宁波市民新冠病毒疫苗认知与接种意愿调查分析

目的 了解宁波市民对新冠病毒疫苗认知情况及接种意愿并分析其影响因素，为人群大规模接种提供依据。方法 采用自行设计的调查问卷通过网络调查新冠病毒疫苗相关知识、态度和行为。结果 调查对象平均年龄（40.54±10.63）岁，86.54%的人表示愿意接种新冠病毒疫苗，对新冠病毒疫苗的安全性、有效性、接种重要性的认可率分别为97.42%、97.52%和98.60%。多因素logistic回归分析结果显示：机关/事业单位/教师（OR=2.901）、医务人员（OR=14.825）、认为自我感染新冠病毒风险较大（OR=8.607）、身边已接种新冠病毒疫苗人数>10人（OR=5.667）、了解新冠病毒疫苗预约接种流程（OR=2.721）、认可新冠病毒疫苗安全性等特征是具备新冠病毒疫苗接种意愿的保护性因素。结论 宁波市民新冠病毒疫苗接种意愿较强，对新冠病毒疫苗的安全性、有效性和接种重要性普遍认可。     

新型冠状病毒疫苗接种对成都市境外输入病例流行病学及临床特征的影响分析

目的 分析新型冠状病毒（新冠病毒）疫苗接种对成都市境外输入病例流行病学及临床特征的影响,为新型冠状病毒肺炎疫情防控提供参考依据。方法 截至2021年4月15日,经成都市入境的新冠病毒感染病例,根据新冠病毒疫苗接种史被分为疫苗接种组和疫苗未接种组。回顾性收集和分析病例的流行病学及临床特征资料。实验室检测项目包括新冠病毒核酸检测、临床指标、血清抗体和淋巴细胞检测。采用WPS 2019软件整理数据,采用R 4.0.3软件进行统计学分析。结果 75例新冠病毒感染病例包括疫苗接种组20例（出现临床症状4例）和疫苗未接种组55例（出现临床症状16例）。疫苗接种组的首针接种时间分布为2020年7-11月,其中接种2剂次疫苗采用一次性接种方式有10例,采取2次间隔接种方式有10例,2次接种间隔14~57 d,完成疫苗接种与发病时间间隔87~224 d。两组病例的分类和临床分型的差异有统计学意义（P<0.05）,其中,疫苗接种组病例分类为无症状感染者的比例较高（40.00%,8/20）,而疫苗未接种组的临床分型以普通型的比例较高（76.36%,42/55）。两组病例的新冠病毒核酸检测2个靶标（ORF1ab和N基因）Ct值、淋巴细胞亚型、降钙素原及C反应蛋白的差异无统计学意义（P>0.05）,疫苗接种组的血清淀粉样蛋白A水平低于疫苗未接种组（P<0.05）,但新冠病毒血清抗体IgM、IgG及总抗体水平均明显高于疫苗未接种组（P<0.05）。结论 新冠病毒疫苗接种后,仍存在感染的风险,但新冠病毒侵入人体后,体内可迅速产生特异性IgM和IgG抗体,对感染者产生一定保护作用,已接种新冠病毒疫苗的病例分类以无症状感染者为主。     

佳木斯大学学生新冠病毒疫苗认知情况、接种意愿及影响因素调查分析

目的：了解大学生对新冠病毒疫苗认知和接种意愿,分析其影响因素,为提高大学生新冠病毒疫苗接种意愿提供理论支持。方法：采用“滚雪球”抽样方法,利用“问卷星”对佳木斯大学学生进行线上问卷调查。分别采用非参数检验、χ²检验比较不同人群对新冠病毒疫苗认知情况及接种意愿,采用多因素逐步logistic回归分析影响大学生新冠病毒疫苗接种意愿的因素。结果：调查的15 418名学生对新冠病毒疫苗认知得分为12 (11～14)分,其中,高认知组(全部题目相加得分≥18分×0.8)共5 184人,占33.62%;愿意接种新冠病毒疫苗的学生共14 165人,占91.87%。logistic回归分析结果显示,男生(OR=1.210)、认为需要对新冠病毒疫苗相关知识进行培训(OR=2.081)、愿意推荐家人或朋友接种新冠病毒疫苗(OR=60.089)、愿意对公众进行新冠病毒疫苗相关知识宣教(OR=1.651)、认知得分越高(OR=1.117)的学生接种新冠病毒疫苗的意愿较高。患有某种慢性疾病的学生(OR=0.229)、妊娠及哺乳期妇女(OR=0.083)、自身有接种禁忌症(OR=0.085)...     

