 75.0 to 78.3) for single-dose vaccination among adults of all ages. VEH was lower and more uncertain among older adults aged 58 years and above: 92% (CI: 91% to 93%) for those who had received full vaccination and 64% (CI: 58% to 69%) for those who had received partial vaccination. Single-dose VEH declined over time during the study period, especially in the older age group. Estimates were sensitive to possible errors in the population count used to determine the residual number of unvaccinated people when vaccine coverage is high. CONCLUSIONS The Costa Rican vaccination program that administered Pfizer and Oxford vaccines are highly effective to prevent COVID-19-related hospitalizations after the Delta variant had become dominant. Moreover, a single dose is reasonably effective, justifying the continuation of the national policy of postponing the application for the second dose of the Pfizer vaccine to accelerate the vaccination and increase the number of people being vaccinated. Timely monitoring of vaccine effectiveness is important to detect eventual failures and motivate the public based on information that the vaccinations are effective.

scholarly journals Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Campaign in Borno State, Nigeria, 2019

2020 ◽  
Author(s):  
Anne Eudes Jean Baptiste ◽  
John Wagai ◽  
Richard Ray Luce ◽  
Balcha Girma Masresha ◽  
Don Klinkenberg ◽  
...  
Keyword(s):  
Vaccination Campaign ◽  
Screening Method ◽  
Population Level ◽  
Vaccine Effectiveness ◽  
Sensitivity Analyses ◽  
Outbreak Response ◽  
Internally Displaced ◽  
Complex Emergency ◽  
Campaign Coverage ◽  
Measles Outbreaks

Abstract Background: From January to May 2019, large measles outbreaks affected Nigeria. Borno state was the most affected, recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 cases investigated and line-listed by March 2019. In Borno state, 22 of the 27 Local Government Areas (LGAs or Districts), including 37 internally displaced persons (IDPs) camps were affected. In response to the situation, an outbreak response immunization (ORI) campaign was conducted in the 13 most affected LGAs. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the outbreak and the ORI campaign. We also assess the measles-containing vaccine (MCV) coverage and vaccine effectiveness (VE) in order to quantify the population-level impactMethods: We reviewed the ORI activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We assessed VE of MCV by applying the screening-method. Sensitivity analyses were also conducted to assess the effect of final classification of cases on the VE of MCV. The MCV coverage was assessed by a post-campaign coverage survey (PCCS) after completion of the ORI through a quantitative survey in the 12 LGAs that were accessible. . Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles by week 9 of 2019. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The overall VE for MCV was 98.4 (95%CI: 97.8 – 98.8). No significant differences were observed in the VE estimates of lab-confirmed and epi-linked cases when compared to the original estimates. The aggregated weighted vaccination coverage was 85.7% (95% CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergency affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

scholarly journals The Public Health Impact of Delaying a Second Dose of the BNT162b2 or mRNA-1273 COVID-19 Vaccine

2021 ◽  
Author(s):  
Santiago Romero-Brufau ◽  
Ayush Chopra ◽  
Alex J Ryu ◽  
Esma Gel ◽  
Ramesh Raskar ◽  
...  
Keyword(s):  
Vaccination Strategy ◽  
Population Level ◽  
Health Impact ◽  
Vaccination Rate ◽  
Agent Based Modeling ◽  
Sensitivity Analyses ◽  
Agent Based ◽  
Cumulative Mortality ◽  
Vaccination Rates ◽  
The Public

AbstractObjectivesTo estimate population health outcomes under delayedsecond dose versus standard schedule SARS-CoV-2 mRNA vaccination.DesignAgent-based modeling on a simulated population of 100,000 based on a real-world US county. The simulation runs were replicated 10 times. To test the robustness of these findings, simulations were performed under different estimates for single-dose efficacy and vaccine administration rates, and under the possibility that a vaccine prevents only symptoms but not asymptomatic spread.Settingpopulation level simulation.Participants100,000 agents are included in the simulation, with a representative distribution of demographics and occupations. Networks of contacts are established to simulate potentially infectious interactions though occupation, household, and random interactionsInterventionswe simulate standard Covid-19 vaccination, versus delayed-second-dose vaccination prioritizing first dose. Sensitivity analyses include first-dose vaccine efficacy of 70%, 80% and 90% after day 12 post-vaccination; vaccination rate of 0.1%, 0.3%, and 1% of population per day; assuming the vaccine prevents only symptoms but not asymptomatic spread; and an alternative vaccination strategy that implements delayed-second-dose only for those under 65 years of age.Main outcome measurescumulative Covid-19 mortality over 180 days, cumulative infections and hospitalizations.ResultsOver all simulation replications, the median cumulative mortality per 100,000 for standard versus delayed second dose was 226 vs 179; 233 vs 207; and 235 vs 236; for 90%, 80% and 70% first-dose efficacy, respectively. The delayed-second-dose strategy was optimal for vaccine efficacies at or above 80%, and vaccination rates at or below 0.3% population per day, both under sterilizing and non-sterilizing vaccine assumptions, resulting in absolute cumulative mortality reductions between 26 and 47 per 100,000. The delayed-second-dose for those under 65 performed consistently well under all vaccination rates tested.ConclusionsA delayed-second-dose vaccination strategy, at least for those under 65, could result in reduced cumulative mortality under certain conditions.

