Portland, OR—A better understanding of who is getting COVID-19 primary and booster vaccines can help public health officials target areas where uptake is low. A new study suggests that whether the potential recipient lives in a rural or urban area can be an important factor.
The research focused on COVID-19 primary and booster vaccinations in the Veterans Health Administration (VHA) from December 2020 to June 2022. The cohort study of nearly 6 million enrolled veterans finds that 69.0% received a primary vaccination, 42.9% a first booster, and a substantially lower 9.3% for the second booster.
The report in Journal of the American Medical Association Network Open advised that older age, Asian or black race, Hispanic ethnicity, and urban residence were independently associated with getting the vaccines. On the other hand, according to the study led by the Veterans Affairs Portland Health Care System and the Oregon Health and Science University in Portland, younger, rural veterans might require more targeting.
“COVID-19 vaccination rates remain suboptimal in the US. Identifying factors associated with vaccination can highlight existing gaps and guide targeted interventions to improve vaccination access and uptake,” the authors pointed out.
The researchers set out to describe the incidence and patient characteristics associated with primary, first booster, and second booster COVID-19 vaccination in the VHA.
Among the veterans included in the study, more than 90% were male, with a median age of 66 years. Of those, 18.3% were black, 8% were Hispanic, and 74.6% were white. “Cumulative incidence for primary vaccination increased with increasing age, from 46.9% (95% CI, 46.8%-47.0%) among veterans aged 18 to 49 years to 82.9% (95% CI, 82.8%-83.0%) among veterans aged 80 to 84 years,” according to the study. “More black veterans completed primary vaccination (71.7%; 95% CI, 71.6%-71.8%) compared with white veterans (68.9%; 95% CI, 68.9%-69.0%), and more urban-dwelling veterans completed primary vaccination (70.9%; 95% CI, 70.9%-71.0%) compared with highly rural–dwelling veterans (63.8%; 95% CI, 63.4%-64.1%).”
The researchers noted that factors independently associated with a higher likelihood of both primary and booster vaccination included older age, female sex, Asian or black race, Hispanic ethnicity, urban residence, and lack of prior SARS-CoV-2 infection.
“In this cohort study of U.S. veterans, COVID-19 vaccination coverage through June 2022 was suboptimal. Primary vaccination can be improved among younger, rural-dwelling veterans,” the study concluded. “Greater uptake of booster vaccination among all veterans is needed.”
The authors added that few studies “have comprehensively described sociodemographic, geographic, and clinical factors associated with receipt of primary and booster vaccination.”
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