2021年阿坝州居民新冠病毒疫苗接种意愿及影响因素分析

目的 了解2021年阿坝藏族羌族自治州（简称“阿坝州”）居民对新冠病毒疫苗的知晓、接种意愿及分析其影响因素。方法 2021-08-10采用分层随机抽样法抽取农区、牧区、半农半牧区的689名志愿者进行面对面新冠病毒疫苗接种意愿及影响因素问卷调查,采用SPSS 22.0统计软件进行统计学分析,率的比较采用χ2检验,利用Logistics回归分析新冠病毒疫苗接种意愿影响因素,检验水准α=0.05。结果 689名调查对象对新冠肺炎、新冠病毒疫苗的知晓率分别为98.0%和96.2%,知晓接种疫苗可以预防新冠肺炎、控制疫情分别为85.9%和85.8%。知晓得分越高,通过卫生机构媒体接受新冠病毒疫苗知识的居民更愿意接种新冠病毒疫苗。结论 阿坝州居民对新冠病毒疫苗知晓较高,了解意愿强烈,可分地区分人群开展相关健康教育,消除疫苗犹豫,加强疫苗接种助力新冠防控。     

推进我国老年人新型冠状病毒疫苗接种的策略分析

【目的】新型冠状病毒疫苗（简称“新冠疫苗”）接种对疫情控制至关重要，我国老年人全程接种和加强接种率较低，亟须加快我国老年人疫苗接种进程。【方法】通过对相关文献和政府网站的梳理，借鉴英国、美国、新加坡和韩国提高老年人接种的政策经验，深入分析我国老年人接种新冠疫苗的现状和原因，从接种重点人群、服务提供及接种意愿3个方面探索提高老年人新冠疫苗接种的策略建议。【结果】实现接种重点人群转变、依靠家庭医生制度建立长久机制、提高接种意愿是推进我国老年人新冠疫苗接种的重要途径。【结论】老年人新冠疫苗接种需要不断强化，现有接种模式应接不暇，应依靠家庭医生制度建立长久机制，从动员模式转变为常态化接种模式。     

德州市3～6岁儿童新冠疫苗接种意愿及影响因素分析

目的 了解德州市儿童新冠疫苗的接种意愿并分析影响因素。方法 2021年12月在山东省免疫规划信息系统中随机抽取德州市3～6岁儿童5 957人为研究对象,查询、导出儿童基本信息及疫苗免疫史,了解新冠疫苗接种意愿并分析影响因素。结果 德州市3～6岁儿童新冠疫苗接种愿意率92.5%(5 512/5 957);多因素logistic回归分析结果显示,年龄越大(OR=1.80)、农村居住(OR=1.28)、水痘疫苗免疫史(OR=2.56)和百白破疫苗全程接种(OR=3.21),是德州市3～6岁儿童愿意接种新冠疫苗的促进因素。不愿接种的445人原因调查中,以“孩子太小,担心儿童接种新冠疫苗安全性”为主(52.8%),其次为“担心疫苗接种后保护作用不持久”(20.2%)。结论 德州市3～6岁儿童新冠病毒疫苗接种愿意率较高,要做好小年龄组儿童家长的宣传教育工作。     

第二针约不上,第一针白打了?

新冠疫苗,你约上了吗? 最近很多人到第二针的接种时间了,却发现,预约不上,心里十分着急. 能推迟接种吗,还是,干脆只打一针就好了? 理想接种:在8周内完成两针 目前国内上市的新冠疫苗,主要为灭活疫苗,都需要打两针. 根据《新冠病毒疫苗接种技术指南(第一版)》,两针的接种间隔时间,建议大于等于3周,并且在8周,也就是56天内尽早完成.     

