Differences In Vaccine Uptake Research Articles

Knowledge, attitudes, beliefs and practices of pregnant women towards the influenza vaccine in Trinidad.

Pregnant women and their babies are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as the highest priority. A knowledge, attitudes,beliefs, and practices (KAP) of pregnant women towards the influenza vaccine in Trinidad. It was disseminated to 480 pregnant women attending the clinic and completed by 146 yielding a response rate of 30%. Women who received the vaccine in a past pregnancy were nine times more likely to consider taking the vaccine in the current pregnancy. There was a statistically significant difference in vaccine uptake based on the source of information received by participants about the influenza vaccine (χ2 (3) = 9.864, P = 0.020), with the highest mean score for uptake shown in women who received information from a health care provider. A moderate, positive correlation was found between knowledge and vaccine uptake (rs (143) =0.430, P < 0.01), a weak, positive correlation between perceived susceptibility and vaccine uptake (rs (143) = 0.264, P < 0.01), and a weak, positive correlation between knowledge and perceived susceptibility (rs (143) = 0.229, P < 0.01). The study findings highlight that the source of information significantly influences vaccine uptake, with health care providers being the most influential source. This underscores the role of primary care physicians in providing accurate and up-to-date information about influenza vaccination to pregnant women. There is a need for accurate information and recommendations to be given to pregnant women by all health care workers including primary care physicians in order to increase vaccine uptake and reduce maternal and neonatal morbidity and mortality.

Regional Differences in Uptake of Vaccination against COVID-19 and Influenza in Germany: Results from the DigiHero Cohort.

During the COVID-19 pandemic in Germany, vaccination uptake exhibited considerable regional disparities. To assess the factors contributing to this variation, we examined the association of sociodemographic variables with COVID-19, COVID-19 booster, and influenza vaccination status within a cohort of 37,078 participants from 13 German federal states in the digital health cohort study commonly known as DigiHero. Our findings revealed variations in vaccination rates based on sociodemographic factors. However, these factors had limited explanatory power regarding regional differences in vaccine uptake. In contrast, we found substantial correlations between regional support of specific parties during the last local elections and the vaccination uptake at the level of each administrative district. In conclusion, sociodemographic factors alone did not suffice to explain the regional disparities in vaccine uptake. Political stances can play a major role, although the current investigation did not assess individual political orientations but rather used only an ecological approach.

Factors associated with COVID-19 vaccine uptake in adolescents: a national cross-sectional study, August 2021–January 2022, England

ObjectivesTo assess socioeconomic and geographical factors associated with COVID-19 vaccine uptake in pupils attending state-funded secondary schools in England.DesignCross-sectional observational study.SettingState-funded schools in England.ParticipantsPupils aged 12–17 years attending state-funded schools...

Measles vaccine uptake among Italian medical students compared to the pre-COVID-19 era

ABSTRACT The COVID-19 pandemic has severely affected health systems worldwide and raised the issue of vaccine hesitancy. In 2022, the World Health Organization reported an outbreak of measles infection among people over 20 years of age in the European Region. Previous studies found low rates of measles immunization among Italian healthcare workers (HCWs) and medical students. Vaccine hesitancy is a relevant cause of low immunization rate among HCWs and the general population. We aim to evaluate the measles vaccine uptake among medical students of a large teaching hospital, compared to the pre-pandemic period. This is a retrospective observational study, that evaluated the immune status and the vaccine acceptance rate for measles in medical students at the University of Tor Vergata, Rome, who underwent occupational health surveillance from 1 January to 1 December 2022. We also compared the data with the results of a pre-pandemic survey conducted in 2018. Vaccine uptake among unprotected medical students was 59.5%. The data showed no significant difference in vaccine uptake compared with the pre-COVID-19 period. Conversely, the rate of serologically immune subjects to measles increased from 89.66% in 2018 to 97.45% in 2022 as a result of the recent mandatory vaccination policy. Despite efforts to tackle vaccine hesitancy during the COVID-19 pandemic, measles vaccine uptake is still low among young adults starting their medical training, and their compliance with free workplace vaccination offers is suboptimal. Occupational health services should raise awareness among workers and work together to implement strategies to achieve comprehensive measles vaccination coverage among occupational health workers.

