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Rates of and Factors Associated With Primary and Booster COVID-19 Vaccine Receipt by US Veterans, December 2020 to June 2022

Rates of and Factors Associated With Primary and Booster COVID-19 Vaccine Receipt by US Veterans, December 2020 to June 2022

Authors :
Kristina L. Bajema
Mazhgan Rowneki
Kristin Berry
Amy Bohnert
C. Barrett Bowling
Edward J. Boyko
Theodore J. Iwashyna
Matthew L. Maciejewski
Ann M. O’Hare
Thomas F. Osborne
Elizabeth M. Viglianti
Denise M. Hynes
George N. Ioannou
Source :
JAMA Network Open. 6:e2254387
Publication Year :
2023
Publisher :
American Medical Association (AMA), 2023.

Abstract

ImportanceCOVID-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.ObjectiveTo describe incidence and patient characteristics associated with primary, first booster, and second booster COVID-19 vaccination in the Veterans Health Administration (VHA).Design, Setting, and ParticipantsThis retrospective cohort study assessed US veterans receiving care in VHA medical centers and outpatient clinics as of December 1, 2020. All VHA enrollees with an inpatient, outpatient, or telehealth encounter in VHA as well as a primary care physician appointment in the preceding 24 months were included.ExposuresDemographic characteristics, place of residence, prior SARS-CoV-2 infection, and underlying medical conditions.Main Outcomes and MeasuresCumulative incidence of primary, first booster, and second booster COVID-19 vaccination through June 2022. Cox proportional hazards regression was used to identify factors independently associated with COVID-19 vaccination.ResultsAmong 5 632 413 veterans included in the study, 5 094 392 (90.4%) were male, the median (IQR) age was 66 (51-74) years, 1 032 334 (18.3%) were Black, 448 714 (8.0%) were Hispanic, and 4 202 173 (74.6%) were White. Through June 2022, cumulative incidences were 69.0% for primary vaccination, 42.9% for first booster, and 9.3% for second booster. 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. 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%). Factors independently associated with 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.Conclusions and RelevanceIn this cohort study of US veterans, COVID-19 vaccination coverage through June 2022 was suboptimal. Primary vaccination can be improved among younger, rural-dwelling veterans. Greater uptake of booster vaccination among all veterans is needed.

Subjects

Subjects :
General Medicine

Details

ISSN :
25743805
Volume :
6
Database :
OpenAIRE
Journal :
JAMA Network Open
Accession number :
edsair.doi...........6b1e08e5e600852914e07bbef34b5c03
Full Text :
https://doi.org/10.1001/jamanetworkopen.2022.54387