北京市医学院校就诊师生新型冠状病毒疫苗接种意愿及影响因素研究

目的了解医学院校就医师生对接种新型冠状病毒疫苗(简称新冠疫苗)的接种意愿及影响因素,为实施新冠疫苗接种提供参考依据。方法 2020年10—12月在北京某医学院校医院就诊的师生为研究对象,在知情同意的原则下,采用无记名自填式问卷调查。调查信息包括基本特征及接种新冠疫苗的意愿。比较不同特征师生新冠疫苗接种意愿的差异,采用多因素logistic回归模型分析新冠疫苗接种意愿的相关因素。结果共招募575名调查对象,534人(93.19%)愿意在新冠疫苗上市后接种疫苗,其中学生332人(92.22%)、教师202人(93.95%)。多因素logistic回归分析显示,认为新冠疫苗在疫情防控中有帮助的学生(OR=5.49,95%CI:2.15～14.01,P0.01)和教师(OR=20.42,95%CI:2.45～169.97,P0.01)接种新冠疫苗的意愿较高。新冠疫苗的产地会影响教师的接种意愿(OR=7.68,95%CI:1.84～32.05,P0.01)。学生和教师对于接种新冠疫苗的主要担忧因素分别为担心疫苗的不良反应(学生63.33%、教师70.70%)和疫苗效果不好(学生26.94%、教师22.33%)。结论医学院校师生有较好医学知识背景,就诊师生较其他人群具有高的患病风险意识,此类人群具有较高的新冠疫苗接种意愿。新冠疫苗对疫情防控重要性的认识程度是影响接种意愿的因素。在实施新冠疫苗接种时,权威机构应该加强新冠疫苗重要性、有效性和安全性的科普教育,增强人们对接种新冠疫苗的信心。     

新冠疫苗为何要接种加强针

虽然全世界都在如火如荼的接种新冠疫苗,但是新冠病毒仍十分猖獗.原因主要有二:除少数国家外,新冠疫苗接种率尚未能形成免疫屏障,新冠病毒在不断变异.另外一个不容忽视的问题是,新冠疫苗的有效性会随着时间的推移而下降.根据以色列卫生部公布的数据,辉瑞新冠疫苗的保护作用在接种6个月后出现下滑.     

板报资料

正接种新冠疫苗可能有哪些不良反应新冠疫苗接种是眼下大家普遍关注的话题。有些人犹豫打不打新冠疫苗,很重要的一个因素就是怕接种后发生不良反应。那么,新冠疫苗接种后可能产生哪些不良反应?是否有严重的不良反应报告?从前期新冠疫苗临床试验研究结果和紧急使用时收集到的信息,新冠疫苗常见不良反应的发生情况与已广泛应用的其他疫苗基本类似。     

The role of vaccines in COVID-19 control strategies in Singapore and China

ObjectivesIn this article, we critically review the development and implementation of COVID-19 vaccination in Singapore and China during the pandemic.MethodsWe collect and analyze data from a range of sources, including scholarly articles, statistics and documents from national governments in the two countries, and reports from international organizations.ResultsThere are important differences in the two countries’ approaches to the evolving pandemic, and thus the roles that COVID-19 vaccination plays in the overall response strategies in these two countries.ConclusionsWhereas Singapore adopted a “living with the virus” strategy, China continued to pursue a COVID-zero strategy. The overall COVID-19 response strategy of Singapore was largely shared by many countries in the world, while that of China was more unique and hardly imitated elsewhere. Nevertheless, vaccination played a significant role in both countries’ responses to the pandemic. A comparison and contrast between the vaccination processes in these two countries thus shed important light on the drivers and outcomes of COVID-19 vaccination in different settings.     

