Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 11, 2022
Date Accepted: Jan 6, 2023
Date Submitted to PubMed: Jan 16, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Association of pediatric COVID-19 vaccination and socioeconomic disparities: a large cohort study from the Pedianet Veneto registry
ABSTRACT
Background:
The success of pediatric COVID-19 vaccination strongly depends on parents' willingness to immunize their children. To date the role of socio-economic status (SES) on pediatric COVID-19 vaccination has not been thoroughly examined.
Objective:
To evaluate the association between the proportion of children vaccinated against COVID-19 and SES in a large pediatric cohort.
Methods:
A case-control study design nested into a pediatric cohort of children living in the Veneto Region between July 2021 and March 2022 was adopted, in which each vaccinated child was matched to up to five unvaccinated children. Data on the children was collected from the Pedianet database and linked with the COVID-19 registry. Children born between 2007-2017 and with a pediatric follow-up to at least January 1st 2022, were georeferenced to determine their area deprivation index (ADI), a measure of social and material deprivation calculated at census block level consisting of 5 socio-economic items. The association between ADI and vaccination status was measured by conditioned logistic regression models. Quantile-g-computation-regression models were applied to develop a weighted combination of the individual items (WDI) to estimate how much each component influenced the likelihood of vaccination. All analyses were stratified by age at vaccination (5-11, 12-14 years).
Results:
The study population consisted of 6,475 (25%) vaccinated children, matched with 32,124 non-vaccinated children. Children in the highest deprivation quintile were 36% less likely to receive a COVID-19 vaccine compared to children with the lowest deprivation (OR:0.64;95%CI:0.59-0.70). Living in a rented house, unemployment and single-parent families were the ADI components that increased the chances of being vaccinated the most. WDI confirmed the robustness of the results.
Conclusions:
These findings suggest that socio-economic disparities play an important role in vaccination coverage, emphasizing the need to promote targeted public health efforts to ensure global vaccine equity.
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