A Survival Analysis of Rural-Urban Disparities in COVID-19 Vaccination Uptake in the United States.

Autor:	Datta BK; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.; Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA., Jaremski JE; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA., Ansa BE; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.; Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA., Odhiambo L; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.; Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, USA., Clary C; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.; Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA., Islam KMM; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.; Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, USA., Johnson JA; Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.; Department of Community & Behavioral Health Sciences, Augusta University, Augusta, GA, USA.
Jazyk:	angličtina
Zdroj:	American journal of health promotion : AJHP [Am J Health Promot] 2024 Nov 11, pp. 8901171241300136. Date of Electronic Publication: 2024 Nov 11.
DOI:	10.1177/08901171241300136
Abstrakt:	Purpose: Though urban-rural disparities in COVID-19 vaccination coverage was documented at a point of time, little is known on the evolution of vaccination uptake over time. This study, using individual level time-to-event data, intend to assess the differences in monthly progression of vaccination uptake among U.S. adults by urban/rural residence. Design: Survival analysis. Setting: Urban and rural areas in 29 U.S. states. Subjects: 135,969 adults aged 18+ years. Measures: Time (in months) to receive the first dose of COVID-19 vaccine since the U.S. Food and Drug Administration (FDA) Emergency Use Authorization of Pfizer-BioNTech- and Moderna- COVID-19 Vaccine in December 2020. Analysis: Kaplan-Meier survivor functions and stratified Cox proportional hazard models were estimated for the event of being vaccinated by urban/rural residence for 25 months starting from December 2020. Monthly survival probabilities for urban- and rural- adults were further assessed within certain demographic and socioeconomic groups. Results: We found a gradual divergence of COVID-19 vaccination uptake in favor of urban adults, which was robust across sex, age groups, race and ethnicity, education, and income levels. In April 2021, after vaccine eligibility was expanded, 42.2% adults in urban and 53.3% adults in rural areas were unvaccinated. While only 19.3% urban adults remained unvaccinated in December 2022, this rate was 32.5% among rural adults. Compared to their urban counterparts, rural adults were 0.77 (95% CI: 0.76 - 0.79) times as likely to receive the first dose of COVID-19 vaccine. Conclusions: Time-to-event analysis of vaccination against COVID-19 indicated a lower uptake among rural adults, which was persistent across different demographic and socioeconomic groups. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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