Inequalities In Vaccination Research Articles

Co-developing a tailored vaccination intervention with Congolese migrants: a participatory study

Abstract Background Disparities in vaccination uptake among migrant populations are well documented. WHO and ECDC have sought renewed focus on participatory research that engages migrants in co-producing tailored initiatives to address vaccination inequities and increase coverage. Methods This community-based participatory research study aims to engage Congolese migrants in co-developing a tailored approach to increase vaccine uptake. Phase 1 used poster walls and in-depth interviews with Congolese migrants (n = 32) to explore COVID-19 vaccination beliefs, experiences, and preferred information sources and communication methods, analysed iteratively and thematically in NVivo. Preliminary results Institutional distrust has shaped this population’s interpretation of the pandemic response and enabled vaccine misinformation and conspiracy theories to take hold. We found complex information networks and preference for Francophone, African and social media. Limited English proficiency and preference for the oral tradition restricted engagement with official public health messaging. Suspicion of government motives, low knowledge, and culturally specific perceptions about vaccination contributed to belief that breakthrough infections and need for COVID-19 boosters imply the vaccine is not effective. The population felt coerced by vaccination reminders and mandates, and were resultantly more hesitant to accept COVID-19 vaccination. Conclusions The population’s specific characteristics suggest that existing and trusted interpersonal networks and oral communication in first languages should be harnessed to spread credible information and encourage vaccine uptake, and mandate policies are unlikely to be effective. Training local role models to facilitate vaccination dialogues and myth-bust may be effective at changing behaviour. The next phases will gather more information from key stakeholders and engage migrants in workshops to co-design insight-driven, tailored interventions. Key messages • Global policy-setting organisations have called urgently for participatory research that engages migrants in the co-production of tailored initiatives to address vaccination inequalities. • Populations with strong interpersonal networks and low trust in public institutions may be receptive to tailored, community-centred dialogue approaches using local messengers and role models.

A community-based participatory approach to engaging Congolese migrants in intervention co-design

Abstract Issue The World Health Organization has called for tailored, community-based interventions to address disparities in vaccination uptake affecting migrant and minoritised populations, however few exist. This study directly responds to global calls for community-centred and participatory approaches to engaging migrants in routine and COVID-19 vaccination. Problem description Black and African migrants are known to be at risk of under-immunisation and have lower COVID-19 vaccine uptake rates in high-income countries. This UK study will use community-based participatory approaches to engage Congolese migrants in co-developing a tailored intervention to increase vaccine uptake. A community-academic coalition will lead the study. Community members will be trained as peer researchers and financially compensated. The final output will be an intervention strategy tailored to and embedded within the Congolese migrant community. Preliminary results The coalition held 20 hours of planning meetings and peer researcher training in 2021 and co-developed a phased study involving 1) community days with poster walls and qualitative in-depth interviews with Congolese migrants, 2) interviews and workshops with local stakeholders, and 3) co-design workshops with Congolese migrants. Following outreach and pre-engagement, approximately 80 migrants attended the community days, with more than 50 interviews and 100% left positive feedback (including: felt valued, welcomed, Congolese language recognised). Lessons Community-academic partnerships are resource-intensive but can be an effective means to build and maintain trust required to deliver a community-based research study. Academic partners should support community partners in understanding the research process to help manage expectations and provide financial compensation for their time and effort. This study offers an innovative engagement model and study design that can be adapted to other underserved populations. Key messages • Global policy-setting organisations have called urgently for participatory research that engages migrants in the co-production of tailored initiatives to address vaccination inequalities. • This study uses a novel, theory-driven, participatory approach to engage with and identify barriers to vaccination in Congolese migrants and co-design a tailored strategy to increase uptake.