Racial residential segregation and COVID-19 vaccine uptake: an analysis of Georgia USA county-level data

BackgroundFoundational literature demonstrates that racial residential segregation results in poorer health outcomes for Black people than white people due to a variety of social determinants of health. COVID-19 vaccine uptake is important for better health outcomes, regardless of race. The COVID-19 pandemic has elevated concerns about racial health disparities but with little discussion of racial residential segregation as a predictor of disparate health outcomes. This paper investigates the relationship between racial residential segregation and COVID-19 vaccine uptake using county level data from the State of Georgia (USA).MethodsUsing publicly available data, regression analysis is conducted for 138 of the 159 counties in Georgia USA, using a dissimilarity index that describes county level differences in racial residential segregation. The primary independent variable is Black-white differences in vaccine uptake at the county level. The analytic methods focus on a spatial analysis to support information for county level health departments as the basis for health policy and resource allocation.ResultsConstructing a variable of the difference in vaccination rates between Black and white residents we find that Black-white differences in COVID-19 vaccination are most notable in the 69 most segregated of the 159 counties in Georgia. A ten-point lower segregation index is associated with an improvement in the Black-white vaccination gap of 1.5 percentage points (95% CI -0.31, -0.00). Income inequality and access to health care resources, such as access to a primary care physician, also predict Black-white differences in vaccination rates at the county level. Suggested mapping approaches of publicly available data at a state county level, provides a resource for local policy makers to address future challenges for epidemic and pandemic situations.ConclusionCounty level and geospatial data analysis can inform policy makers addressing the impact of racial residential segregation on local health outcomes, even for pandemic and epidemic issues.

Sociodemographic characteristics differ across routine adult vaccine cohorts: An All of Us descriptive study.

The National Institutes of Health All of Us (AoU) Research Program is currently building a database of 1million+ adult subjects. With it, we describe the characteristics of those with documented vaccinations. To describe the sociodemographic, health status, and lifestyle factors associated with vaccinations. This is a retrospective study involving data from the AoU program (R2020Q4R2, N= 315,297). Five vaccine cohorts [influenza, hepatitis B (HBV), pneumococcal <65 years old, pneumococcal ≥65 years old, and human papillomavirus (HPV)] were generated based on vaccination history. The influenza cohort comprised participants with documented influenza vaccinations in electronic health records (EHRs) from September 2017 to May 2018. Other vaccine cohorts comprised participants with ≥1 lifetime record(s) of vaccination documented in the EHR by December 2018. The vaccine cohorts were compared to the overall AoU cohort. Descriptive statistics were generated using EHR- and survey-based sociodemographic, health, and lifestyle information. The SAMBA (0.9.0) R package was utilized to adjust for EHR selection and outcome misclassification biases to infer sources of disparity for pneumococcal vaccinations in older adults. Cohort counts were as follows: influenza (n= 15,346), HBV (n= 6323), pneumococcal <65 (n= 15,217), pneumococcal ≥65 (n= 15,100), and HPV (n= 2125). All vaccine cohorts had higher proportions of White and non-Hispanic/Latino participants compared to the overall AoU cohort. The largest differences were found in pneumococcal age ≥65, with 80.2% White participants compared to 52.9% in the overall study population. Multivariable analysis revealed that race/ethnic disparities in pneumococcal vaccination among older adults were explained by biological sex, income, health insurance, and education-related variables. Racial, ethnic, education, and income characteristics differ across the vaccine cohorts among AoU participants. These findings inform future utilization of large health databases in vaccine epidemiology research and emphasize the need for more targeted interventions that address differences in vaccine uptake.

COVID-19 vaccine uptake among healthcare workers: an achievable quality improvement target.

