Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Study Measures and Definitions
2.2.1. Vaccination Intention
2.2.2. Vaccination Eligibility Date
2.2.3. Vaccination Promptness
2.2.4. Vaccination Hesitancy
2.3. Statistical Analysis
Missing Data
3. Results
3.1. Baseline Vaccination Intention
3.2. Vaccination Promptness
3.3. Factors Affecting Vaccination Promptness
3.4. Reasons for Vaccination Hesitancy
4. Discussion
4.1. Strengths and Limitations
4.2. Implications for the Future
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Vaccination Group | Vaccination Eligibility Date | Definition | Analysis Sample n (%) |
---|---|---|---|
Priority Group 1 | 12/14/2020 | Healthcare workers, residents and staff of long-term care facilities | 145 (11.9%) |
Priority Group 2 | 1/18/2021 | Older adults (age 65+) | 531 (43.4%) |
Priority Group 3a | 2/24/2021 | Primary, secondary, and preschool teachers and other school staff | 68 (5.6%) |
Priority Group 3b | 3/3/2021 | Other frontline essential workers | 141 (11.5%) |
Priority Group 4a | 3/17/2021 | People with high-risk medical conditions; People living in close group settings like homeless shelters, jails, or prisons | 289 (23.6%) |
Priority Group 4b | 3/30/2021 | Other essential workers; other people living in group settings like dormitories or fraternity houses | 9 (0.7%) |
All adults (Ages 16+) | 4/7/2021 | Everyone 16 years of age or older | 40 (3.3%) |
Variables | Analysis Population (n = 1223) | BL Vax Intent = ‘NO’ (n = 90) | BL Vax Intent = ‘UNSURE’ (n = 372) | BL Vax Intent = ‘YES’ (n = 761) | p-Value + |
---|---|---|---|---|---|
Baseline Age in years | 0.0001 | ||||
Mean ± SD | 61.2 ± 12.1 | 58.0 ± 11.3 | 58.7 ± 12.3 | 62.8 ± 11.8 | |
Min–Max | 26.0–90 | 26.0–81.0 | 26.0–87.0 | 27.0–98.0 | |
Sex | 0.0001 | ||||
Female | 848 (69.3%) | 72 (80.0%) | 293 (78.8%) | 483 (63.5%) | |
Male | 375 (30.7%) | 18 (20.0%) | 79 (21.2%) | 278 (36.5%) | |
Race | 0.0001 | ||||
White | 1069 (87.4%) | 68 (75.6%) | 295 (79.3%) | 706 (92.8%) | |
Black | 102 (8.3%) | 15 (16.7%) | 51 (13.7%) | 36 (4.7%) | |
Other | 52 (4.3%) | 7 (7.8%) | 26 (7.0%) | 19 (2.5%) | |
Hispanic Ethnicity | 0.0027 | ||||
Non-Hispanic | 1167 (95.4%) | 85 (94.4%) | 344 (92.5%) | 738 (97.0%) | |
Hispanic | 56 (4.6%) | 5 (5.6%) | 28 (7.5%) | 23 (3.0%) | |
Education Level | 0.0001 | ||||
HS or less | 85 (7.0%) | 7 (7.8%) | 43 (11.6%) | 35 (4.6%) | |
Some College | 278 (22.7%) | 25 (27.8%) | 96 (25.8%) | 157 (20.6%) | |
College Grad | 480 (39.2%) | 40 (44.4%) | 136 (36.6%) | 304 (39.9%) | |
Graduate School | 380 (31.1%) | 18 (20.0%) | 97 (26.1%) | 265 (34.8%) | |
Household Income | 0.0001 | ||||
<30,000 | 96 (7.8%) | 7 (7.8%) | 44 (11.8%) | 45 (5.9%) | |
30,000–49,999 | 144 (11.8%) | 18 (20.0%) | 60 (16.1%) | 66 (8.7%) | |
50,000–74,999 | 195 (15.9%) | 15 (16.7%) | 52 (14.0%) | 128 (16.8%) | |
75,000–89,999 | 213 (17.4%) | 14 (15.6%) | 69 (18.5%) | 130 (17.1%) | |