Associations of race/ethnicity and socioeconomic factors with vaccination among US adults during the COVID-19 pandemic, January to March 2021

To date, there has been limited data available to understand the associations between race/ethnicity and socioeconomic and related characteristics with novel coronavirus disease (COVID-19) vaccination in the United States. I leveraged the large, nationally-representative cross-sectional surveys of the U.S. Household Pulse Survey between January and March 2021 with relatively complete race/ethnicity and socioeconomic data to examine national trends in levels of COVID-19 vaccine initiation and intention in adults aged 18–85 years. I further estimated the multivariable associations between race/ethnicity, education, income, and financial hardship with the adjusted prevalence odds ratios of: 1) receipt of ≥1 COVID-19 vaccine dose; and 2) among those unvaccinated, the definite intention to receive a vaccine. I observed persistent disparities in vaccine initiation for non-Hispanic Blacks, Hispanics, and non-Hispanic multiracial/other race persons, and vaccine intention for Blacks and multiracial/other race persons, compared to non-Hispanic Whites and Asians. In late March 2021, the prevalence estimates of Hispanics and Blacks receiving a vaccine were 12-percentage points and 8-percentage points lower than for Whites, respectively. Education and income exhibited dose–response relationships with vaccine initiation (P for trend ≤0.01 and <0.001, respectively). Substantial financial hardship was linked to 35–44% lower adjusted odds of vaccination (P<.001). In this large, nationally-representative study, I found persistent racial/ethnic and socioeconomic disparities in vaccine initiation and intention, more than three months after COVID-19 vaccines first became available. Addressing these persistent racial/ethnic and socioeconomic inequities in vaccination is essential to mitigate the pandemic's higher risks of infection and adverse health outcomes in Hispanic, Black, and socioeconomically-disadvantaged communities.

Immunising older Australians: Pre-COVID-19 associations of opportunistic immunisation in general practice registrar consultations.

Vaccine uptake in older Australians issuboptimal. Thisexploratory study aims to establish the associations of opportunistic older person immunisation in general practice registrars' practice. This study was a cross-sectional analysis of data fromthe Registrar Clinical Encounters in Training (ReCEnT) study. Univariate andmultivariable regressions explored associations between vaccine recommendations and patient, registrar, practice and consultation factors. A total of 2839 registrars provided data on 74,436 consultations. Associations of lower odds of immunisation included Aboriginal and Torres Strait Islander peoples (odds ratio [OR] 0.69; 95% confidence interval [CI]: 0.50, 0.96), rural/remote practice location (OR 0.75; 95% CI: 0.58, 0.98, compared with major cities) and in areas of greater relative socioeconomic disadvantage (OR per decile 1.03; 95% CI: 1.01, 1.05). Patients new to the practice (OR 2.46; 95% CI: 2.06, 2.94), or to the registrar (2.02; 95% CI: 1.87, 2.18) had higher odds of receiving an immunisation. Our findings suggest that general practice registrars may be proactively facilitating immunisation in new patients, but that inequities in vaccination persist.

Factors associated with timely receipt of COVID vaccination in patients with cancer.

