Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine Uptake.
Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine Uptake.
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DOI：
10.1016/j.amepre.2021.08.027
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发表时间：
2022-04
影响因子：
5.5
通讯作者：
Washington DL
中科院分区：
文献类型：
--
作者：
Haderlein TP;Wong MS;Jones KT;Moy EM;Yuan AH;Washington DL
公平获得COVID-19疫苗对于减轻COVID-19对少数种族/族裔的负面影响至关重要。美国少数种族/族裔的COVID-19疫苗接种率低于白人，尽管COVID-19死亡率/病例率较高。退伍军人健康管理局提供了一个独特的管理式医疗系统的背景下，几乎没有访问障碍。这项研究评估了种族/民族作为退伍军人健康管理局COVID-19疫苗接种的预测因素。该队列由年龄≥65岁的退伍军人健康管理局门诊使用者组成（N= 3，474，874）。于二零二零年十二月十四日至二零二一年二月二十三日期间评估COVID-19疫苗接种。进行多变量logistic回归分析，控制人口统计学、医学合并症和流感疫苗接种史。接近印度卫生服务合同卫生服务提供地区进行了测试，作为一个主持人。数据分析于二零二一年进行。黑人（OR=1.28，95% CI=1.17，1.40），西班牙裔（OR=1.15，95% CI=1.05，1.25）和亚洲人（OR=1.21，95% CI=1.02，1.43）比白人更有可能接受退伍军人健康管理局COVID-19疫苗接种。美国印第安人/阿拉斯加原住民比白人更不可能接受退伍军人健康管理局COVID-19疫苗接种，但仅限于居住在合同医疗服务提供区县的人（OR= 0.58，95% CI= 0.47，0.72）。流感疫苗接种史可正向预测COVID-19疫苗接种（OR= 2.28，95%CI =2.22，2.34）。在退伍军人健康管理局，与美国普通人群相比，大多数种族/少数民族群体的COVID-19疫苗接种率高于白人，这表明疫苗接种障碍减少。印第安人保健服务可以为美洲印第安人/阿拉斯加土著人口提供安全网。解决非退伍军人健康管理局环境中的疫苗接种障碍可能会减少种族/民族差异。
Equitable COVID-19 vaccine access is imperative to mitigating negative COVID-19 impacts among racial/ethnic minorities. U.S. racial/ethnic minorities have lower COVID-19 vaccination rates than Whites despite higher COVID-19 death/case rates. The Veterans Health Administration provides the unique context of a managed care system with few access barriers. This study evaluates race/ethnicity as a predictor of Veterans Health Administration COVID-19 vaccination. The cohort was composed of Veterans Health Administration outpatient users aged ≥65 years (N=3,474,874). COVID-19 vaccination was assessed between December 14, 2020 and February 23, 2021. Multivariable logistic regressions were conducted, controlling for demographics, medical comorbidity, and influenza vaccination history. Proximity to Indian Health Service Contract Health Service Delivery Areas was tested as a moderator. Data analyses were conducted during 2021. Blacks (OR=1.28, 95% CI=1.17, 1.40), Hispanics (OR=1.15, 95% CI=1.05, 1.25), and Asians (OR=1.21, 95% CI=1.02, 1.43) were more likely than Whites to receive Veterans Health Administration COVID-19 vaccinations. American Indian/Alaska Natives were less likely than Whites to receive Veterans Health Administration COVID-19 vaccinations, but only those residing in Contract Health Service Delivery Area counties (OR= 0.58, 95% CI= 0.47, 0.72). Influenza vaccine history positively predicted COVID-19 vaccine uptake (OR= 2.28, 95% CI=2.22, 2.34). In the Veterans Health Administration, compared with the general U.S. population, COVID-19 vaccine receipt is higher among most racial/ethnic minority groups than Whites, suggesting reduced vaccination barriers . The Indian Health Service may provide a safety net for American Indian/Alaska Native populations. Addressing vaccination access barriers in non–Veterans Health Administration settings can potentially reduce racial/ethnic disparities.
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