scholarly journals Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years

2009 ◽  
Vol 14 (35) ◽  
Author(s):  
G Giammanco ◽  
S Ciriminna ◽  
I Barberi ◽  
L Titone ◽  
M Lo Giudice ◽  
...  
Keyword(s):  
Vaccination Programme ◽  
Vaccine Coverage ◽  
Varicella Vaccine ◽  
Age Groups ◽  
Vaccination Strategy ◽  
Paediatric Population ◽  
Incidence Rates ◽  
Universal Vaccination ◽  
Varicella Vaccination ◽  
Local Health

Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence. Overall, the programme achieved its target, with 87.5% vaccine coverage for the birth cohort 2005 and 90.2% for adolescents born in 1995 and 1996. Varicella surveillance data obtained from a total of 28,188 children (0-14 years-old) monitored by family paediatricians showed a decline in incidence rates from 95.7 (95% confidence interval (CI): 72.2-126.8) for 1,000 person-years (PY) in 2004 to 9.0 (95% CI: 6.4-12.6) for 1,000 PY in 2007. In Europe, the only similar experience is the routine childhood varicella vaccination programme in Germany that started in 2004 with a single dose at the age of 11-14 months. The two-cohort universal vaccination programme implemented in Sicily, as well as the network for the surveillance study, can offer a model to other European countries that are considering introducing universal childhood varicella vaccination.

scholarly journals Rubella outbreak in Poland in 2013 – an analysis of surveillance data at the national and province level

2015 ◽  
Vol 125 (2) ◽  
pp. 65-71
Author(s):  
Dorota Mrozek-Budzyn ◽  
Renata Majewska ◽  
Agnieszka Kiełtyka ◽  
Małgorzata Augustyniak
Keyword(s):  
Incidence Rate ◽  
Vaccination Coverage ◽  
Vaccine Coverage ◽  
Clinical Signs ◽  
Vaccination Strategy ◽  
Disease Outbreak ◽  
Surveillance Data ◽  
Good Time ◽  
Adult Males ◽  
Laboratory Confirmation

Abstract Introduction. Poland is a member of the WHO European Region where a complete eradication of measles and rubella is planned to be finished by 2015. Poland accounted for 99% of all reported rubella cases in 27 EU/EEA countries in 2013. It is a good time to evaluate whether the established Polish vaccination strategy was sufficient to reach the goal of rubella elimination in the near future. Aim. The aim of this study was to analyze the epidemiology of rubella in Poland when the disease outbreak took place in 2013, to determine the reasons of that situation and to find the solution for future rubella elimination strategies. Material and methods. To analyze the epidemiology of rubella in Poland during the disease outbreak in 2013 the authors used rubella surveillance data collected by the Provincial and National Notifiable Disease Reporting System in 2004-2013. The information at the provincial level derived from one of the 16 provinces (Malopolska). The data on MMR vaccination coverage in 2003-2012 derived from the National Surveillance System. The percentages of rubella cases and vaccine coverage between Poland with Malopolska province were compared. Results. The outbreak started in late 2012 and continued through 2013, when 38548 rubella cases (incidence rate 100.1/ 100 000) were notified. Geographically, rubella cases were reported from the entire country, with the highest incidence rate in Malopolska province (254.9/100 000). Only 5 cases from Malopolska and 120 in whole country were laboratory confirmed, the remaining 99.7% were reported solely on the basis of clinical signs. The vaccination coverage was not sufficient to protect the population against rubella outbreak in Poland, especially among adolescents and young adult males. Conclusions. The strengthening of routine immunization program and implementation of some additional vaccination campaigns in young adults as well as laboratory confirmation of all suspected cases are the challenges that will have to be met to eliminate rubella in Poland

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.

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