Vaccination Status and Trends in Adult Coronavirus Disease 2019–Associated Hospitalizations by Race and Ethnicity: March 2020–August 2022

Author:

Ko Jean Y12ORCID,Pham Huong1,Anglin Onika1,Chai Shua J34,Alden Nisha B5,Meek James6,Anderson Evan J789,Weigel Andy10,Kohrman Alexander11,Lynfield Ruth12,Rudin Dominic13,Barney Grant14,Bennett Nancy M15,Billing Laurie M16,Sutton Melissa17,Talbot H Keipp18,Swain Ashley19,Havers Fiona P12,Taylor Christopher A1,Kirley Pam Daily,Kawasaki Breanna,Yousey-Hindes Kimberly,Openo Kyle P,Henderson Justin,Bye Erica,Nkouaga Florent,Spina Nancy,Bushey Sophrena,Shiltz Eli,Abdullah Nasreen,Schaffner William,Price Andrea,

Affiliation:

1. Centers for Disease Control and Prevention COVID-19 Response , Atlanta, Georgia , USA

2. US Public Health Service Commissioned Corps , Rockville, Maryland , USA

3. California Emerging Infections Program , Oakland, California , USA

4. Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

5. Colorado Department of Public Health and Environment , Denver, Colorado , USA

6. Connecticut Emerging Infections Program, Yale School of Public Health , New Haven, Connecticut , USA

7. Emory University School of Medicine , Atlanta, Georgia , USA

8. Georgia Department of Public Health, Georgia Emerging Infections Program , Atlanta, Georgia , USA

9. Atlanta Veterans Affairs Medical Center , Atlanta, Georgia , USA

10. Iowa Department of Public Health , Des Moines, Iowa , USA

11. Michigan Department of Health and Human Services , Lansing, Michigan , USA

12. Minnesota Department of Health , St. Paul, Minnesota , USA

13. New Mexico Emerging Infections Program , Albuquerque, New Mexico , USA

14. New York State Department of Health , Albany, New York , USA

15. University of Rochester School of Medicine and Dentistry , Rochester, New York , USA

16. Ohio Department of Health , Columbus, Ohio , USA

17. Public Health Division, Oregon Health Authority , Portland, Oregon , USA

18. Vanderbilt University Medical Center , Nashville, Tennessee , USA

19. Salt Lake County Health Department , Salt Lake City, Utah , USA

Abstract

Abstract Background We sought to determine whether race/ethnicity disparities in severe coronavirus disease 2019 (COVID-19) outcomes persist in the era of vaccination. Methods Population-based age-adjusted monthly rate ratios (RRs) of laboratory-confirmed COVID-19–associated hospitalizations were calculated among adult patients from the COVID-19–Associated Hospitalization Surveillance Network, March 2020 - August 2022 by race/ethnicity. Among randomly sampled patients July 2021 - August 2022, RRs for hospitalization, intensive care unit (ICU) admission, and in-hospital mortality were calculated for Hispanic, Black, American Indian/Alaskan Native (AI/AN), and Asian/Pacific Islander (API) persons vs White persons. Results Based on data from 353 807 patients, hospitalization rates were higher among Hispanic, Black, and AI/AN vs White persons March 2020 - August 2022, yet the magnitude declined over time (for Hispanic persons, RR = 6.7; 95% confidence interval [CI], 6.5–7.1 in June 2020 vs RR < 2.0 after July 2021; for AI/AN persons, RR = 8.4; 95% CI, 8.2–8.7 in May 2020 vs RR < 2.0 after March 2022; and for Black persons RR = 5.3; 95% CI, 4.6–4.9 in July 2020 vs RR < 2.0 after February 2022; all P ≤ .001). Among 8706 sampled patients July 2021 - August 2022, hospitalization and ICU admission RRs were higher for Hispanic, Black, and AI/AN patients (range for both, 1.4–2.4) and lower for API (range for both, 0.6–0.9) vs White patients. All other race and ethnicity groups had higher in-hospital mortality rates vs White persons (RR range, 1.4–2.9). Conclusions Race/ethnicity disparities in COVID-19–associated hospitalizations declined but persist in the era of vaccination. Developing strategies to ensure equitable access to vaccination and treatment remains important.

Funder

Council of State and Territorial Epidemiologists

Michigan Department of Health and Human Services

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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