167 Background: In many jurisdictions patients with new hematological cancers, or those receiving hematopoietic stem cell transplant or immunosuppressive agents, were prioritized for COVID vaccination due to increased risk of infection and death. In Ontario, Canada those residing in congregate settings, or regions with high positivity rates or high proportions of essential workers were also prioritized. While vaccine inequities exist, it remains unclear whether they persisted amongst the prioritized cancer population. Methods: We undertook a retrospective, population-based study to evaluate factors associated with COVID vaccination in patients residing in Ontario, Canada, &gt;18 years of age, and diagnosed with cancer between 01/2010 and 09/2020. Factors associated with time from vaccine approval to full vaccination (two doses) and third doses were evaluated using multivariable Cox proportional hazards regression models. Results: The cohort consisted of 356,535 patients; as of 30 January 2022 of which 86.8% had received at least two doses. Compared to patients with more remote diagnoses (&gt; 1 year), newly diagnosed patients rate of vaccination was lower (HR: 0.89, 95%CI: 0.88-0.91, p &lt; 0.01) and a greater proportion were unvaccinated (13.6% vs 11.8%; p &lt; 0.01). Conversely, rate of vaccination was higher in patients treated with systemic therapy in the last 6 months (HR: 1.04, 95%CI: 1.03-1.05, p &lt; 0.01). Rate of vaccination was 25% lower in recent (HR:0.74,95% CI: 0.72-0.76, p &lt; 0.01) and non-recent immigrants (HR: 0.80, 95% CI: 0.79-0.81, p &lt; 0.01), and a greater proportion remained unvaccinated, compared to those who were Canadian-born (20.1 and 16.6% vs 10.9%; p &lt; 0.01). Compared to the most advantaged quintiles, quintiles with the lowest socioeconomic status (14.5% vs 9.4%; p &lt; 0.01), or highest residential instability (13.3% vs 10.8%; p &lt; 0.01), material deprivation (10.5% vs 9.6%; p &lt; 0.01), or ethnic concentration quintiles (13.7% vs 10.4%; p &lt; 0.01) had higher proportions of unvaccinated patients. Rate of vaccination was 20% lower in patients with the lowest socioeconomic status (HR: 0.83, 95% CI: 0.81-0.84, p &lt; 0.01) and those with highest material deprivation (HR: 0.80, 95% CI: 0.79-0.82, p &lt; 0.01) relative to more advantaged groups. Similar trends were observed for receipt of third doses in the eligible cohort. Conclusions: Despite direct government funding of COVID vaccines and distribution policies aimed a prioritizing high-risk populations marginalized patients with cancer were less likely to be vaccinated than other cancer patients. Differences in receipt of vaccination are likely due to the interplay between systemic barriers to access (low trust, transportation barriers, work schedules), and cultural/ social influences impacting uptake. Future efforts should work directly members of high-risk communities to understand how to improve vaccine delivery among these communities.

Assessment of Practices Affecting Racial and Ethnic COVID-19 Vaccination Equity in 10 Large US Cities.

Context:In the United States, COVID-19 vaccines have been unequally distributed between different racial and ethnic groups. Public reporting of race and ethnicity data for COVID-19 vaccination has the potential to help guide public health responses aimed at promoting vaccination equity. However, there is evidence that such data are not readily available.Objectives:This study sought to assess gaps and discrepancies in COVID-19 vaccination reporting in 10 large US cities in July 2021.Design, Setting, and Participants:For the 10 cities selected, we collected COVID-19 vaccination and population data using publicly available resources, such as state health department Web sites and the US Census Bureau American Community Survey. We examined vaccination plans and news sources to identify initial proposals and evidence of implementation of COVID-19 vaccination best practices.Main Outcome Measure:We performed quantitative assessment of associations of the number of vaccination best practices implemented with COVID-19 racial and ethnic vaccination equity. We additionally assessed gaps and discrepancies in COVID-19 vaccination reporting between states.Results:Our analysis did not show that COVID-19 vaccination inequity was associated with the number of vaccination best practices implemented. However, gaps and variation in reporting of racial and ethnic demographic vaccination data inhibited our ability to effectively assess whether vaccination programs were reaching minority populations.Conclusions:Lack of consistent public reporting and transparency of COVID-19 vaccination data has likely hindered public health responses by impeding the ability to track the effectiveness of strategies that target vaccine equity.

The French Covid-19 vaccination policy did not solve vaccination inequities: a nationwide study on 64.5 million people

BackgroundTo encourage Covid-19 vaccination, France introduced during the Summer 2021 a ‘Sanitary Pass’, which morphed into a ‘Vaccine Pass’ in early 2022. While the sanitary pass led to an increase in Covid-19 vaccination rates, spatial heterogeneities in vaccination rates remained. To identify potential determinants of these heterogeneities and evaluate the French sanitary and vaccine passes’ efficacies in reducing them, we used a data-driven approach on exhaustive nationwide data, gathering 141 socio-economic, political and geographic indicators.MethodsWe considered the association between vaccination rates and each indicator at different time points: before the sanitary pass announcement (week 2021-W27), before the sanitary pass came into force (week 2021-W31) and 1 month after (week 2021-W35) and the equivalent dates for the vaccine pass (weeks 2021-W49, 2022-W03 and 2022-W07).ResultsThe indicators most associated with vaccination rates were the share of local income coming from unemployment benefits, overcrowded households rate, immigrants rate and vote for an ‘anti-establishment’ candidate at the 2017 Presidential election. These associations increase over time. Consequently, living in a district below the median of such indicator decreases the probability to be vaccinated by about 30% at the end of the studied period, and this probability gradually decreases by deciles of these indicators.ConclusionsOur analysis reveals that factors related to poverty, immigration and trust in the government are strong determinants of vaccination rate, and that vaccination inequities tended to increase after the introduction of the French sanitary and vaccination passes.