Adolescents’ attitudes to the COVID-19 vaccination

Vaccines against COVID-19 are now available for adolescents in Hong Kong but vaccine hesitancy is a major barrier to herd immunity. This survey study explores Hong Kong adolescents’ attitudes towards the COVID-19 vaccination. 2609 adolescents from across Hong Kong completed an online survey focused on the intent to vaccinate and the reasons for their choice. 39% of adolescents intended to take the COVID-19 vaccination and significant factors for this decision include: having at least one parent vaccinated, knowing somebody diagnosed with COVID-19 and receiving the influenza vaccine. Adolescents’ major concerns were either the safety and efficacy of the vaccine or the risk of infection. This study has proved that even in adolescents the vaccine hesitancy model is prominent with adolescents’ intentions highly related to confidence in the vaccine and perception of disease risk. Future interventions should target these specific concerns to ensure adolescents are well educated to overcome vaccine hesitancy.     

浙江省≥60岁人群新冠疫苗接种意愿和影响因素

  目的  了解浙江省≥60岁人群新型冠状病毒疫苗(简称新冠疫苗)的接种意愿及其影响因素。  方法  2020年9月1日—2020年11月30日采用分层抽样法对浙江省≥60岁人群进行问卷调查,收集基本信息、接种意愿、COVID-19风险意识等信息,采用χ2检验比较各组接种意愿率的差异,并用多因素Logistic回归分析模型分析接种意愿的影响因素。  结果  共1 858名≥60岁老年人完成调查,其新冠疫苗免费接种、自费接种的意愿率分别为88.3%和66.1%。多因素Logistic回归分析模型显示,对于免费接种,居住在乡村(OR=1.6,95% CI:1.2~2.2)、无外出(OR=1.6,95% CI:1.1~2.3)、听说过COVID-19(OR=3.7,95% CI:2.4~5.8)、认为COVID-19会造成严重后果(OR=2.3,95% CI:1.6~3.5)的老年人接种意愿更高。愿意自费接种的主要原因是认同新冠疫苗的安全性和有效性;不愿意自费接种的原因主要包括新冠疫苗需要收费和担心新冠疫苗的不良反应。  结论  浙江省≥60岁人群新冠疫苗免费接种意愿较高,但仍应加强关于新冠疫苗知识的宣传教育,并落实全民免费接种政策,以增强该人群接种疫苗的依从性。     

Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey

BackgroundHIV infection is a significant independent risk factor for both severe COVID-19 presentation at hospital admission and in-hospital mortality. Available information has suggested that people living with HIV and AIDS (PLWHA) could benefit from COVID-19 vaccination. However, there is a dearth of evidence on willingness to receive COVID-19 vaccination among PLWHA.ObjectiveThe aim of this study was to investigate willingness to receive COVID-19 vaccination among a national sample of PLWHA in China.MethodsThis cross-sectional online survey investigated factors associated with willingness to receive COVID-19 vaccination among PLWHA aged 18 to 65 years living in eight conveniently selected Chinese metropolitan cities between January and February 2021. Eight community-based organizations (CBOs) providing services to PLWHA facilitated the recruitment. Eligible PLWHA completed an online survey developed using a widely used encrypted web-based survey platform in China. We fitted a single logistic regression model to obtain adjusted odds ratios (aORs), which involved one of the independent variables of interest and all significant background variables. Path analysis was also used in the data analysis.ResultsOut of 10,845 PLWHA approached by the CBOs, 2740 completed the survey, and 170 had received at least one dose of the COVID-19 vaccine. This analysis was performed among 2570 participants who had never received COVID-19 vaccination. Over half of the participants reported willingness to receive COVID-19 vaccination (1470/2570, 57.2%). Perceptions related to COVID-19 vaccination were significantly associated with willingness to receive COVID-19 vaccination, including positive attitudes (aOR 1.11, 95% CI 1.09-1.12; P<.001), negative attitudes (aOR 0.96, 95% CI 0.94-0.97; P<.001), perceived support from significant others (perceived subjective norm; aOR 1.53, 95% CI 1.46-1.61; P<.001), and perceived behavioral control (aOR 1.13, 95% CI 1.11-1.14; P<.001). At the interpersonal level, receiving advice supportive of COVID-19 vaccination from doctors (aOR 1.99, 95% CI 1.65-2.40; P<.001), CBO staff (aOR 1.89, 95% CI 1.51-2.36; P<.001), friends and/or family members (aOR 3.22, 95% CI 1.93-5.35; P<.001), and PLWHA peers (aOR 2.38, 95% CI 1.85-3.08; P<.001) was associated with higher willingness to receive COVID-19 vaccination. The overall opinion supporting COVID-19 vaccination for PLWHA on the internet or social media was also positively associated with willingness to receive COVID-19 vaccination (aOR 1.59, 95% CI 1.31-1.94; P<.001). Path analysis indicated that interpersonal-level variables were indirectly associated with willingness to receive COVID-19 vaccination through perceptions (β=.43, 95% CI .37-.51; P<.001).ConclusionsAs compared to PLWHA in other countries and the general population in most parts of the world, PLWHA in China reported a relatively low willingness to receive COVID-19 vaccination. The internet and social media as well as interpersonal communications may be major sources of influence on PLWHA’s perceptions and willingness to receive COVID-19 vaccination.     

