Characterizing Low Vaccination Coverage of COVID-19 in Georgia in 2021: A Quantitative Study Público
Khan, Nafis (Spring 2022)
Abstract
Background: Unequal coverage of the COVID-19 vaccine has been an obstacle in controlling the COVID-19 pandemic in the state of Georgia. Using the Georgia Department of Public Health’s COVID-19 surveillance data we assessed the association of age, race, ethnicity, sex, and rurality with vaccination status and reasons for being unvaccinated among adults with confirmed COVID-19 within Georgia.
Methods: Monthly vaccination status among confirmed cases was computed over 2021. We examined the demographic composition of vaccinated and unvaccinated cases and estimated associations between demographic characteristics and being unvaccinated using logistic regression. Nine reasons for being unvaccinated against COVID-19 were grouped into 3 categories: accessibility issues (inaccessible, inconvenient, expensive); confliction of beliefs (religious exemption, philosophical objection, parental/patient refusal); and medical/other reasons (medical contraindication, concurrent illness, forgot to vaccinate). We computed bivariate correlations among reasons for being unvaccinated and conducted principal components analysis (PCA) to identify whether the 9 responses could be reduced to a smaller set of factors. We conducted logistic regressions to examine associations between demographic factors and the 3 categories of vaccine hesitancy separately.
Results: Analyzing the 695,472 confirmed cases showed unvaccinated outnumbered vaccinated 3:1 during 2021. Younger Georgians (18-49) had the highest likelihood of being unvaccinated confirmed cases, as did Black and American Indian race groups. ‘No access’ was the most cited reason for being unvaccinated (33.53%), followed by ‘philosophical objection’ (8.75%) and ‘parental/patient refusal’ (8.57%). There was a low degree of correlation among the reasons for being unvaccinated, with the first and second principal components explaining 14.21% and 12.16% of the variation in reasons for being unvaccinated, respectively. There were significant, positive associations of being middle age (50-64) and being Asian with accessibility issues, and inverse associations of being female and living in non-metro areas with accessibility.
Conclusion: In 2021, accessibility was the most common reason for being unvaccinated among confirmed COVID-19 cases reported to the Georgia Department of Public Health. The analysis provides retrospective insight into commonly cited reasons for being unvaccinated as well as patterns of hesitancy among demographic groups. This may be used to design better interventions focused on improving vaccination uptake across the state.
Table of Contents
Table of Contents
Abstract 7
Background. 7
Methods. 7
Results. 7
Conclusion. 7
Introduction. 8
Extended Literature Review.. 10
What is known about vaccine hesitancy?. 10
What are the characterizations of vaccine hesitancy?. 11
Race. 11
Socioeconomic Status (SES): 12
Education. 13
Political preference. 14
Age. 15
Where does vaccine hesitancy occur?. 16
Research objectives. 18
Methods. 19
Data sources. 19
Outcomes. 19
Demographic characteristics. 20
Statistical analysis. 20
Results. 23
Tables and Figures. 30
. 30
Discussion, Limitations, and Interpretation. 38
Secondary Analysis. 44
Strengths and Limitations. 45
Key Findings and Implications. 46
Bibliography. 49
About this Master's Thesis
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