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Association between vaccination rates and COVID-19 health outcomes in the United States: a population-level statistical analysis.
Du, Hongru; Saiyed, Samee; Gardner, Lauren M.
Afiliación
  • Du H; Center for Systems Science and Engineering, Johns Hopkins University, 3400 N. Charles Street, Shaffer 4, Baltimore, MD, 21218, USA. hdu9@jhu.edu.
  • Saiyed S; Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA. hdu9@jhu.edu.
  • Gardner LM; Center for Systems Science and Engineering, Johns Hopkins University, 3400 N. Charles Street, Shaffer 4, Baltimore, MD, 21218, USA.
BMC Public Health ; 24(1): 220, 2024 01 18.
Article en En | MEDLINE | ID: mdl-38238709
ABSTRACT

BACKGROUND:

Population-level vaccine efficacy is a critical component of understanding COVID-19 risk, informing public health policy, and mitigating disease impacts. Unlike individual-level clinical trials, population-level analysis characterizes how well vaccines worked in the face of real-world challenges like emerging variants, differing mobility patterns, and policy changes.

METHODS:

In this study, we analyze the association between time-dependent vaccination rates and COVID-19 health outcomes for 48 U.S. states. We primarily focus on case-hospitalization risk (CHR) as the outcome of interest, using it as a population-level proxy for disease burden on healthcare systems. Performing the analysis using Generalized Additive Models (GAMs) allowed us to incorporate real-world nonlinearities and control for critical dynamic (time-changing) and static (temporally constant) factors. Dynamic factors include testing rates, activity-related engagement levels in the population, underlying population immunity, and policy. Static factors incorporate comorbidities, social vulnerability, race, and state healthcare expenditures. We used SARS-CoV-2 genomic surveillance data to model the different COVID-19 variant-driven waves separately, and evaluate if there is a changing role of the potential drivers of health outcomes across waves.

RESULTS:

Our study revealed a strong and statistically significant negative association between vaccine uptake and COVID-19 CHR across each variant wave, with boosters providing additional protection during the Omicron wave. Higher underlying population immunity is shown to be associated with reduced COVID-19 CHR. Additionally, more stringent government policies are generally associated with decreased CHR. However, the impact of activity-related engagement levels on COVID-19 health outcomes varied across different waves. Regarding static variables, the social vulnerability index consistently exhibits positive associations with CHR, while Medicaid spending per person consistently shows a negative association. However, the impacts of other static factors vary in magnitude and significance across different waves.

CONCLUSIONS:

This study concludes that despite the emergence of new variants, vaccines remain highly correlated with reduced COVID-19 harm. Therefore, given the ongoing threat posed by COVID-19, vaccines remain a critical line of defense for protecting the public and reducing the burden on healthcare systems.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Vacunas / COVID-19 Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Vacunas / COVID-19 Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos