Accessibility evaluation of COVID-19 vaccine registration websites across the United States.
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ABSTRACT:
SUBMITTER: Alismail S
PROVIDER: S-EPMC8244541 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Publications
Accessibility evaluation of COVID-19 vaccine registration websites across the United States.
Alismail Sarah S Chipidza Wallace W
Journal of the American Medical Informatics Association : JAMIA 20210801 9
This exploratory study investigated the web accessibility of 54 official COVID-19 vaccine registration websites in the US and their concordance with the WCAG 2.0 and 2.1 guidelines. We employed AChecker, WAVE, and SortSite web accessibility evaluation tools to conduct automated analyses of these websites. The results showed suboptimal compliance with WCAG 2.0 and 2.1 guidelines, as determined using the AChecker, WAVE, and SortSite tools. These shortcomings in compliance may pose difficulties to ...[more]
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Project description:BackgroundAnticipating an initial shortage of vaccines for COVID-19, the Centers for Disease Control (CDC) in the United States developed priority vaccine allocations for specific demographic groups in the population. This study evaluates the performance of the CDC vaccine allocation strategy with respect to multiple potentially competing vaccination goals (minimizing mortality, cases, infections, and years of life lost (YLL)), under the same framework as the CDC allocation: four priority vaccination groups and population demographics stratified by age, comorbidities, occupation and living condition (congested or non-congested).Methods and findingsWe developed a compartmental disease model that incorporates key elements of the current pandemic including age-varying susceptibility to infection, age-varying clinical fraction, an active case-count dependent social distancing level, and time-varying infectivity (accounting for the emergence of more infectious virus strains). The CDC allocation strategy is compared to all other possibly optimal allocations that stagger vaccine roll-out in up to four phases (17.5 million strategies). The CDC allocation strategy performed well in all vaccination goals but never optimally. Under the developed model, the CDC allocation deviated from the optimal allocations by small amounts, with 0.19% more deaths, 4.0% more cases, 4.07% more infections, and 0.97% higher YLL, than the respective optimal strategies. The CDC decision to not prioritize the vaccination of individuals under the age of 16 was optimal, as was the prioritization of health-care workers and other essential workers over non-essential workers. Finally, a higher prioritization of individuals with comorbidities in all age groups improved outcomes compared to the CDC allocation.ConclusionThe developed approach can be used to inform the design of future vaccine allocation strategies in the United States, or adapted for use by other countries seeking to optimize the effectiveness of their vaccine allocation strategies.
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Project description:This study examines the accessibility to COVID-19 vaccination resources in two counties surrounding Newark, NJ in the New York Metropolitan Area, United States. The study area represents diverse population makeups. COVID-19 vaccines were made available by different types of vaccination sites including county mass vaccination sites, medical facilities and pharmacies, and a FEMA community vaccination center in spring 2021. We used the two-step floating catchment area method to measure accessibility and calculated the average accessibility scores of different population groups. We examined the patterns and tested the significance of the differences in accessibility across population groups. The results showed clear spatial heterogeneity in the accessibility to vaccine resources with the existing infrastructure (medical/pharmacy vaccine sites). Accessibility patterns changed with the introduction of county mass sites and the FEMA community site. The county mass vaccination sites in one county greatly increased accessibilities for populations of minority and poverty. The FEMA community site in the other county accomplished the same. Both the local health department and the federal government played an important role in mitigating pre-existing inequalities during the vaccination campaign. Our study shows that social determinants of health need to be addressed and taken into explicit consideration when planning resource distribution during the pandemic.
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Project description:BackgroundPrimary care providers are regarded as trustworthy sources of information about COVID-19 vaccines. Although primary care practices often provide information about common medical and public health topics on their practice websites, little is known about whether they also provide information about COVID-19 vaccines on their practice websites.ObjectiveThis study aimed to investigate the prevalence and correlates of COVID-19 vaccine information on family medicine practices' website home pages in the United States.MethodsWe used the Centers for Medicare and Medicaid National Provider Identifier records to create a sampling frame of all family medicine providers based in the United States, from which we constructed a nationally representative random sample of 964 family medicine providers. Between September 20 and October 8, 2021, we manually examined the practice websites of these providers and extracted data on the availability of COVID-19 vaccine information, and we implemented a 10% cross-review quality control measure to resolve discordances in data abstraction. We estimated the prevalence of COVID-19 vaccine information on practice websites and website home pages and used Poisson regression with robust error variances to estimate crude and adjusted prevalence ratios for correlates of COVID-19 vaccine information, including practice size, practice region, university affiliation, and presence of information about seasonal influenza vaccines. Additionally, we performed sensitivity analyses to account for multiple comparisons.ResultsOf the 964 included family medicine practices, most (n=509, 52.8%) had ≥10 distinct locations, were unaffiliated with a university (n=838, 87.2%), and mentioned seasonal influenza vaccines on their websites (n=540, 56.1%). In total, 550 (57.1%) practices mentioned COVID-19 vaccines on their practices' website home page, specifically, and 726 (75.3%) mentioned COVID-19 vaccines anywhere on their practice website. As practice size increased, the likelihood of finding COVID-19 vaccine information on the home page increased (n=66, 27.7% among single-location practices, n=114, 52.5% among practices with 2-9 locations, n=66, 56.4% among practices with 10-19 locations, and n=304, 77.6% among practices with 20 or more locations, P<.001 for trend). Compared to clinics in the Northeast, those in the West and Midwest United States had a similar prevalence of COVID-19 vaccine information on website home pages, but clinics in the south had a lower prevalence (adjusted prevalence ratio 0.8, 95% CI 0.7 to 1.0; P=.02). Our results were largely unchanged in sensitivity analyses accounting for multiple comparisons.ConclusionsGiven the ongoing COVID-19 pandemic, primary care practitioners who promote and provide vaccines should strongly consider utilizing their existing practice websites to share COVID-19 vaccine information. These existing platforms have the potential to serve as an extension of providers' influence on established and prospective patients who search the internet for information about COVID-19 vaccines.
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Project description:BackgroundThe onset of the COVID-19 pandemic and the concurrent development of vaccines offered a rare and somewhat unprecedented opportunity to study antivaccination behavior as it formed over time via the use of archived versions of websites.ObjectiveThis study aims to assess how existing antivaccination websites modified their content to address COVID-19 vaccines and pandemic restrictions.MethodsUsing a preexisting collection of 25 antivaccination websites curated by the IvyPlus Web Collection Program prior to the pandemic and crawled every 6 months via Archive-It, we conducted a content analysis to see how these websites acknowledged or ignored COVID-19 vaccines and pandemic restrictions. Websites were assessed for financial behaviors such as having storefronts, mention of COVID-19 vaccines in general or by manufacturer name, references to personal freedom such as masking, safety concerns like side effects, and skepticism of science.ResultsThe majority of websites addressed COVID-19 vaccines in a negative fashion, with more websites making appeals to personal freedom or expressing skepticism of science than questioning safety. This can potentially be attributed to the lack of available safety data about the vaccines at the time of data collection. Many of the antivaccination websites we evaluated actively sought donations and had a membership option, evidencing these websites have financial motivations and actively build a community around these issues. The content analysis also offered the opportunity to test the viability of archived websites for use in scholarly research. The archived versions of the websites had significant shortcomings, particularly in search functionality, and required supplementation with the live websites. For web archiving to be a viable source of stand-alone content for research, the technology needs to make significant improvements in its capture abilities.ConclusionsIn summary, we found antivaccination websites existing prior to the COVID-19 pandemic largely adapted their messaging to address COVID-19 vaccines with very few sites ignoring the pandemic altogether. This study also demonstrated the timely and significant need for more robust web archiving capabilities as web-based environments become more ephemeral and unstable.
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Project description:Vaccine hesitancy is the next great barrier for public health. Arab Americans are a rapidly growing demographic in the United States with limited information on the prevalence of vaccine hesitancy. We therefore sought to study the attitudes towards the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the United States. This was a cross sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine. A total of 4000 surveys were sent via e-mail from 28 December 2020 to 31 January 2021, and 513 responses were received. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. On multivariable analysis, we found that respondents who had declined an influenza vaccine in the preceding 5 years (p < 0.001) and allied health professionals (medical assistants, hospital administrators, case managers, researchers, scribes, pharmacists, dieticians and social workers) were more likely to be vaccine hesitant (p = 0.025). In addition, respondents earning over $150,000 US dollars annually were less likely to be vaccine hesitant and this finding was significant on multivariable analysis (p = 0.011). Vaccine hesitancy among health care providers could have substantial impact on vaccine attitudes of the general population, and such data may help inform vaccine advocacy efforts.
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Project description:BackgroundMonovalent booster/additional doses of COVID-19 vaccines were first authorized in August 2021 in the United States. We evaluated the real-world effectiveness of receipt of a monovalent booster/additional dose of COVID-19 vaccine compared with receiving a primary vaccine series without a booster/additional dose.MethodsCohorts of individuals receiving a COVID-19 booster/additional dose after receipt of a complete primary vaccine series were identified in 2 administrative insurance claims databases (Optum, CVS Health) supplemented with state immunization information system data between August 2021 and March 2022. Individuals with a complete primary series but without a booster/additional dose were one-to-one matched to boosted individuals on calendar date, geography, and clinical factors. COVID-19 diagnoses were identified in any medical setting, or specifically in hospitals/emergency departments (EDs). Propensity score-weighted hazards ratios (HRs) and 95% confidence intervals (CI) were estimated with Cox proportional hazards models; vaccine effectiveness (VE) was estimated as 1 minus the HR by vaccine brand overall and within subgroups of variant-specific eras, immunocompromised status, and homologous/heterologous booster status.ResultsAcross both data sources, we identified 752,165 matched pairs for BNT162b2, 410,501 for mRNA-1273, and 11,398 for JNJ-7836735. For any medically diagnosed COVID-19, meta-analyzed VE estimates for BNT162b2, mRNA-1273, and JNJ-7836735, respectively, were: BNT162b2, 54% (95% CI, 53%-56%); mRNA-1273, 58% (95% CI, 56%-59%); JNJ-7836735, 34% (95% CI, 23%-44%). For hospital/ED-diagnosed COVID-19, VE estimates ranged from 70% to 76%. VE was generally lower during the Omicron era than the Delta era and for immunocompromised individuals. There was little difference observed by homologous or heterologous booster status.ConclusionThe original, monovalent booster/additional doses were reasonably effective in real-world use among the populations for which they were indicated during the study period. Additional studies may be informative in the future as new variants emerge and new vaccines become available.Registration: The study protocol was publicly posted on the BEST Initiative website (https://bestinitiative.org/wp-content/uploads/2022/03/C19-VX-Effectiveness-Protocol_2022_508.pdf).
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