加拿大魁北克省和安大略省按年龄和地区层面的健康社会决定因素划分的疫苗护照对首剂SARS-CoV-2疫苗覆盖率的影响:中断时间序列分析

CMAJ open Pub Date : 2023-10-24 Print Date: 2023-09-01 DOI:10.9778/cmajo.20220242
Jorge Luis Flores Anato, Huiting Ma, Mackenzie A Hamilton, Yiqing Xia, Sam Harper, David Buckeridge, Marc Brisson, Michael P Hillmer, Kamil Malikov, Aidin Kerem, Reed Beall, Caroline E Wagner, Étienne Racine, Stefan Baral, Ève Dubé, Sharmistha Mishra, Mathieu Maheu-Giroux
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引用次数: 0

摘要

背景:在加拿大,所有省份在2021年都实施了疫苗护照,以减少严重急性呼吸系统综合征冠状病毒2型在非必要室内空间的传播,并提高疫苗接种率(魁北克和安大略省于2021年9月至2022年3月实施的政策)。我们试图按年龄、地区收入和种族化居民比例评估疫苗护照政策对第一剂严重急性呼吸系统综合征冠状病毒2型疫苗接种覆盖率的影响。方法:我们使用魁北克和安大略省疫苗登记处与人口普查信息相关的数据进行了中断时间序列分析(2050万人口,年龄≥12岁;分析单位:传播地区)。我们将负二项回归拟合到第一剂疫苗接种,使用调整基线疫苗接种覆盖率的自然样条(开始:2021年7月;结束:魁北克2021年10月,安大略2021年11月)。我们获得了反事实的疫苗接种率和覆盖率,并估计了疫苗护照的绝对和相对影响。结果:在这两个省份,在宣布疫苗护照之前,第一剂疫苗接种覆盖率为82%(年龄≥12岁)。该公告导致魁北克的覆盖率估计增加了0.9个百分点(95%置信区间[CI]0.4-1.2),安大略的覆盖率预计增加了0.7个百分点(95%CI 0.5-0.8)。这相当于在11周内接种了23%(95%CI 10%-36%)和19%(95%CI 15%-22%)的疫苗。12-39岁人群的影响更大。尽管低收入和种族化程度较高地区的覆盖率较低,但两个省的地区一级收入或种族化比例的绝对影响几乎没有变化。解释:在2个省的疫苗覆盖率较高的背景下,疫苗护照的宣布对第一剂疫苗的覆盖率影响较小,对减少疫苗覆盖率中的经济和种族不平等影响不大。研究结果表明,还需要其他政策来提高低收入和种族化社区的疫苗接种覆盖率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of a vaccine passport on first-dose SARS-CoV-2 vaccine coverage by age and area-level social determinants of health in the Canadian provinces of Quebec and Ontario: an interrupted time series analysis.

Background: In Canada, all provinces implemented vaccine passports in 2021 to reduce SARS-CoV-2 transmission in non-essential indoor spaces and increase vaccine uptake (policies active September 2021-March 2022 in Quebec and Ontario). We sought to evaluate the impact of vaccine passport policies on first-dose SARS-CoV-2 vaccination coverage by age, and area-level income and proportion of racialized residents.

Methods: We performed interrupted time series analyses using data from Quebec's and Ontario's vaccine registries linked to census information (population of 20.5 million people aged ≥ 12 yr; unit of analysis: dissemination area). We fit negative binomial regressions to first-dose vaccinations, using natural splines adjusting for baseline vaccination coverage (start: July 2021; end: October 2021 for Quebec, November 2021 for Ontario). We obtained counterfactual vaccination rates and coverage, and estimated the absolute and relative impacts of vaccine passports.

Results: In both provinces, first-dose vaccination coverage before the announcement of vaccine passports was 82% (age ≥ 12 yr). The announcement resulted in estimated increases in coverage of 0.9 percentage points (95% confidence interval [CI] 0.4-1.2) in Quebec and 0.7 percentage points (95% CI 0.5-0.8) in Ontario. This corresponds to 23% (95% CI 10%-36%) and 19% (95% CI 15%-22%) more vaccinations over 11 weeks. The impact was larger among people aged 12-39 years. Despite lower coverage in lower-income and more-racialized areas, there was little variability in the absolute impact by area-level income or proportion racialized in either province.

Interpretation: In the context of high vaccine coverage across 2 provinces, the announcement of vaccine passports had a small impact on first-dose coverage, with little impact on reducing economic and racial inequities in vaccine coverage. Findings suggest that other policies are needed to improve vaccination coverage among lower-income and racialized neighbourhoods and communities.

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