Social differences in COVID-19 vaccination rates–Findings from a German nationwide study

Abstract Background The COVID-19 vaccination aims to prevent the transmission of the novel coronavirus (SARS-CoV-2) as well as to reduce severe courses of the disease and deaths. But various studies indicate social differences in willingness to be vaccinated. This study aims to examine the influence of different social determinants on COVID-19 vaccination in Germany. Methods The analyses are based on data from the sixth follow-up survey of the German Health Update (GEDA 2021), a nationwide cross-sectional telephone survey of the adult population living in Germany. COVID-19 vaccination rates are analyzed considering age, education, income, urban-rural residence and migration background. Poisson regressions were used to examine associations of each social determinant with COVID-19 vaccination rates. Adjustments were made for age, sex, (education) and date of participation. Results Overall, the rate of COVID-19 vaccination for the survey period was 86.7%, with significant differences in vaccination rate by social determinants. The vaccination rate increases significantly with age (94.2% for over 60-year-olds), higher level of education (91.5%) or income (93.0%). In addition, people living in rural areas in Germany (83.5%) and people with an own migration experience (79.1%) had a significantly lower vaccination rate. An age-differentiated analysis also showed the social differences in COVID-19 vaccination rate are significantly lower among those over 60-years old. Conclusions The results suggest social differences in COVID-19 vaccination especially in younger age groups. This should be considered when designing targeted measures to overcome potential barriers to vaccination. However, a large number of other factors affecting vaccination behavior must be taken into account like structural barriers, confidence in decision-makers, the safety of vaccination, and a sense of responsibility towards the community. Key messages • Sociodemographic and socioeconomic determinants affect COVID-19 vaccination rates. • The social differences in COVID-19 vaccination are lower among those over 60-years old.

Under the International Health Regulations (IHR) 2005 States Parties (SP) are required to develop and maintain core public health capacities and report related progress to World Health Organization (WHO) annually,including those related to Points of Entry (PoEs).Using an appropriate tool,provided by WHO, Italian PoEs assessments in 2020 and 2021 were conducted to have the status quo,describe any differences among years and promote corrective actions if required. The tool was designed in 2009 to support SP in ascertaining prior capacities in PoEs and monitoring their progress in order to designate PoEs under IHR.The tool was translated in Italian.Coordination and communication among authorities involved in each PoE (C1),core capacity at all times (C2) and at PHEIC (Public Health Emergency of International Concern) (C3) were assessed by cross border health Authorities for 2020 and 2021.For each of these sections the maximum score is 100%. For each year,a descriptive analysis was conducted and any differences in scores between the two years were noted.The presence of a contingency and vectors' control plans was also investigated.The assessment was completed respectively for 2020 and 2021 by 24 and 25 airports, 53 and 52 ports. C1 in 2020 resulted on average 89% for airports and 95% for ports, in 2021 respectively 90% and 95%; C2 in 2020 resulted on average 64% for airports and 63% for ports, in 2021 respectively 63% and 64%; C3 in 2020 resulted on average 68% for airports and 61% for ports,in 2021 respectively 63% and 58%.Few differences in scores between 2020 and 2021 were noted in some PoEs. 4 PoEs declared the presence of a contingency plan only in 2021.Few PoEs stated to not have a vectors' control plan in both years.The assessment pointed out a good level of coordination and communication among all the stakeholders involved, including the Italian Red Cross,but it revealed lower scores for the other IHR core capacities. Improvement actions have to be pursued surely.

Key messages:
The specified tool helps cross border and national Authorities to understand strengths and weaknesses in each PoE and leads to develop a specific plan of action to overcome potential gaps. Maintaining a good level of core capacities at points of entry is fundamental to protect national public health.

Background:
The COVID-19 vaccination aims to prevent the transmission of the novel coronavirus (SARS-CoV-2) as well as to reduce severe courses of the disease and deaths. But various studies indicate social differences in willingness to be vaccinated. This study aims to examine the influence of different social determinants on COVID-19 vaccination in Germany.

Methods:
The analyses are based on data from the sixth follow-up survey of the German Health Update (GEDA 2021), a nationwide cross-sectional telephone survey of the adult population living in Germany. COVID-19 vaccination rates are analyzed considering age, education, income, urban-rural residence and migration background. Poisson regressions were used to examine associations of each social determinant with COVID-19 vaccination rates. Adjustments were made for age, sex, (education) and date of participation.

Results:
Overall, the rate of COVID-19 vaccination for the survey period was 86.7%, with significant differences in vaccination rate by social determinants. The vaccination rate increases significantly with age (94.2% for over 60-year-olds), higher level of education (91.5%) or income (93.0%). In addition, people living in rural areas in Germany (83.5%) and people with an own migration experience (79.1%) had a significantly lower vaccination rate. An age-differentiated analysis also showed the social differences in COVID-19 vaccination rate are significantly lower among those over 60-years old.

Conclusions:
The results suggest social differences in COVID-19 vaccination especially in younger age groups. This should be considered when designing targeted measures to overcome potential barriers to vaccination. However, a large number of other factors affecting vaccination behavior must be taken into account like structural barriers, confidence in decision-makers, the safety of vaccination, and a sense of responsibility towards the community.

Introduction:
Information on post-infection and vaccine-induced SARS-CoV-2 seroprevalence is important for public health policies. A 3rd wave of National Serological Survey (ISN3COVID-19) was conducted to measure SARS-CoV-2 seroprevalence and characterize specific antibodies distribution in Portuguese population in September -November 2021, following a mass vaccination campaign. Methods: ISN3COVID-19 was a cross-sectional epidemiological study that collected serum samples and questionnaire data on a sample of Portuguese residents aged 1 year or older (n = 4545). SARS-CoV-2 IgG anti-nucleoprotein and antispike antibody levels were measured using Abbott Chemiluminescent Microparticle Immunoassays. Seroprevalence was estimated for the overall sample and stratified by age group, sex, region and self-reported chronic conditions. Medians and respective 95% confidence intervals (95%CI) were used to describe the distribution of SARS-CoV-2 antibodies in specific population subgroups.

Conclusions:
The SARS-CoV-2 seroprevalence was high and consistent with vaccine coverage in Portugal. Seropositivity was associated with sex, age and previous chronic conditions. The anti-SARS-CoV-2 anti-spike IgG levels varied according to vaccine brand and number of doses. These results show that monitoring seroprevalence and SARS-CoV-2 antibody distribution is of paramount importance to guide public health policies. Key messages: Significant increase in SARS-CoV-2 seroprevalence following the mass vaccination campaign consistent with the high vaccine coverage achieved in Portugal. The way we used to contact resident population was innovative, easy and quick, necessary features to complete the intervention in a short time. This confirmed the importance in recruiting and adhering to vaccinations and leds to a driving effect also in the following days. Hubs as capacious and familiar places for the population, have allowed an excellent organization with a fast vaccination course, facilitated reception, resources optimization of health personnel.