Are children who do not receive their first Measles Mumps and Rubella (MMR1) vaccination by 24 months more likely to share a household with older non-vaccinated children? Linked household-level analysis of primary care electronic health records (EHRs).

ObjectivesOnly 89.4% of UK children receive MMR1 by age 24 months. We investigated whether children not receiving MMR1 by this age were more likely to share a household with children also not vaccinated by this age, and its variation by sex, ethnic background and area-level deprivation.&#x0D; ApproachWe identified 208,907 children born between 2013-2019 and eligible for MMR1 from the primary care EHRs of 1,192,630 children registered to a general practitioner in North East London between 2001-2021. We estimated the proportion of children and 95% Confidence Interval (CI) receiving MMR1 between 12 and 24 months of age. We calculated prevalence ratios (PR) by sex, ethnicity, and deprivation (Index of Multiple Deprivation (IMD) quintiles). We identified all children with the same pseudonymised Unique Property Reference Numbers (pUPRNs) at the MMR1 date. We are completing analyses to calculate mutually adjusted PRs and examine household-level associations in timeliness of MMR1.&#x0D; ResultsOverall, 172,319 (82.5%) of 208,907 eligible children received an MMR1 between age 12-24 months. Non-receipt of MMR1 by 24 months was less likely in children from South Asian ethnic backgrounds (PR 0.74; 95% CI: 0.68,0.79), and more likely in those from Black ethnic backgrounds (1.43;1.31,1.56) and in those living in the most deprived IMD quintile (1.83;1.49,2.23). We identified 137,919 children with the same pUPRNs at the MMR1 date, comprising 69,892 boys (50.7%) and 41,846 (30.3%), 32,631 (23.7%), 10,793 (7.8%), 12,246 (8.9%) and 40,403 (29.3) from White, South Asian, Black, Mixed/Other and Missing ethnic backgrounds respectively. We are calculating adjusted PRs and will estimate associations between non-receipt of MMR1 in the youngest and oldest children within a household.&#x0D; ConclusionOur findings suggest that non-receipt of MMR1 by 24 months is ethnically patterned and more likely in areas of higher deprivation. Household-level analyses provide actionable insights into the characteristics of measles-susceptible households and opportunities for data-enabled primary care interventions to reduce vaccination inequalities and prevent measles outbreaks.

State capture through indemnification demands? Effects on equity in the global distribution of COVID-19 vaccines

