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Trends in Disparities in COVID Hospitalizations Among Community-Dwelling Residents of Two Counties in Connecticut, Before and After Vaccine Introduction, March 2020 - September 2021
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  • Caroline McWilliams,
  • Laura Bothwell,
  • Kimberly Yousey-Hindes,
  • James Hadler
Caroline McWilliams
Yale University School of Public Health

Corresponding Author:[email protected]

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Laura Bothwell
Yale University School of Public Health
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Kimberly Yousey-Hindes
Yale University School of Public Health
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James Hadler
Yale University School of Public Health
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Abstract

Background. Prior to the introduction of vaccines, COVID-19 hospitalizations of non-institutionalized persons in Connecticut disproportionately affected communities of color and individuals of low socioeconomic status (SES). Whether the magnitude of these disparities changed 7-9 months after vaccine rollout during the Delta wave is not well documented. Methods. All initially hospitalized patients with laboratory-confirmed COVID-19 during July-September 2021, were obtained from the Connecticut COVID-NET database, including patients’ geocoded residential addresses. Census tract measures of poverty and crowding were determined by linking geocoded residential addresses to the 2014-2018 American Community Survey. Age-adjusted incidence and relative rates of COVID-19 hospitalization were calculated and compared to those from July-December 2020. Vaccination levels by age and race/ethnicity at the beginning and end of the study period were obtained from Connecticut’s COVID vaccine registry and age-adjusted average values were determined. Results. There were 708 COVID-19 hospitalizations among community residents of the two counties, July-September 2021. Age-adjusted incidence was highest among non-Hispanic Blacks and Hispanic/Latinx compared to non-Hispanic Whites ((RR 4.10 (95% CI 3.41-4.94) and 3.47 (95% CI 2.89-4.16)). While RR decreased significantly among Hispanic/Latinx and among the lowest SES groups, it increased among non-Hispanic Blacks (from RR 3.1 (95% CI 2.83-3.32) to RR 4.10). Average age-adjusted vaccination rates among those >12 years were lowest among non-Hispanic Blacks compared to Hispanic/Latinx and non-Hispanic Whites (50.6% vs 64.7% and 66.6%). Conclusions. While racial/ethnic and SES disparities in COVID-19 hospitalization have mostly decreased over time, disparities among non-Hispanic Blacks increased, possibly due to differences in vaccination rates.
30 Sep 2022Submitted to Influenza and other respiratory viruses
03 Oct 2022Submission Checks Completed
03 Oct 2022Assigned to Editor
25 Oct 2022Editorial Decision: Revise Minor
15 Nov 20221st Revision Received
17 Nov 2022Submission Checks Completed
17 Nov 2022Assigned to Editor
17 Nov 2022Editorial Decision: Accept
Jan 2023Published in Influenza and Other Respiratory Viruses volume 17 issue 1. 10.1111/irv.13082