Social vulnerability negatively impacts vaccine uptake
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Key takeaways:
- Fewer than half of people in a study received vaccines against RSV, COVID-19 or influenza.
- Race and socioeconomic conditions significantly affect the vaccine uptake.
Researchers presented data at IDWeek showing that socioeconomic vulnerability and race can negatively impact vaccine uptake.
“One of the study’s most interesting findings is that racial differences in vaccination rates persisted even when we considered factors like income, health insurance and neighborhood,” Elie Saade, MD, MPH, FIDSA, associated professor of medicine at Case Western Reserve University, said during a press briefing ahead of the conference. “This shows that addressing access issues isn’t enough.”
More than one-third of adults in a survey said they did not plan to receive recommended respiratory vaccines this fall, and there have been other indicators of low uptake of the vaccines.
The CDC’s Social Vulnerability Index (SVI) is based on 16 U.S. Census variables and can determine areas that may need significant support before, during or after a disaster. The index also has been used to explore health care issues.
Saade and colleagues analyzed data from patients with acute respiratory infections who were treated at the University Hospitals of Cleveland between Oct. 1, 2023, and April 30, 2024, matching patient demographics and vaccination statuses with SVI census tract-level public data for a study population of 341,029 people.
Among the population, 60% were female and 40% were male. Although African-American people made up roughly 14% of the study population, they made up 37% of people in the highest vulnerability group.
Overall, 37% of participants received an influenza vaccine, 18% received a COVID-19 vaccine and 8.8% received an RSV vaccine.
According to the researchers, ED visits increased, primary care visits decreased and the odds of receiving any of the three vaccines decreased as patients’ vulnerability indicators increased, especially among Black patients.
For example, compared with white patients in the lowest vulnerability bracket, the odds of a white or Black patient in the highest vulnerability bracket receiving an RSV vaccine were reduced by 22% (OR = 0.78; 95% CI, 0.72-0.84) and 58% (OR = 0.42; 95% CI, 0.37-0.48), respectively.
Those odds were 28% and 41% lower for influenza vaccination, and 31% and 50% lower for COVID-19 vaccination, respectively, the researchers found.
“Our key takeaway here is that differences in vaccination rates are not simply a matter of individual choice or awareness,” Saade said. “They are rooted in the social, economic and racial structures of our communities. Therefore, public health efforts need to move beyond traditional health education campaigns and address these broader social and structural determinants of health.”
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Saade E, et al. Abstract 371. Presented at IDWeek; Oct. 16-19, 2024; Los Angeles.
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