There is a need to optimize SARS-CoV-2 vaccination rates amongst healthcare workers (HCWs) to protect staff and patients from healthcare-associated COVID-19 infection. During the COVID-19 pandemic, many organizations implemented vaccine mandates for HCWs. Whether or not a traditional quality improvement approach can achieve high-rates of COVID-19 vaccination is not known. Our organization undertook iterative changes that focused on the barriers to vaccine uptake. These barriers were identified through huddles, and addressed through extensive peer outreach, with a focus on access and issues related to equity, diversity and inclusion. The outreach interventions were informed by real-time data on COVID-19 vaccine uptake in our organization. The vaccine rate reached 92.3% by 6 December 2021 with minimal differences in vaccine uptake by professional role, clinical department, facility or whether the staff had a patient facing role. Improving vaccine uptake should be a quality improvement target in healthcare organizations and our experience shows that high vaccine rates are achievable through concerted efforts targeting specific barriers to vaccine confidence.

Sociodemographic differences in Covid-19 vaccine uptake in Denmark: a nationwide register-based cohort study

BackgroundCovid-19 vaccination is the main strategy to reduce SARS-CoV-2 transmission, mortality and morbidity. This study aimed to examine sociodemographic differences in Covid-19 vaccine uptake among all individuals invited for Covid-19 vaccination in Denmark.MethodsThis study was designed as a nationwide register-based cohort study. The study population included all Danish residents aged 12 years or above in Denmark between December 27, 2020 and October 20, 2021. Individuals who died during the study period before receiving an invitation for Covid-19 vaccination were excluded. Associations between sociodemographic factors and Covid-19 vaccination uptake were analyzed using logistic regression models adjusting for age, sex, immigration status, educational level, disposable income and history of SARS-CoV-2 infection.ResultsThe study population included 5,164,558 individuals. The overall vaccination coverage was 87.1% by October 20, 2021. In the full adjusted logistic regression models, the highest ORs for non-vaccination were observed among individuals aged 12–24 years (OR: 8.99 (95% CI: 8.76–9.23)), descendants of non-western immigrants (OR: 5.26 (95% CI: 5.18–5.33)), individuals who never had a PCR-test performed (OR: 2.93 (95% CI: 2.90–2.96)), individuals with primary school as highest completed educational level (OR: 2.87 (95% CI: 2.83–2.91)) and individuals with disposable income < 33,605 EUR (OR: 3.72 (95% CI: 3.52–3.93)).ConclusionOverall, the Covid-19 vaccine uptake was high in Denmark. However, large sociodemographic differences in the vaccine uptake exist. The youngest age groups had the lowest vaccination coverage. Furthermore, the impact of the sociodemographic factors was more pronounced in the youngest age groups. The identified determinants may be used to design policies to help maximize the vaccination coverage.

Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History.

Background The purpose of this study was to estimate COVID-19 vaccination rate among Medicare beneficiaries with cancer history and determine whether COVID-19 vaccine uptake is higher among non-Hispanic White beneficiaries compared with racially and ethnically minoritized beneficiaries.MethodsWe used US representative, cross-sectional data from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 Rapid Response Community Supplement Survey. A total of 1,863 respondents with self-reported cancer history (other than skin cancer) were included. The outcome was self-reported receipt of at least one coronavirus vaccine dose since vaccines became available. The key independent variable of interest was self-reported race and ethnicity. We applied sample weights to account for the survey design and provide population estimates to 9.6 million beneficiaries with cancer history. Weighted descriptive statistics and multivariable logistic regression analyses were conducted.ResultsDuring the first 4 months of vaccine availability, 69.6% of beneficiaries received at least one vaccine dose of which 65.4% had two vaccine doses. A larger proportion of non-Hispanic White beneficiaries (71.9%) had at least one vaccine dose compared with non-Hispanic Black (60.4%) and Hispanic (57.4%) beneficiaries. An estimated 30.4% of beneficiaries were still unvaccinated, that represents approximately 2.9 million unvaccinated beneficiaries with cancer history. Hispanic beneficiaries were 42% (OR: 0.58; 95% CI: 0.33–0.99; p = .048) less likely to be vaccinated compared with non-Hispanic White beneficiaries.ConclusionsResults indicate racial and ethnic differences in vaccine uptake among Medicare beneficiaries with cancer history. Effective strategies are needed to help increase vaccine confidence and uptake among adults with cancer history.

