Understanding a national increase in COVID-19 vaccination intention, the Netherlands, November 2020-March 2021.
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ABSTRACT:
SUBMITTER: Sanders JG
PROVIDER: S-EPMC8431991 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundVaccine uptake differs between social groups. Mobile vaccination units (MV-units) were deployed in the Netherlands by municipal health services in neighbourhoods with low uptake of COVID-19 vaccines.AimWe aimed to evaluate the impact of MV-units on vaccine uptake in neighbourhoods with low vaccine uptake.MethodsWe used the Dutch national-level registry of COVID-19 vaccinations (CIMS) and MV-unit deployment registrations containing observations in 253 neighbourhoods where MV-units were deployed and 890 contiguous neighbourhoods (total observations: 88,543 neighbourhood-days). A negative binomial regression with neighbourhood-specific temporal effects using splines was used to study the effect.ResultsDuring deployment, the increase in daily vaccination rate in targeted neighbourhoods ranged from a factor 2.0 (95% confidence interval (CI): 1.8-2.2) in urbanised neighbourhoods to 14.5 (95% CI: 11.6-18.0) in rural neighbourhoods. The effects were larger in neighbourhoods with more voters for the Dutch conservative Reformed Christian party but smaller in neighbourhoods with a higher proportion of people with non-western migration backgrounds. The absolute increase in uptake over the complete intervention period ranged from 0.22 percentage points (95% CI: 0.18-0.26) in the most urbanised neighbourhoods to 0.33 percentage point (95% CI: 0.28-0.37) in rural neighbourhoods.ConclusionDeployment of MV-units increased daily vaccination rate, particularly in rural neighbourhoods, with longer travel distance to permanent vaccination locations. This public health intervention shows promise to reduce geographic and social health inequalities, but more proactive and long-term deployment is required to identify its potential to substantially contribute to overall vaccination rates at country level.
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Project description:BackgroundExcess all-cause mortality has been used in many countries as an estimate of mortality effects from COVID-19. What was the excess mortality in Israel in 2020 and when, where and for whom was this excess?MethodsMortality rates between March to November 2020 for various demographic groups, cities, month and week were compared with the average rate during 2017-2019 for the same groups or periods.ResultsTotal mortality rates for March-November were significantly higher by 6% in 2020, than the average of 2017-2019, 14% higher among the Arab population and 5% among Jews and Others. Significantly higher monthly mortality rates were found in August, September and October by 11%, 13% and 19%, respectively, among Jews and Others, and by 19%, 64% and 40% in the Arab population. Excess mortality was significant only at older ages, 7% higher rates at ages 65-74 and 75-84 and 8% at ages 85 and above, and greater for males than females in all ages and population groups. Interestingly, mortality rates decreased significantly among the younger population aged under 25. The cities with most significant excess mortality were Ramla (25% higher), Bene Beraq (24%), Bat Yam (15%) and Jerusalem (8%).ConclusionIsrael has seen significant excess mortality in August-October 2020, particularly in the Arab sector. The excess mortality in March-November was statistically significant only at older ages, over 65. It is very important to protect this susceptible population from exposure and prioritize them for inoculations. Lockdowns were successful in lowering the excess mortality. The excess mortality is similar to official data on COVID-19 deaths.
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Project description:BackgroundLimited data exist on population-based risks and risk ratios (RRs) of coronavirus disease 2019 (COVID-19)-associated hospitalizations and clinical outcomes stratified by age and race/ethnicity.MethodsUsing data from electronic health records and claims from 4 US health systems for the period March 2020-March 2021, we calculated risk and RR by age and race/ethnicity for COVID-19-associated hospitalizations and clinical outcomes among adults (≥18 years). COVID-19-associated hospitalizations were defined based on COVID-19 discharge codes or a positive severe acute respiratory syndrome coronavirus 2 result. Proportions of acute exacerbations of underlying conditions were estimated among hospitalized patients with select underlying conditions, stratified by age and race/ethnicity.ResultsAmong 2.6 million adults included in the patient cohort, 6879 had COVID-19-associated hospitalizations during March 2020-March 2021 (risk: 264 per 100 000 population). Compared with younger, non-Hispanic White adults, non-Hispanic Black and Hispanic adults aged ≥65 years had the highest hospitalization risk ratios (RR, 8.6; 95% CI, 7.6-9.9; and RR, 9.3; 95% CI, 8.5-10.3, respectively). Among hospitalized adults with COVID-19 and renal disease or cardiovascular disease, the highest proportion of acute renal failure (55.5%) or congestive heart failure (43.9%) occurred in older, non-Hispanic Black patients. Among hospitalized adults with chronic lung disease or asthma, the highest proportion of respiratory failure (62.9%) or asthma exacerbation (66.7%) occurred in older, Hispanic patients.ConclusionsDuring the first year of the US COVID-19 pandemic in this cohort, older non-Hispanic Black and Hispanic adults had the highest relative risks of COVID-19-associated hospitalization and adverse outcomes and, among those with select underlying conditions, the highest occurrences of acute exacerbations of underlying conditions.
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Project description:ObjectivesIn the Netherlands, during the first phase of the COVID-19 epidemic, the hotspot of COVID-19 overlapped with the country's main livestock area, while in subsequent phases this distinct spatial pattern disappeared. Previous studies show that living near livestock farms influence human respiratory health and immunological responses. This study aimed to explore whether proximity to livestock was associated with SARS-CoV-2 infection.MethodsThe study population was the population of the Netherlands excluding the very strongly urbanised areas and border areas, on January 1, 2019 (12, 628, 244 individuals). The cases are the individuals reported with a laboratory-confirmed positive SARS-CoV-2 test with onset before January 1, 2022 (2, 223, 692 individuals). For each individual, we calculated distance to nearest livestock farm (cattle, goat, sheep, pig, poultry, horse, rabbit, mink). The associations between residential (6-digit postal-code) distance to the nearest livestock farm and individuals' SARS-CoV-2 status was studied with multilevel logistic regression models. Models were adjusted for individuals' age categories, the social status of the postal code area, particulate matter (PM10)- and nitrogen dioxide (NO2)-concentrations. We analysed data for the entire period and population as well as separately for eight time periods (Jan-Mar, Apr-Jun, Jul-Sep and Oct-Dec in 2020 and 2021), four geographic areas of the Netherlands (north, east, west and south), and for five age categories (0-14, 15-24, 25-44, 45-64 and > 65 years).ResultsOver the period 2020-2021, individuals' SARS-CoV-2 status was associated with living closer to livestock farms. This association increased from an Odds Ratio (OR) of 1.01 (95% Confidence Interval [CI] 1.01-1.02) for patients living at a distance of 751-1000 m to a farm to an OR of 1.04 (95% CI 1.04-1.04), 1.07 (95% CI 1.06-1.07) and 1.11 (95% CI 1.10-1.12) for patients living in the more proximate 501-750 m, 251-500m and 0-250 m zones around farms, all relative to patients living further than 1000 m around farms. This association was observed in three out of four quarters of the year in both 2020 and 2021, and in all studied geographic areas and age groups.ConclusionsIn this exploratory study with individual SARS-CoV-2 notification data and high-resolution spatial data associations were found between living near livestock farms and individuals' SARS-CoV-2 status in the Netherlands. Verification of the results in other countries is warranted, as well as investigations into possible underlying exposures and mechanisms.
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