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Socioeconomic inequalities in COVID-19 infection and vaccine uptake among children and adolescents in Catalonia, Spain: a population-based cohort study

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Title: Socioeconomic inequalities in COVID-19 infection and vaccine uptake among children and adolescents in Catalonia, Spain: a population-based cohort study
Authors: Irene López-Sánchez, Aida Perramon-Malavez, Antoni Soriano-Arandes, Clara Prats, Talita Duarte-Salles, Berta Raventós, Elena Roel
Contributors: Institut Català de la Salut, [López-Sánchez I] Real World Epidemiology Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain. Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain. [Perramon-Malavez A, Prats C] Department of Physics, Universitat Politècnica de Catalunya (UPC-BarcelonaTech), Barcelona, Spain. [Soriano-Arandes A] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca d’Infecció i Immunitat al Pacient, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Duarte-Salles T] Real World Epidemiology Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain. Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands. [Raventós B] Real World Epidemiology Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain. Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Universitat Politècnica de Catalunya. Departament de Física, Universitat Politècnica de Catalunya. BIOCOM-SC - Biologia Computacional i Sistemes Complexos
Source: Front Pediatr
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Universitat Politècnica de Catalunya (UPC)
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Frontiers in Pediatrics, Vol 12 (2024)
Publisher Information: Frontiers Media SA, 2024.
Publication Year: 2024
Subject Terms: TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia biológica::inmunomodulación::inmunoterapia::inmunización::inmunoterapia activa::vacunación, socioeconomic deprivation, Àrees temàtiques de la UPC::Enginyeria biomèdica::Aspectes econòmics, Adolescents, Pediatrics, RJ1-570, 03 medical and health sciences, 0302 clinical medicine, children, Assistència sanitària, DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections, ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus, adolescents, Other subheadings::Other subheadings::Other subheadings::/prevention & control, Estatus social, Otros calificadores::Otros calificadores::Otros calificadores::/prevención & control, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunization::Immunotherapy, Active::Vaccination, DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::adolescente, COVID-19, SALUD PÚBLICA::atención a la salud (salud pública)::promoción de la salud::monitorización de las desigualdades en salud::estratificadores de equidad::atención a la salud (salud pública)::factores socioeconómicos, infection, Coronavirus disease, PUBLIC HEALTH::Health Care (Public Health)::Health Promotion::Health Inequality Monitoring::Equity Stratifiers::Health Care (Public Health)::Socioeconomic Factors, Spain, Àrees temàtiques de la UPC::Enginyeria biomèdica::Aspectes socials, vaccine uptake, NAMED GROUPS::Persons::Age Groups::Adolescent, Socioeconomic deprivation index, Àrees temàtiques de la UPC::Ciències de la salut::Medicina, Vaccine, COVID-19 (Malaltia) - Vacunació
Description: IntroductionThis study aims to investigate the relationship between deprivation, as measured by a socioeconomic deprivation index (SDI) score for census tract urban areas, and COVID-19 infections and vaccine uptake among children and adolescents before and after the vaccination rollout in Catalonia, Spain.MethodsWe conducted a population-based cohort study using primary care records. Individuals were followed 3 months before the start of the vaccination campaign in Spain and 3 months after. Children (5–11 years) and adolescents (12–15 years) with at least 1 year of prior history observation available and without missing deprivation data. For each outcome, we estimated cumulative incidence and crude Cox proportional-hazard models by SDI quintiles, and hazard ratios (HRs) of COVID-19 infection and vaccine uptake relative to the least deprived quintile, Q1.ResultsBefore COVID-19 vaccination rollout, 290,625 children and 179,685 adolescents were analyzed. Increased HR of deprivation was associated with a higher risk of COVID-19 infection in both children [Q5: 1.55 (95% CI, 1.47–1.63)] and adolescents [Q5: 1.36 (95% CI, 1.29–1.43)]. After the rollout, this pattern changed among children, with lower risk of infection in more deprived areas [Q5: 0.62 (95% CI, 0.61–0.64)]. Vaccine uptake was higher among adolescents than children, but in both age groups, non-vaccination was more common among those living in more deprived areas (39.3% and 74.6% in Q1 vs. 26.5% and 66.9% in Q5 among children and adolescents, respectively).ConclusionsChildren and adolescents living in deprived areas were at higher risk of COVID-19 non-vaccination. Socioeconomic disparities in COVID-19 infection were also evident before vaccine rollout, with a higher infection risk in deprived areas across age groups. Our findings suggest that changes in the association between deprivation and infections among children after the vaccine rollout were likely due to testing disparities.
Document Type: Article
Other literature type
File Description: application/pdf
ISSN: 2296-2360
DOI: 10.3389/fped.2024.1466884
Access URL: https://pubmed.ncbi.nlm.nih.gov/39633820
https://hdl.handle.net/11351/12463
https://doaj.org/article/2518c751b3db440d8f42f55ae74f34a8
https://hdl.handle.net/2117/424930
https://doi.org/10.3389/fped.2024.1466884
Rights: CC BY
Accession Number: edsair.doi.dedup.....ae42581758764eea25b1318e5600f765
Database: OpenAIRE
Description
Abstract:IntroductionThis study aims to investigate the relationship between deprivation, as measured by a socioeconomic deprivation index (SDI) score for census tract urban areas, and COVID-19 infections and vaccine uptake among children and adolescents before and after the vaccination rollout in Catalonia, Spain.MethodsWe conducted a population-based cohort study using primary care records. Individuals were followed 3 months before the start of the vaccination campaign in Spain and 3 months after. Children (5–11 years) and adolescents (12–15 years) with at least 1 year of prior history observation available and without missing deprivation data. For each outcome, we estimated cumulative incidence and crude Cox proportional-hazard models by SDI quintiles, and hazard ratios (HRs) of COVID-19 infection and vaccine uptake relative to the least deprived quintile, Q1.ResultsBefore COVID-19 vaccination rollout, 290,625 children and 179,685 adolescents were analyzed. Increased HR of deprivation was associated with a higher risk of COVID-19 infection in both children [Q5: 1.55 (95% CI, 1.47–1.63)] and adolescents [Q5: 1.36 (95% CI, 1.29–1.43)]. After the rollout, this pattern changed among children, with lower risk of infection in more deprived areas [Q5: 0.62 (95% CI, 0.61–0.64)]. Vaccine uptake was higher among adolescents than children, but in both age groups, non-vaccination was more common among those living in more deprived areas (39.3% and 74.6% in Q1 vs. 26.5% and 66.9% in Q5 among children and adolescents, respectively).ConclusionsChildren and adolescents living in deprived areas were at higher risk of COVID-19 non-vaccination. Socioeconomic disparities in COVID-19 infection were also evident before vaccine rollout, with a higher infection risk in deprived areas across age groups. Our findings suggest that changes in the association between deprivation and infections among children after the vaccine rollout were likely due to testing disparities.
ISSN:22962360
DOI:10.3389/fped.2024.1466884