Improving HPV Vaccination Rates in a Racially and Ethnically Diverse Pediatric Population.

Nationally, 54.2% of youth are fully vaccinated for human papilloma virus (HPV) with persistent gender and racial/ethnic disparities. We used a quality improvement approach to improve completion of the HPV vaccine series by age 13 years. As a secondary aim, we examined racial/ethnic and gender differences in vaccine uptake. The study setting included 2 pediatric, academic, primary care practices in Massachusetts. We designed a multilevel patient-, provider-, and systems-level intervention addressing parental hesitancy, provider communication, and clinical operations. Rates of HPV series completion by age 13 were monitored using a control p chart. Bivariate and multivariate analyses evaluated vaccine completion differences on the basis of clinic size, gender, and race/ethnicity. Between July 1, 2014, and September 30, 2021, control p charts showed special cause variation with HPV vaccine initiation by age 9 years, increasing from 1% to 52%, and vaccine completion by 13 years, increasing from 37% to 77%. Compared with White and Black children, Hispanic children were more likely to initiate the HPV vaccine at age 9 (adjusted odds ratio [95% confidence interval] = (1.4-2.6)] and complete the series by age 13 (adjusted odds ratio [95% confidence interval] = 2.3 (1.7-3.0). A multilevel intervention was associated with sustained HPV vaccine series completion by age 13 years. Hispanic children were more likely to be vaccinated. Qualitative family input was critical to intervention design. Provider communication training addressed vaccine hesitancy. Initiation of the vaccine at age 9 and clinicwide vaccine protocols were key to sustaining improvements.

Factors associated with COVID-19 vaccine uptake among French population aged 65 years and older: results from a national online survey

BackgroundIn France, the increase in COVID-19 vaccine uptake among older adults slowed down between May and June 2021. Using the data from a national survey, we aimed to assess COVID-19 vaccine uptake among French residents aged 65 years and older, particularly at risk of severe form of the infection, and identify factors associated with non-vaccination.MethodsA cross-sectional online survey collected the immunization status/intention to get the COVID-19 vaccine, reasons for vaccination/non-vaccination and factors potentially associated with vaccine uptake between May 10 and 23, 2021 among a large sample of French residents. Characteristics of participants were compared according to immunization status. Factors potentially associated with non-vaccination were computed into a multivariate logistic regression.ResultsAmong the 1941 survey participants, 1612 (83%) reported having received at least one dose of COVID-19 vaccine. Among the 329 unvaccinated, 197 (60%) declared having the intention to get vaccinated. Younger age (adjusted odds ratio (aOR) = 1.50; 95% confidence interval (CI), 1.05–2.14), thinking previously having COVID-19 (aOR = 4.01; 95% CI, 2.17–7.40), having suffered economic impact due to the pandemic (aOR = 2.63; 95% CI, 1.71–4.04), reporting an “unsafe” opinion about COVID-19 vaccine safety (aOR = 6.79; 95% CI, 4.50–10.26), reporting an “unsupportive” opinion about vaccination in general (aOR = 4.24; 95% CI, 2.77–6.49) were independent risk factors for non-vaccination. On the other hand, trust in COVID-19 vaccine information delivered by the doctor (aOR = 0.28; 95% CI, 0.16–0.48) and trust in the government’s actions (aOR = 0.50; 95% CI, 0.34–0.74) were independent protective factors for non-vaccination. Political affiliation also remained significantly associated with vaccine uptake.ConclusionsDespite high overall COVID-19 vaccine uptake among the study participants, differences in vaccine uptake according to the level of concerns regarding COVID-19 vaccine safety, socioeconomic profile and trust in the government were observed. Our results reinforce the importance of “reaching out” vaccination strategy that specifically targets the most vulnerable fringe of older adult population.