Management of COVID-19 and vaccination in Nepal: A qualitative study

Objective

The aim of this research is to investigate the perspective of citizens of Nepal on the management COVID-19, the roll-out of the vaccine, and to gain an understanding of attitudes towards the governments' handling of the COVID-19 pandemic.

Method

A qualitative methodology was used. In-depth interviews were conducted with 18 males and 23 females aged between 20 and 86 years old from one remote and one urban district of Nepal. Interviews were conducted in November and December 2021. A thematic approach was used to analyse the data, utilising NVivo 12 data management software.

Result

Three major themes were identified: (1) Peoples' perspective on the management of COVID-19, (2) people's perception of the management of COVID-19 vaccination and (3) management and dissemination of information. It was found that most participants had heard of COVID-19 and its mitigation measures, however, the majority had limited understanding and knowledge about the disease. Most participants expressed their disappointment concerning poor testing, quarantine, vaccination campaigns and poor accountability from the government towards the management of COVID-19. Misinformation and stigma were reported as the major factors contributing to the spread of COVID-19. People's knowledge and understanding were mainly shaped by the quality of the information they received from various sources of communication and social media. This heavily influenced their response to the pandemic, the preventive measures they followed and their attitude towards vaccination.

Conclusion

Our study concludes that the study participants' perception was that testing, quarantine centres and vaccination campaigns were poorly managed in both urban and rural settings in Nepal. Since people's knowledge and understanding of COVID-19 are heavily influenced by the quality of information they receive, we suggest providing contextualised correct information through a trusted channel regarding the pandemic, its preventive measures and vaccination. This study recommends that the government proactively involve grassroots-level volunteers like Female Community Health Volunteers to effectively prepare for future pandemics.

Patient and Public Contribution

This study was based on in-depth interviews with 41 people from diverse socioeconomic backgrounds. This study would not have been possible without their participation.     

Changes in COVID-19 vaccine acceptance rate among recovered critically Ill patients: A 12-month follow-up study

IntroductionWe surveyed a cohort of patients who recovered from severe SARS-CoV-2 infection to determine the COVID-19 vaccination rate. We also compared the willingness to accept COVID-19 vaccine before and after its availability to assess changes in perception and attitude towards vaccination.Materials and MethodsRecovered patients with severe hypoxemic respiratory failure from SARS-CoV-2 infection treated in the ICU at Grady Memorial Hospital, Atlanta, Georgia between April 1, 2020, and June 30, 2020 were followed up over a 1-year period to assess vaccine acceptability and acceptance rates, and changes in perception towards COVID-19 vaccination before and after vaccine availability.ResultsA total of 98 and 93 patients completed the initial and follow up surveys respectively. During the initial survey, 41% of the patients intended to receive vaccination, 46% responded they would not accept a vaccine against COVID-19 even if it were proven to be ‘safe and effective ‘and 13% undecided. During the follow up survey, 44% of the study cohort had received at least one dose of a COVID-19 vaccine. Major reasons provided by respondents for not accepting COVID-19 vaccine were lack of trust in the effectiveness of the vaccine, pharmaceutical companies, government, vaccine technology, fear of side effects and perceived immunity against COVID-19. Respondents were more likely to be vaccinated if recommended by their physicians (OR 6.4, 95% CI 2.8–8.3), employers (OR 2.5, 95% CI 1.9–5.8), and family and friends (OR 1.6, 95% CI 1.1–4.5).ConclusionWe found a suboptimal COVID-19 vaccination rate in a cohort of patients who recovered from severe infection. COVID-19 vaccine information and recommendation by healthcare providers, employers, and family and friends may improve vaccination uptake.     

