TY - JOUR
T1 - Vaccine Effectiveness Against SARS-CoV-2 Related Hospitalizations in People who had Experienced Homelessness or Incarceration – Findings from the Minnesota EHR Consortium
AU - DeSilva, Malini B.
AU - Knowlton, Gregory
AU - Rai, Nayanjot K.
AU - Bodurtha, Peter
AU - Essien, Inih
AU - Riddles, John
AU - Mehari, Lemlem
AU - Muscoplat, Miriam
AU - Lynfield, Ruth
AU - Rowley, Elizabeth A.K.
AU - Chamberlain, Alanna M.
AU - Patel, Palak
AU - Hughes, Alexandria
AU - Dickerson, Monica
AU - Thompson, Mark G.
AU - Griggs, Eric P.
AU - Tenforde, Mark
AU - Winkelman, Tyler N.A.
AU - Benitez, Gabriela Vazquez
AU - Drawz, Paul E.
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - COVID-19 disproportionately affects people experiencing homelessness or incarceration. While homelessness or incarceration alone may not impact vaccine effectiveness, medical comorbidities along with social conditions associated with homelessness or incarceration may impact estimated vaccine effectiveness. COVID-19 vaccines reduce rates of hospitalization and death; vaccine effectiveness (VE) against severe outcomes in people experiencing homelessness or incarceration is unknown. We conducted a retrospective, observational cohort study evaluating COVID-19 vaccine VE against SARS-CoV-2 related hospitalization (positive SARS-CoV-2 molecular test same week or within 3 weeks prior to hospital admission) among patients who had experienced homelessness or incarceration. We utilized data from 8 health systems in the Minnesota Electronic Health Record Consortium linked to data from Minnesota’s immunization information system, Homeless Management Information System, and Department of Corrections. We included patients 18 years and older with a history of experiencing homelessness or incarceration. VE and 95% Confidence Intervals (CI) against SARS-CoV-2 hospitalization were estimated for primary series and one booster dose from Cox proportional hazard models as 100*(1-Hazard Ratio) during August 26, 2021, through October 8, 2022 adjusting for patient age, sex, comorbid medical conditions, and race/ethnicity. We included 80,051 individuals who had experienced homelessness or incarceration. Adjusted VE was 52% (95% CI, 41–60%) among those 22 weeks or more since their primary series, 66% (95% CI, 53–75%) among those less than 22 weeks since their primary series, and 69% (95% CI: 60–76%) among those with one booster. VE estimates were consistently lower during the Omicron predominance period compared with the combined Omicron and Delta periods. Despite higher exposure risk, COVID-19 vaccines provided good effectiveness against SARS-CoV-2 related hospitalizations in persons who have experienced homelessness or incarceration.
AB - COVID-19 disproportionately affects people experiencing homelessness or incarceration. While homelessness or incarceration alone may not impact vaccine effectiveness, medical comorbidities along with social conditions associated with homelessness or incarceration may impact estimated vaccine effectiveness. COVID-19 vaccines reduce rates of hospitalization and death; vaccine effectiveness (VE) against severe outcomes in people experiencing homelessness or incarceration is unknown. We conducted a retrospective, observational cohort study evaluating COVID-19 vaccine VE against SARS-CoV-2 related hospitalization (positive SARS-CoV-2 molecular test same week or within 3 weeks prior to hospital admission) among patients who had experienced homelessness or incarceration. We utilized data from 8 health systems in the Minnesota Electronic Health Record Consortium linked to data from Minnesota’s immunization information system, Homeless Management Information System, and Department of Corrections. We included patients 18 years and older with a history of experiencing homelessness or incarceration. VE and 95% Confidence Intervals (CI) against SARS-CoV-2 hospitalization were estimated for primary series and one booster dose from Cox proportional hazard models as 100*(1-Hazard Ratio) during August 26, 2021, through October 8, 2022 adjusting for patient age, sex, comorbid medical conditions, and race/ethnicity. We included 80,051 individuals who had experienced homelessness or incarceration. Adjusted VE was 52% (95% CI, 41–60%) among those 22 weeks or more since their primary series, 66% (95% CI, 53–75%) among those less than 22 weeks since their primary series, and 69% (95% CI: 60–76%) among those with one booster. VE estimates were consistently lower during the Omicron predominance period compared with the combined Omicron and Delta periods. Despite higher exposure risk, COVID-19 vaccines provided good effectiveness against SARS-CoV-2 related hospitalizations in persons who have experienced homelessness or incarceration.
KW - COVID-19
KW - COVID-19 Vaccines
KW - Homelessness
KW - Minnesota
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U2 - 10.1007/s10900-023-01308-3
DO - 10.1007/s10900-023-01308-3
M3 - Article
AN - SCOPUS:85178953860
SN - 0094-5145
VL - 49
SP - 448
EP - 457
JO - Journal of Community Health
JF - Journal of Community Health
IS - 3
ER -