Multi-tiered intervention to increase maternal immunization coverage: A randomized, controlled trial

ObjectiveTo evaluate the impact of a multi-component intervention package of maternal immunization uptake in obstetric care clinics. MethodsIn a multi-level, cluster- and individually-randomized controlled trial we implemented an evidence-based intervention that targeted practice-, provider- and patient-level barriers to vaccine uptake. Obstetric practices were randomized to receive the practice and provider-level interventions or continue their normal standard of care. We enrolled pregnant women at practices in Georgia and Colorado and randomized women into patient-level intervention and control groups, resulting in four study arms. The primary outcomes were receipt of the influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccines during pregnancy. A sample size of 550 women per arm (2200 total) was planned and enrolled to compare the intervention between the four study arms. ResultsBetween June 2017 and July 2018, 4907 women were screened and 2200 women were randomized, 550 to each of the four study arms. We were unable to follow-up with 108 women, for a final sample size of 2092. Sample characteristics and sample size were similar among study arms. There was no significant increase in Tdap or influenza vaccine uptake overall. Among women who had no intention of or were unsure about receiving the influenza vaccine during pregnancy, those who received just the patient-level intervention were 61% more likely to receive the influenza vaccine than those in the control arm (Relative risk: 1.61; 95% Confidence Interval: 1.18–2.21). There was no significant difference in vaccine uptake for either influenza or tetanus, diphtheria and acellular pertussis between the four arms of the study. ConclusionsThis trial highlights the need for more targeted interventions to improve vaccine uptake. Future work should focus on clinics with low baseline vaccine uptake and the patient-level intervention should be expanded and targeted towards women with low vaccine confidence.

586-P: COVID-Vaccine Attitudes and Uptake in Young Adults with Type 1 Diabetes (T1D)

Objective: Vaccination can help prevent COVID-infection and serious health complications. This is particularly important for people with diabetes, who may be at higher risk for COVID-complications. While unvaccinated adults tend to be younger in general, there are no data on vaccine attitudes or uptake in young adults with T1D. We explored vaccine uptake in young adults with T1D across demographic and clinical factors and identified common reasons for not getting the vaccine. Methods: At baseline of an ongoing behavioral intervention trial (Feb-Dec 2021) , 35 young adults with T1D (M age= 20.2±1.6, 57% female, 54% non-Hispanic White, 23% Hispanic, 9% Black, 14% other/multiple, M A1c=8.9±2.4%) reported on vaccination status. Unvaccinated participants provided open-text comments on their reasons. Results: Overall, 69% of participants were vaccinated (2 doses) . Unvaccinated participants had higher median A1c than vaccinated participants (9.7% vs. 7.6%, p=0.03) ; every 1.0% increase in A1c was associated with 22.2% decreased odds of being vaccinated. There were no differences in vaccine uptake by age, gender, race/ethnicity, education, employment, pump or CGM use, or health insurance. The unvaccinated participants reported reasons including: distrust of the vaccine research/effectiveness (4) , uncertainty about health impacts (including T1D) /waiting to see impact on others’ health (2) , no time to get vaccinated (1) , indifference (1) , no desire for vaccination (2) , and still thinking about it (1) . Conclusion: In a small, diverse sample of young adults with T1D, COVID-vaccinations mirrored national rates. Some participants may have been vaccinated after completing surveys at baseline. Patterns of high A1c and unvaccinated status may place young adults at increased risk as the pandemic continues. Healthcare providers are well positioned to counsel young adults about vaccine information and considerations related to T1D, which may reduce misinformation and increase uptake. Disclosure K.R.Desai: None. S.Devaraj: None. C.G.Minard: None. M.E.Hilliard: None. S.A.Carreon: None. B.Duran: None. W.Levy: None. S.Lyons: None. R.Streisand: None. T.S.Tang: None. S.Mckay: None. B.Anderson: None.

COVID-19 Vaccination Willingness and Vaccine Uptake among Healthcare Workers: A Single-Center Experience.