BackgroundState capture by the pharmaceutical industry is a form of corruption whereby pharmaceutical companies shift laws or policies about their products away from the best interest of the public and toward their private benefit. State capture often limits equitable access to pharmaceutical products by inflating drug prices and increasing barriers to entry into the pharmaceutical industry. During the COVID-19 pandemic, the high demand and low supply of COVID-19 vaccines has put governments that manage vaccine procurement at risk of capture by COVID-19 vaccine manufacturers, both through bilateral deals and the COVID-19 Vaccine Global Access (COVAX) Facility; this threatens equity in the global distribution of these products. The purpose of this study is to determine whether COVID-19 vaccine manufacturers have been engaging in state capture and, if so, to examine the implications of state capture on equitable access to COVID-19 vaccines.MethodsA targeted rapid literature search was conducted on state capture by the pharmaceutical industry. Results were limited to journal articles, books, and grey literature published between 2000 and 2021 in or translated to English. A literature search was also conducted for information about state capture during the COVID-19 pandemic. Results were limited to media articles published between March 2020 and July 2021 in or translated to English. All articles were qualitatively analyzed using thematic analysis.ResultsCOVID-19 vaccine manufacturers have demanded financial indemnification from national governments who procure their vaccines. While most high-income countries are legislatively capable of indemnifying vaccine manufacturers, many low- and middle-income countries (LMICs) are not. A number of LMICs have thus changed their legislations to permit for manufacturers’ indemnification demands. Amending legislation in this way is state capture and has led to delays in LMICs and vaccine manufacturers signing procurement contracts. This has critically stalled access to vaccines in LMICs and created disparities in access to vaccines between high-income countries and LMICs.ConclusionsCOVID-19 vaccine manufacturers’ indemnification demands constitute state capture in many LMICs though not in high-income countries; this has enhanced global COVID-19 vaccine inequities. Results underscore the need to find alternatives to financial indemnification that do not hinder critical efforts to end the pandemic.

Worldwide vaccine inequality threatens to unleash the next COVID-19 variant

The emergence of the Omicron variant (B.1.1.529 BA.1) near Johannesburg heralded the development of an unprecedented number of new COVID-19 infections across South Africa in November 2021. Omicron and its subvariants would soon become the dominant strains across Africa, Europe, and the United States. As with the Delta variant (B.1.617.2), Omicron emerged from an industrialized nation with one of the lowest vaccination rates of any well-developed country. The emergence of variants from undervaccinated regions is a direct consequence of the virus replicating unchecked through an unprotected population. Despite this, the United States and other higher-income nations have adopted a strategy of preferentially inoculating their citizens with multiple and booster doses, whereas lower-income nations struggle with vaccine availability, infrastructure, and their own vaccine manufacturing capability. Much more needs to be done to address worldwide vaccine inequities and prevent the emergence of the next devastating variant. The persistence of the pandemic anywhere remains an ongoing threat to citizens everywhere.

COVID-19 vaccine hesitancy cannot fully explain disparities in vaccination coverage across the contiguous United States

Vaccine hesitancy has been identified as a major obstacle preventing comprehensive coverage against the COVID-19 pandemic. However, few studies have analyzed the association between ex-ante vaccine hesitancy and ex-post vaccination coverage. This study leveraged one-year county-level data across the contiguous United States to examine whether the prospective vaccine hesitancy eventually translates into differential vaccination rates, and whether vaccine hesitancy can explain socioeconomic, racial, and partisan disparities in vaccine uptake. A set of structural equation modeling was fitted with vaccine hesitancy and vaccination rate as endogenous variables, controlling for various potential confounders. The results demonstrated a significant negative link between vaccine hesitancy and vaccination rate, with the difference between the two continuously widening over time. Counties with higher socioeconomic statuses, more Asian and Hispanic populations, more elderly residents, greater health insurance coverage, and more Democrats presented lower vaccine hesitancy and higher vaccination rates. However, underlying determinants of vaccination coverage and vaccine hesitancy were divergent regarding their different associations with exogenous variables. Mediation analysis further demonstrated that indirect effects from exogenous variables to vaccination coverage via vaccine hesitancy only partially explained corresponding total effects, challenging the popular narrative that portrays vaccine hesitancy as a root cause of disparities in vaccination. Our study highlights the need of well-funded, targeted, and ongoing initiatives to reduce persisting vaccination inequities.

Barely Tweeting and Rarely About Racism: Assessing US State Health Department Twitter Use During the COVID-19 Vaccine Rollout.

