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CDC report spotlights socioeconomic status in COVID vaccine coverage

COVID-19 vaccination coverage in less socioeconomically vulnerable US counties was 1.9 percentage points higher than that in the most susceptible counties in the first 2.5 months of vaccine rollout, a study yesterday in Morbidity and Mortality Weekly Report (MMWR) finds.

Centers for Disease Control and Prevention (CDC) researchers led the study, which used the agency’s social vulnerability index (SVI) to classify counties according to low, moderate, or high vulnerability and vaccine data for 49,264,338 residents of 49 states and Washington, DC, who received one or two COVID-19 vaccine doses from Dec 14, 2020, to Mar 1, 2021, and for whom county of residence was available.

Vaccine coverage was 15.8% in counties with low social vulnerability, compared with 13.9% in those with high susceptibility. Much of the disparity was tied to socioeconomic status, with 2.5 percentage points higher coverage in low-vulnerability counties than in those with high-vulnerability status.

Low- and high-vulnerability counties had similar vaccine coverage in terms of percentage of residents with a disability and those with limited English proficiency.

Compared with highly vulnerable counties, less susceptible counties’ vaccine coverage was at least 0.5 percentage points lower in residents aged 65 and older (-2.3 percentage points), multiunit housing (-1.3), and households without a vehicle (-0.7). But the largest disparity between the two types of counties was the percentage of adults with less than a high school diploma (2.8-percentage-point difference).

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“Although vaccination coverage estimates by county-level social vulnerability varied widely among states, disparities in vaccination coverage were observed in the majority of states,” the authors said.

Better vaccine coverage in vulnerable populations needs to be prioritized in light of their increased COVID-19 infection and mortality burdens, according to the researchers.

“As vaccine supply increases and administration expands to additional priority groups, CDC, state, and local jurisdictions should continue to monitor vaccination levels by SVI metrics to aid in the development of community efforts to improve vaccination access, outreach, and administration among populations most affected by COVID-19,” they concluded.
Mar 17 MMWR study

 

Aspirin linked to less serious COVID-19 outcomes

A low-dose aspirin treatment is associated with a lower likelihood of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality in hospitalized COVID-19 patients, according to a study published yesterday in Anesthesia & Analgesia.

The retrospective observational study looked at 412 hospitalized COVID-19 patients across the United States from March to July 2020, 98 of whom (23.7%) received aspirin. Of those who received aspirin, 75.5% were taking it before admission and 86.7% received it within 24 hours of hospital admission.

Those treated with aspirin had adjusted hazard risks for mechanical ventilation, ICU admission, and in-hospital mortality of 0.56 (95% confidence interval [CI], 0.37 to 0.85), 0.57 (95% CI, 0.38 to 0.85), and 0.53 (95% CI, 0.31 to 0.90), respectively.

While no major bleeding or overt thrombosis differences were recorded, the initial levels of fibrinogen, a protein involved in blood clotting, were lower in those on aspirin (524 vs 635 milligrams per deciliter). The aspirin group also needed significantly less oxygen support upon hospital admission.

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Overall, patients who received aspirin were more likely to have hypertension (78.6% of aspirin users vs 52.5% of nonaspirin users), diabetes mellitus (55.1% vs 29.0%), coronary artery disease (34.7% vs 5.7%), renal disease (31.6% vs 12.4%), and liver disease (13.3% vs 6.7%), and they were more likely to be on home beta blockers (34.7% vs 16.9%). If they received aspirin upon hospital arrival, the dose was a median of 81 milligrams for a median duration of 6 days.

“Aspirin is low cost, easily accessible and millions are already using it to treat their health conditions,” said lead author Jonathan Chow, MD, in a George Washington University press release. “Finding this association is a huge win for those looking to reduce risk from some of the most devastating effects of COVID-19.”
Mar 17 Anesth Analg study
Mar 17 George Washington University press release



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