Healthcare workers (HCWs) are at higher risk of developing COVID-19 due to their professional exposition to the SARS-CoV-2 virus. This study assesses the intention of vaccination against COVID-19 before the vaccines were approved, and the rate of vaccine uptake during the first nine months of immunization among HCWs. A cross-sectional seroprevalence study was carried out during July 2020 in University Clinical Hospital Center Bezanijska Kosa in Belgrade, Serbia that included 62.8% of all HCWs. Besides serological testing for IgG antibodies, data about HCWs’ intention to accept COVID-19 vaccination if a vaccine became available were collected. This cohort of HCWs was followed up until the end of October 2021 to assess the number of vaccinated and PCR-positive staff. In the cross-sectional study, 18.3% HCWs had positive SARS-CoV-2 IgG antibodies without difference with IgG-negative HCWs regarding age, gender, profession type, and years of service. Before vaccines became available, a significantly higher percentage of IgG-positive HCWs compared to IgG-negative HCWs was unsure whether to be vaccinated (62.5% vs. 49.0%), and significantly fewer stated that they would not be vaccinated (16.7% vs. 25.1%). When the vaccines became available in Serbia, among IgG-negative HCWs, those who stated clear positive (yes) and clear negative (no) attitude toward vaccination before the immunization period had begun were vaccinated at 28% and 20%, respectively, while 51% of unsure HCWs received a vaccine (p = 0.006). Among IgG-positive HCWs, there was no statistical difference in vaccine uptake regarding those with previous negative, positive, and unsure opinions about vaccination (p = 0.498). In multivariate analysis, independent factors associated with uptake were being female (OR = 1.92; 95%CI: 1.04–3.55), age of 30–59 years, previously vaccine-unsure (OR = 1.84; 95%CI: 1.04–3.25), and those with previous positive vaccine attitudes (OR = 2.48; 95%CI:1.23–5.01), while nurses were less likely to become vaccinated (OR = 0.39 95% CI: 0.20–0.75) These findings indicate a positive change in attitudes of HCWs towards COVID-19 vaccination.

Influenza and Pneumococcal Vaccination Among Male Veterans and Nonveterans, 2016-2018.

The Advisory Committee on Immunization Practices recommends persons aged ≥6 months receive an influenza vaccination annually, and certain adults aged ≥19 years receive the 23-valent pneumococcal polysaccharide vaccine alone or in series with the 13-valent pneumococcal conjugate vaccine, depending on age, chronic conditions, and smoking status. This study examines the prevalence of influenza and pneumococcal vaccination relative to Healthy People 2020 goals to understand how vaccination receipt differs by veteran status and sociodemographic subgroups. We analyzed pooled data from the 2016-2018 National Health Interview Survey (N = 35 094) in 2021 to estimate the prevalence of influenza and pneumococcal vaccination for men aged 25-64 years and for men aged ≥65 years by veteran status and selected sociodemographic subgroups. We used 2-tailed t tests with an α = .05 to identify significant differences. Among men, 44.7% of veterans and 33.5% of nonveterans aged 25-64 years and 71.0% of veterans and 64.9% of nonveterans aged ≥65 years received an influenza vaccine in the past year. Among men aged 25-64 years at high risk for pneumococcal disease, 35.9% of veterans and 20.8% of nonveterans had ever received ≥1 dose of any pneumococcal vaccination. Disparities in the prevalence of vaccination within examined sociodemographic characteristics were often smaller in magnitude among veterans than among nonveterans for both vaccinations. Vaccination rates were below Healthy People 2020 targets for both groups, except influenza vaccination among veterans aged ≥65 years. Understanding differences in vaccine uptake may inform efforts to improve vaccination rates by identifying subgroups who are at high risk of disease and have low vaccination rates.

Abstract PO-271: Racial and ethnic disparities in human papillomavirus (HPV) vaccine uptake among adults aged 27-45 years in the United States