The general public was discussing racism and potential inequities in COVID-19 vaccinations among African Americans on Twitter before the first COVID-19 vaccine received emergency use authorization, but it is unclear how US state health departments (SHDs) were using Twitter to address the inequities. This study examines the frequency, content and timing of SHD tweets during the US rollout of the first SARS Co-V2 vaccine. This was a prospective study of tweets posted from the official Twitter accounts of each of the 50 US SHDs and the DC health department from October 19, 2020 to February 28, 2021. We retrieved the content and metadata of 100% of their tweets; calculated frequencies and proportions of tweets containing key terms related to COVID-19 vaccines, equity and racism; stratified the data by region; and charted longitudinal trends. Overall, SHDs tweeted infrequently, and rarely tweeted about inequities, mistrust or racism. Though 55.48% of all SHD tweets were about COVID-19, hardly any tweets contained the terms: race/ethnicity (1.20%); equity (1.09); mistrust (.59%); or racism (.06%). Similar patterns existed among vaccination-related tweets, which accounted for 24.38% of all tweets. Only 21.64% of vaccination-related tweets containing any race/ethnicity, equity, mistrust, or racism terms were posted prior to the first Emergency Use Authorization (EUA). Those about African Americans (70.45%) were posted ≥8 weeks after EUA. Concerns about racism and inequities in COVID-19 vaccination continue on Twitter, but SHDs rarely tweet about them. This strikes a worrisome chord of disconnection from the science linking health inequities to racism.

When Lack of Trust in the Government and in Scientists Reinforces Social Inequalities in Vaccination Against COVID-19.

ObjectiveTo assess whether lack of trust in the government and scientists reinforces social and racial inequalities in vaccination practices.DesignA follow-up of the EpiCov random population-based cohort survey.SettingIn July 2021, in France.ParticipantsEighty-thousand nine hundred and seventy-one participants aged 18 years and more.Main Outcome MeasuresAdjusted odds ratios of COVID-19 vaccination status (received at least one dose/ intends to get vaccinated/ does not know whether to get vaccinated/refuses vaccination) were assessed using multinomial regressions to test associations with social and trust factors and to study how these two factors interacted with each other.ResultsIn all, 72.2% were vaccinated at the time of the survey. The population of unvaccinated people was younger, less educated, had lower incomes, and more often belonged to racially minoritized groups, as compared to vaccinated people. Lack of trust in the government and scientists to curb the spread of the epidemic were the factors most associated with refusing to be vaccinated: OR = 8.86 (7.13 to 11.00) for the government and OR = 9.07 (7.71 to 10.07) for scientists, compared to vaccinated people. Lack of trust was more prevalent among the poorest which consequently reinforced social inequalities in vaccination. The poorest 10% who did not trust the government reached an OR of 16.2 (11.9 to 22.0) for refusing to be vaccinated compared to the richest 10% who did.ConclusionThere is a need to develop depoliticised outreach programmes targeted at the most socially disadvantaged groups, and to design vaccination strategies conceived with people from different social and racial backgrounds to enable them to make fully informed choices.

Addressing vaccine inequities among Ukrainian refugees

Addressing vaccine inequities among Ukrainian refugees

Cost-effectiveness of Coronavirus Disease 2019 Vaccination in Low- and Middle-Income Countries.

ABSTRACTBackgroundDespite the advent of safe and effective COVID-19 vaccines, pervasive inequities in global vaccination persist.MethodsWe projected health benefits and donor costs of delivering vaccines for up to 60% of the population in 91 low- and middle-income countries (LMICs). We modeled a highly contagious (Re at model start = 1.7), low-virulence (IFR = 0.32%) “omicron-like” variant and a similarly contagious “severe” variant (IFR = 0.59%) over 360 days, accounting for country-specific age structure and healthcare capacity. Costs included vaccination startup (US$630 million) and per-person procurement and delivery (US$12.46/person vaccinated).ResultsIn the omicron-like scenario, increasing current vaccination coverage to achieve at least 15% in each of the 91 LMICs would prevent 11 million new infections and 120,000 deaths, at a cost of US$0.95 billion, for an incremental cost-effectiveness ratio (ICER) of US$670/year-of-life saved (YLS). Increases in vaccination coverage to 60% would additionally prevent up to 68 million infections and 160,000 deaths, with ICERs < US$8,000/YLS. ICERs were < US$4,000/YLS under the more severe variant scenario and generally robust to assumptions about vaccine effectiveness, uptake, and costs.ConclusionsFunding expanded COVID-19 vaccine delivery in LMICs would save hundreds of thousands of lives, be similarly or more cost-effective than other donor-funded global aid programs, and improve health equity.