Addressing Barriers to COVID-19 Vaccination Among Older U.S. Veterans

Efforts are being made to ensure that COVID-19 vaccination among older adults is as complete as possible. Dialogue-based interventions tailored to patients’ specific concerns have shown potential for effectiveness in promoting vaccination. We implemented a quality improvement project intended to help patients in an outpatient geriatrics clinic overcome barriers to COVID-19 vaccination. We offered tailored conversations by telephone in which we discussed the barriers to vaccination that the patients were facing and offered to provide relevant information and/or logistical assistance. Of the 184 patients reached by phone, 125 (68%) endorsed having already been vaccinated and 59 (32%) did not. About one third of the unvaccinated patients were willing to participate in tailored conversations (20 patients?=?34% of the unvaccinated). In follow-up calls 30 days after the intervention we found that four of these 20 patients had received COVID-19 vaccination, one patient was scheduled for vaccination, 10 continued to be deciding about vaccination, four had decided against it and one could not be reached. Dialogue-based interventions that are conducted by telephone and are tailored to the specific barriers to vaccination being faced by older adults may have some effectiveness in encouraging vaccination against COVID-19. The effectiveness of such interventions may be decreased in populations that already have high vaccination rates and in which many patients have already formed strong opinions regarding vaccination against COVID-19. Completion of Plan-Do-Study-Act cycles is a feasible way to design, implement and work to optimize quality improvement efforts related to COVID-19 vaccination.

     

Reasons for COVID-19 Vaccine Hesitancy Among Chinese People Living With HIV/AIDS: Structural Equation Modeling Analysis

BackgroundMany countries and organizations recommended people living with HIV/AIDS (PLWHA) receive the COVID-19 vaccine. However, vaccine hesitancy still exists and becomes a barrier for promoting COVID-19 vaccination among PLWHA.ObjectiveThis study aims to investigate factors that contributed to COVID-19 vaccine hesitancy among PLWHA.MethodsThe study used a multicenter cross-sectional design and an online survey mode. We recruited PLWHA aged 18-65 years from 5 metropolitan cities in China between January 2021 and February 2021. Participants completed an online survey through Golden Data, a widely used encrypted web-based survey platform. Multiple linear regression models were used to assess the background characteristics in relation to COVID-19 vaccine hesitancy, and structural equation modeling was performed to assess the relationships among perceived benefits, perceived risks, self-efficacy, subjective norms, and COVID-19 vaccine hesitancy.ResultsAmong 1735 participants, 41.61% (722/1735) reported COVID-19 vaccine hesitancy. Older age, no other vaccinations in the past 3 years, and having chronic disease history were positively associated with COVID-19 vaccine hesitancy. Structural equation modeling revealed a direct relationship of perceived benefits, perceived risks, and subjective norms with self-efficacy and vaccine hesitancy and an indirect relationship of perceived benefits, perceived risks, and subjective norms with vaccine hesitancy. Moreover, self-efficacy toward COVID-19 vaccination was low. PLWHA had concerns of HIV disclosure during COVID-19 vaccination. Family member support could have an impact on COVID-19 vaccination decision-making.ConclusionsCOVID-19 vaccine hesitancy was high among PLWHA in China. To reduce COVID-19 vaccine hesitancy, programs and strategies should be adopted to eliminate the concerns for COVID-19 vaccination, disseminate accurate information on the safety and efficacy of the COVID-19 vaccine, encourage family member support for COVID-19 vaccination, and improve PLWHA’s trust of medical professionals.     

