Disparities in SARS-CoV-2 Infection by Race, Ethnicity, Language, and Social Vulnerability: Evidence from a Citywide Seroprevalence Study in Massachusetts, USA

Author:

Matias Wilfredo R.ORCID,Fulcher Isabel R.,Sauer Sara M.,Nolan Cody P.,Guillaume Yodeline,Zhu Jack,Molano Francisco J.,Uceta Elizabeth,Collins Shannon,Slater Damien M.,Sánchez Vanessa M.,Moheed Serina,Harris Jason B.,Charles Richelle C.,Paxton Ryan M.,Gonsalves Sean F.,Franke Molly F.,Ivers Louise C.

Abstract

Abstract  Objectives Uncovering and addressing disparities in infectious disease outbreaks require a rapid, methodical understanding of local epidemiology. We conducted a seroprevalence study of SARS-CoV-2 infection in Holyoke, Massachusetts, a majority Hispanic city with high levels of socio-economic disadvantage to estimate seroprevalence and identify disparities in SARS-CoV-2 infection. Methods We invited 2000 randomly sampled households between 11/5/2020 and 12/31/2020 to complete questionnaires and provide dried blood spots for SARS-CoV-2 antibody testing. We calculated seroprevalence based on the presence of IgG antibodies using a weighted Bayesian procedure that incorporated uncertainty in antibody test sensitivity and specificity and accounted for household clustering. Results Two hundred eighty households including 472 individuals were enrolled. Three hundred twenty-eight individuals underwent antibody testing. Citywide seroprevalence of SARS-CoV-2 IgG was 13.1% (95% CI 6.9–22.3) compared to 9.8% of the population infected based on publicly reported cases. Seroprevalence was 16.1% (95% CI 6.2–31.8) among Hispanic individuals compared to 9.4% (95% CI 4.6–16.4) among non-Hispanic white individuals. Seroprevalence was higher among Spanish-speaking households (21.9%; 95% CI 8.3–43.9) compared to English-speaking households (10.2%; 95% CI 5.2–18.0) and among individuals in high social vulnerability index (SVI) areas based on the CDC SVI (14.4%; 95% CI 7.1–25.5) compared to low SVI areas (8.2%; 95% CI 3.1–16.9). Conclusions The SARS-CoV-2 IgG seroprevalence in a city with high levels of social vulnerability was 13.1% during the pre-vaccination period of the COVID-19 pandemic. Hispanic individuals and individuals in communities characterized by high SVI were at the highest risk of infection. Public health interventions should be designed to ensure that individuals in high social vulnerability communities have access to the tools to combat COVID-19.

Funder

Sullivan Family Foundation

Harvard Data Science Initiative, Harvard University

Centers for Disease Control and Prevention

Division of Intramural Research, National Institute of Allergy and Infectious Diseases

Publisher

Springer Science and Business Media LLC

Subject

Public Health, Environmental and Occupational Health,Health Policy,Sociology and Political Science,Anthropology,Health (social science)

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