The Impact of Neocolonialism on India's COVID-19 Response.

In this paper, we analyze the impact of COVID-19 in India and the nation’s shortcomings in responding appropriately to the pandemic. We discuss how international vaccine inequities, rooted in neocolonialism, and the WHO’s broad recommendation of Global North pandemic responses (i.e., lockdowns, nonspecific social distancing) blunted the effectiveness of India’s COVID-19 response and instead heightened classism, economic turmoil, and unnecessary infection and death from the virus.

Vaccine Equity: Lessons Learned from the COVID-19 Pandemic.

The COVID-19 pandemic has disproportionately affected racial and ethnic minorities, a group who is also less likely to be fully vaccinated. Vaccine hesitancy and vaccine access both play a role in the vaccine inequities observed during the COVID-19 pandemic. Strategies to improve access and reduce hesitancy are discussed.

Towards a new model of global health justice: the case of COVID-19 vaccines

This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad...

The COVID-19 Vaccination and Vaccine Inequity Worldwide: An Empirical Study Based on Global Data.

Vaccination is critical for controlling the COVID-19 pandemic. However, the progress of COVID-19 vaccination varies from different countries, and global vaccine inequity has been a worldwide public health issue. This study collected data from the Our World in Data COVID-19 vaccination data set between 13 December 2020 and 1 January 2022. The measurement reflecting the pandemic situation included New cases, New deaths, Hospital patients, ICU patients, and the Reproduction rate. Indicators for measuring the vaccination coverage included Total vaccinations per hundred and People vaccinated per hundred. The Human Development Index (HDI) measured the country’s development level. Findings indicated that countries with higher HDI have more adequate vaccine resources, and global vaccine inequity exists. The study also found that vaccination significantly mitigates the pandemic, and reaching 70% immunization coverage can further control the epidemic. In addition, the emergence of Omicron variants makes the COVID-19 epidemic situation even worse, suggesting the importance and necessity of addressing vaccine inequity. The globe will face a greater challenge in controlling the pandemic if lower-vaccinated countries do not increase their vaccination coverage. Addressing the issue of vaccine inequity needs the cooperation of HIC, LMIC, public health departments, and vaccine producers. Moreover, the media has to contribute to effective public health communication by raising public perceptions of the COVID-19 pandemic, vaccination, and vaccine inequity.

Heterogeneity in Spatial Inequities in COVID-19 Vaccination Across 16 Large US Cities.

Differences in vaccination coverage can perpetuate COVID-19 disparities. We explored the association between neighborhood-level social vulnerability and COVID-19 vaccination coverage in 16 large US cities from the beginning of the vaccination campaign in December 2020 through September 2021. We calculated the proportion of fully vaccinated adults in 866 zip code tabulation areas (ZCTA) of 16 large US cities: Long Beach, Los Angeles, Oakland, San Diego, San Francisco, and San Jose (CA); Chicago (IL); Indianapolis (IN); Minneapolis (MN); New York City (NY); Philadelphia (PA); and Austin, Dallas, Fort Worth, Houston, and San Antonio (TX). We computed absolute and relative total and Social Vulnerability Index(SVI)-related inequities by city. COVID-19 vaccination coverage was 0.75 times (95% CI 0.69-0.81) or 16% (95% CI 12.1-20.2%) percentage points lower in neighborhoods with the highest social vulnerability as compared to those with the lowest. These inequities were heterogeneous, with cities in the West region generally displaying narrower inequities in both the absolute and relative scales. The SVI domains of socioeconomic status and household composition & disability showed the strongest associations with vaccination coverage. Inequities in COVID-19 vaccinations hamper efforts to achieve health equity, as they mirror and could lead to even wider inequities in other COVID-19 outcomes.