Abstract Background: More than 36,000 new cases of human papillomavirus (HPV)-associated cancers are diagnosed annually in the United States, with racial/ethnic differences observed in incidence and mortality. HPV vaccination is a means of primary prevention against HPV-associated cancers, and in 2018, the Food and Drug Administration expanded age of eligibility for the HPV vaccine to 27-45 years. However, no study has examined differences in vaccine uptake based on race/ethnicity since the expansion of age of eligibility. Objective: To characterize racial/ethnic differences in HPV vaccine uptake among eligible adults aged 27-45 years in the United States, and identify socioeconomic factors associated with differential vaccine uptake. Methods: We analyzed nationally representative, cross-sectional data from the 2019 National Health Interview Survey (n = 9,440). Outcome of interest was HPV vaccine uptake, defined as receipt of at ≥ 1 dose of the vaccine. Main independent variable was race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, non-Hispanic other). Other covariates included age, sex, marital status, highest level of education, annual income, insurance status, having a usual place of care, and geographic region of residence. Weighted, multivariable logistic regression model estimated odds of HPV vaccine uptake based on race/ethnicity, while adjusting for other covariates. Results: Majority of respondents were non-Hispanic whites (60.7%). Vaccine uptake rate was only 15.5%. In the unadjusted analysis, there were associations between HPV vaccine uptake and race/ethnicity, sex, marital status, education, income, insurance, place of care, and geography (p &amp;lt; 0.001). After adjusting for covariates, significant racial/ethnic differences in HPV vaccine uptake persisted. Compared to non-Hispanic whites, non-Hispanic blacks were 36% (aOR = 1.36; 95% CI 1.09, 1.70) more likely to receive the HPV vaccine. However, Hispanics were 27% less likely than non-Hispanic whites to receive the HPV vaccine (aOR = 0.73; 95% CI 0.58, 0.92). Additionally, individuals who did not have a usual place of care had lower odds of vaccine uptake (aOR = 0.72; 95% CI 0.57, 0.93), as were those with lower educational levels (high school aOR = 0.62; 95% CI 0.50, 0.78; some college aOR = 0.83; 95% CI 0.70, 0.98), compared to college graduates or more. Compared to participants residing in the South, those in the West were more likely to receive the vaccine (aOR = 1.49; 95% CI 1.24, 1.80); and females had over three times the odds of receiving the vaccine (aOR = 3.58; 95% CI 3.03, 4.23) than males. Conclusions: Only 1-in-6 adults between 27 and 45 years in the United States have received at least one dose of the HPV vaccine, and Hispanics are significantly less likely to do so, as are individuals without a usual place of care. Given the importance of the vaccine in cancer prevention, it is critical that these disparities be mitigated. Citation Format: Nosayaba Osazuwa-Peters, Natalie Rincon, Kelsey Rae McDowell, Tiarney Ritchwood, Eric Adjei Boakye. Racial and ethnic disparities in human papillomavirus (HPV) vaccine uptake among adults aged 27-45 years in the United States [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-271.

Mediators of Racial Differences in COVID-19 Vaccine Acceptance and Uptake: A Cohort Study in Detroit, MI.

Despite their disparate rates of infection and mortality, many communities of color report high levels of vaccine hesitancy. This paper describes racial differences in COVID-19 vaccine uptake in Detroit, and assesses, using a mediation model, how individuals’ personal experiences with COVID-19 and trust in authorities mediate racial disparities in vaccination acceptance. The Detroit Metro Area Communities Study (DMACS) is a panel survey of a representative sample of Detroit residents. There were 1012 respondents in the October 2020 wave, of which 856 (83%) were followed up in June 2021. We model the impact of race and ethnicity on vaccination uptake using multivariable logistic regression, and report mediation through direct experiences with COVID as well as trust in government and in healthcare providers. Within Detroit, only 58% of Non-Hispanic (NH) Black residents were vaccinated, compared to 82% of Non-Hispanic white Detroiters, 50% of Hispanic Detroiters, and 52% of other racial/ethnic groups. Trust in healthcare providers and experiences with friends and family dying from COVID-19 varied significantly by race/ethnicity. The mediation analysis reveals that 23% of the differences in vaccine uptake by race could be eliminated if NH Black Detroiters were to have levels of trust in healthcare providers similar to those among NH white Detroiters. Our analyses suggest that efforts to improve relationships among healthcare providers and NH Black communities in Detroit are critical to overcoming local COVID-19 vaccine hesitancy. Increased study of and intervention in these communities is critical to building trust and managing widespread health crises.