90,000+ | 575 (47.0%) | 36 (40.0%) | 147 (39.5%) | 392 (51.5%) | |
BMI | 0.0003 | ||||
Mean ± SD | 28.6 ± 6.1 | 30.7 ± 7.3 | 29.0 ± 5.9 | 28.2 ± 5.9 | |
Min–Max | 16.0–62.0 | 17.3–62.0 | 16.0–53.7 | 16.0–54.1 | |
BMI Group | 0.0273 | ||||
Underweight (BMI < 18.5) | 15 (1.2%) | 1 (1.1%) | 6 (1.6%) | 8 (1.1%) | |
Healthy (18.5 ≤ BMI < 25) | 327 (26.7%) | 16 (17.8%) | 86 (23.1%) | 225 (29.6%) | |
Overweight (25 ≤ BMI < 30) | 467 (38.2%) | 30 (33.3%) | 146 (39.2%) | 291 (38.2%) | |
Obese (30 ≤ BMI < 40) | 350 (28.6%) | 34 (37.8%) | 116 (31.2%) | 200 (26.3%) | |
Severely Obese (BMI ≥ 40) | 64 (5.2%) | 9 (10.0%) | 18 (4.8%) | 37 (4.9%) | |
Current Smoker | 0.0353 | ||||
Yes | 39 (3.2%) | 3 (3.3%) | 19 (5.1%) | 17 (2.2%) | |
No | 1184 (96.8%) | 87 (96.7%) | 353 (94.9%) | 744 (97.8%) | |
Received a COVID-19 vaccine during the study period | <0.0001 | ||||
Yes | 1130 (92.4%) | 51 (56.7%) | 334 (89.8%) | 745 (97.9%) | |
No | 93 (7.6%) | 39 (43.3%) | 38 (10.2%) | 16 (2.1%) |
Characteristic | Param Est. (SE) | Hazard Ratio (95% CI) | Joint Test p-Value | Pairwise Comparison p-Value |
---|---|---|---|---|
Age at baseline (in decades, centered at 65) | 0.19 (0.03) | 1.21 (1.13–1.29) | 0.0001 | |
Age2 at baseline (in decades, centered at 65) | 0.05 (0.02) | 1.05 (1.01–1.06) | 0.0066 | |
Male | −0.06 (0.07) | 0.95 (0.83–1.08) | 0.3947 | |
Minority Race | −0.06 (0.11) | 0.95 (0.77–1.16) | 0.5900 | |
Hispanic | 0.18 (0.15) | 1.20 (0.88–1.62) | 0.2466 | |
Some College or less | −0.23 (0.07) | 0.80 (0.69–0.92) | 0.0014 | |
Income < $50,000 | −0.17 (0.08) | 0.84 (0.72–0.98) | 0.0312 | |
BL Vaccination Intention (‘Yes’ = ref) | 0.0001 | |||
No | −1.84 (0.19) | 0.16 (0.11–0.23) | 0.0001 | |
Unsure | −0.26 (0.10) | 0.77 (0.63–0.94) | 0.0088 | |
Minority Race XBL Vaccination Intention (BVI) | ||||
Minority: Yes X BVI = ‘Unsure’ | 0.98 (0.31) | 2.67 (1.46–4.88) | 0.0014 | |
BL Vaccination Intention X Time to Vaccination | 0.0535 | |||
BVI = ’Unsure’ X Time to Vaccination | −0.09 (0.04) | 0.92 (0.85–0.99) | 0.0203 |
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Neighbors, C.E.; Faldowski, R.A.; Pieper, C.F.; Taylor, J.; Gaines, M.; Sloane, R.; Wixted, D.; Woods, C.W.; Newby, L.K. Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study. Vaccines 2023, 11, 1639. https://doi.org/10.3390/vaccines11111639
Neighbors CE, Faldowski RA, Pieper CF, Taylor J, Gaines M, Sloane R, Wixted D, Woods CW, Newby LK. Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study. Vaccines. 2023; 11(11):1639. https://doi.org/10.3390/vaccines11111639
Chicago/Turabian StyleNeighbors, Coralei E., Richard A. Faldowski, Carl F. Pieper, Joshua Taylor, Megan Gaines, Richard Sloane, Douglas Wixted, Christopher W. Woods, and L. Kristin Newby. 2023. "Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study" Vaccines 11, no. 11: 1639. https://doi.org/10.3390/vaccines11111639