Sociodemographic and geographic disparities in COVID-19 booster vaccination in Nueces County, Texas, USA

Abstract

ObjectiveThis paper explores sociodemographic determinants and geographic disparities in COVID-19 booster uptake among fully vaccinated adults in Nueces County, Texas, USA with a population of over 353,000. MethodsA logistic generalized additive model was applied to analyze 184,252 official vaccination records of fully vaccinated adults over the period between December 2020 and August 2022. An individual's odds in receiving a booster shot were estimated with a host of sociodemographic characteristics as predictors. ResultsModel estimation results reveal that male (odds ratio 0.836, 95% confidence interval 0.835–0.836, p < 0.001) and Hispanic residents (odds ratio 0.944, 95% confidence interval 0.943–0.945, p < 0.001) in the county were less likely to take a booster shot. Between the ages of 25 and 75, booster uptake increased with age (age 75 vs. 45 odd ratio 3.058, 95% confidence interval 3.052–3.063, p < 0.001). Booster uptake was lower in rural areas (odds ratio 0.804, 95% confidence interval 0.795–0.814, p < 0.001) and communities with high social vulnerability (highest vs. moderate vulnerability odd ratio 0.800, 95% confidence interval 0.767–0.836, p < 0.001). ConclusionEmpirical results confirm that booster uptake varied across individuals and communities of different socioeconomic and demographic characteristics. To advance health equity, a more inclusive vaccine campaign should pay particular attention to those underserved populations.