Regional differences in vaccine uptake and serological responses to vaccine and circulating strains of H1N1 viruses among patients with confirmed influenza

BackgroundSeasonal epidemics of influenza are characterized through national or international surveillance efforts to determine vaccine efficacy and vaccine strain selection, but they do not provide detailed information about local variations in factors that can influence influenza cases and disease severity. MethodsSurveillance for influenza like illness was performed in Emergency Medicine Departments in Taipei, Taiwan and Baltimore, Maryland during the winter of 2015–16. Detailed demographic and clinical data were obtained. Nasal swabs or washes were collected for influenza virus diagnosis, sequencing and isolation. Serum was collected to determine neutralizing antibody levels. ResultsH1N1 viruses dominated both sites, but more influenza cases occurred in Taipei compared to Baltimore. H1 HA clade diversity was greater in Taipei. Vaccination rates were lower in Taipei than Baltimore, but vaccination was associated with an increase in serum neutralizing antibodies to recent H1N1 strains in Taipei, but not Baltimore. There was a higher level of preexisting immunity to circulating H1N1 strains in Baltimore. ConclusionsRegional differences in preexisting immunity and H1N1 strain circulation may have contributed to the vastly different 2015-16 influenza seasons in Taipei and Baltimore and suggest immune responses to vaccination can be affected by the degree of preexisting immunity in the population.

Racial/Ethnic and Socioeconomic Disparities in Adult Vaccination Coverage

Adults from racial and ethnic minorities and low-income groups are disproportionately affected by vaccine-preventable diseases. The objective of this study is to examine the trends in adult vaccination coverage in the U.S. by race/ethnicity and SES from 2010 to 2019. Temporal trends in influenza; pneumococcal; herpes zoster; and tetanus, diphtheria, and acellular pertussis vaccination coverage were examined by race/ethnicity and SES in 2020 using the National Health Interview Surveys from 2010 to 2019. Influenza vaccination coverage differed by race/ethnicity among adults aged ≥65 years (61.4% for Black, 63.9% for Hispanic, 71.9% for Asian, and 72.4% for White adults). Race/ethnicity, household income, education level, and health insurance type were significantly associated with receipt of influenza; pneumococcal; tetanus, diphtheria, and acellular pertussis; and zoster vaccinations among adults aged ≥65 years in a multivariable-adjusted regression model. Socioeconomic differences in influenza vaccine uptake narrowed among adults aged 18-64 years from 2010 to 2019. By contrast, racial/ethnic and socioeconomic differences in vaccine uptake persisted from 2010 to 2019 among adults aged ≥65 years. Racial and ethnic disparities in vaccine uptake persisted over the last decade. Socioeconomic disparities in influenza vaccine coverage narrowed among adults aged 18-64 years; however, disparities persisted among adults aged ≥65 years. Efforts are urgently needed to achieve equity in immunization rates.

Pediatric Vaccination During the COVID-19 Pandemic.

The impact of the coronavirus disease 2019 pandemic on vaccination coverage, critical to preventing vaccine-preventable diseases, has not been assessed during the reopening period. Vaccine uptake and vaccination coverage for recommended vaccines and for measles-containing vaccines at milestone ages were assessed in a large cohort of children aged 0 to 18 years in Southern California during January to August 2020 and were compared with those in the same period in 2019. Differences in vaccine uptake and vaccination coverage (recommended vaccines and measles-containing vaccines) in prepandemic (January to March), stay-at-home (April to May), and reopening (June to August) periods in 2020 and 2019 were compared. Total and measles-containing vaccine uptake declined markedly in all children during the pandemic period in 2020 compared with 2019, but recovered in children aged 0 to 23 months. Among children aged 2 to 18 years, measles-containing vaccine uptake recovered, but total vaccine uptake remained lower. Vaccination coverage (recommended and measles-containing vaccines) declined and remained reduced among most milestone age cohorts ≤24 months during the pandemic period, whereas recommended vaccination coverage in older children decreased during the reopening period in 2020 compared with 2019. Pediatric vaccine uptake decreased dramatically during the pandemic, resulting in decreased vaccination coverage that persisted or worsened among several age cohorts during the reopening period. Additional strategies, including immunization tracking, reminders, and recall for needed vaccinations, particularly during virtual visits, will be required to increase vaccine uptake and vaccination coverage and reduce the risk of outbreaks of vaccine-preventable diseases.