JMIR Publications

ABSTRACT

Background:

Despite widespread COVID-19 vaccination, breakthrough infections remain a public health concern, with transmission risks potentially linked to community behaviors and age-specific preventive practices. While mask-wearing and social distancing are well-established mitigation strategies, their adoption patterns across age groups, particularly among vaccinated individuals, are poorly understood.

Objective:

This study focuses on understanding breakthrough infections among vaccinated individuals, high-risk behaviors and socioeconomic determinants of COVID-19 susceptibility to guide effective public health interventions.

Methods:

A 31-question voluntary survey was distributed using convenience sampling through the Qualtrics survey platform. Log-binomial regression model was used to estimate the Relative Risk (RR) to measure the association between testing COVID positive and the different activities.

Results:

Among the vaccinated individuals, those who tested positive were 11.103 times more likely to engage in going to a restaurant or bar compared to those who tested negative (p=0.010). There was a significant difference in practicing social distancing and mask wearing between the different age groups (p=0.015) with 100% of the participants above 70 years old practicing it followed by 96.8% of the 18-29 years old. The study found lower infection rates in the same age groups compared to the other age groups. Moreover, the 18-29 age group demonstrated notable associations with practising social distancing and mask-wearing in various settings.

Conclusions:

Compliance with social distancing and mask-wearing was higher among older and younger participants, and non-compliance with social distancing and mask wearing was associated with a higher positivity rate. Activities like going to a restaurant or bar was significantly associated with testing COVID-19 positive in vaccinated individuals.