COVID-19 Incidence and hospitalization during the delta surge were inversely related to vaccination coverage among the most populous U.S. Counties

ObjectiveWe tested whether COVID-19 incidence and hospitalization rates during the Delta surge were inversely related to vaccination coverage among the 112 most populous counties in the United States, comprising 44 percent of the country's total population.MethodsWe measured vaccination coverage as the percent of the county population fully vaccinated as of July 15, 2021. We measured COVID-19 incidence as the number of confirmed cases per 100,000 population during the 14-day period ending August 12, 2021 and hospitalization rates as the number of confirmed COVID-19 admissions per 100,000 population during the same 14-day period.ResultsIn log-linear regression models, a 10-percentage-point increase in vaccination coverage was associated with a 28.3% decrease in COVID-19 incidence (95% confidence interval, 16.8 - 39.7%), a 44.9 percent decrease in the rate of COVID-19 hospitalization (95% CI, 28.8 - 61.0%), and a 16.6% decrease in COVID-19 hospitalizations per 100 cases (95% CI, 8.4 - 24.8%). Inclusion of demographic covariables, as well as county-specific diabetes prevalence, did not weaken the observed inverse relationship with vaccination coverage. A significant inverse relationship between vaccination coverage and COVID-19 deaths per 100,000 during August 20 – September 16 was also observed. The cumulative incidence of COVID-19 through June 30, 2021, a potential indicator of acquired immunity due to past infection, had no significant relation to subsequent case incidence or hospitalization rates in August.ConclusionHigher vaccination coverage was associated not only with significantly lower COVID-19 incidence during the Delta surge, but also significantly less severe cases of the disease.Public Interest SummaryWe tested whether COVID-19 incidence and hospitalization rates during the Delta variant-related surge were inversely related to vaccination coverage among the 112 most populous counties in the United States, together comprising 44 percent of the country's total population. A 10-percentage-point increase in vaccination coverage was associated with a 28.3% decrease in COVID-19 incidence, a 44.9 percent decrease in the rate of COVID-19 hospitalization, and a 16.6% decrease in COVID-19 hospitalizations per 100 cases. Inclusion of demographic covariables, as well as county-specific diabetes prevalence, did not weaken the observed inverse relationship with vaccination coverage. A significant inverse relationship between vaccination coverage and COVID-19 deaths per 100,000 during August 20 – September 16 was also observed. Higher vaccination coverage was associated not only with significantly lower COVID-19 incidence during the Delta surge, but also significantly less severe cases of the disease.     

Ecological Analysis of the Decline in Incidence Rates of COVID-19 Among Nursing Home Residents Associated with Vaccination,United States,December 2020-January 2021

ObjectiveTo evaluate if facility-level vaccination after an initial vaccination clinic was independently associated with COVID-19 incidence adjusted for other factors in January 2021 among nursing home residents.DesignEcological analysis of data from the CDC's National Healthcare Safety Network (NHSN) and from the CDC's Pharmacy Partnership for Long-Term Care Program.Setting and ParticipantsCMS-certified nursing homes participating in both NHSN and the Pharmacy Partnership for Long-Term Care Program.MethodsA multivariable, random intercepts, negative binomial model was applied to contrast COVID-19 incidence rates among residents living in facilities with an initial vaccination clinic during the week ending January 3, 2021 (n = 2843), vs those living in facilities with no vaccination clinic reported up to and including the week ending January 10, 2021 (n = 3216). Model covariates included bed size, resident SARS-CoV-2 testing, staff with COVID-19, cumulative COVID-19 among residents, residents admitted with COVID-19, community county incidence, and county social vulnerability index (SVI).ResultsIn December 2020 and January 2021, incidence of COVID-19 among nursing home residents declined to the lowest point since reporting began in May, diverged from the pattern in community cases, and began dropping before vaccination occurred. Comparing week 3 following an initial vaccination clinic vs week 2, the adjusted reduction in COVID-19 rate in vaccinated facilities was 27% greater than the reduction in facilities where vaccination clinics had not yet occurred (95% confidence interval: 14%-38%, P < .05).Conclusions and ImplicationsVaccination of residents contributed to the decline in COVID-19 incidence in nursing homes; however, other factors also contributed. The decline in COVID-19 was evident prior to widespread vaccination, highlighting the benefit of a multifaced approach to prevention including continued use of recommended screening, testing, and infection prevention practices as well as vaccination to keep residents in nursing homes safe.