ABSTRACT
Background. In the U.S., non-Hispanic Black individuals are disproportionately represented amongst COVID-19 mortalities. The COVID-19 vaccines are poised to change this outcome;however, inequitable access and decades of medical mistreatment have resulted in healthcare mistrust and an associated low uptake within this group. Loma Linda University (LLU) houses the largest mass vaccination site in San Bernardino County (SBC) California;nevertheless, there has been a perpetual low representation of Black vaccinees. To increase the number of Black persons vaccinated, a selected team at LLU leveraged a community-academic partnership model to address vaccine hesitancy and increase access to the COVID-19 vaccines. The objective of this study was to evaluate the number of Black persons vaccinated in community settings compared to the mass clinic. Methods. LLU developed a tiered approach to increase COVID-19 vaccinations within Black SBC communities. The first tier engaged faith leaders with the academic community in disseminating COVID-19 health information, the second included culturally representative LLU healthcare professionals in the delivery of COVID-19 educational webinars, and the third was to conduct low barrier, remote-site vaccination clinics, within targeted Black communities. Following these efforts, we compared the number of Black individuals vaccinated in the LLU mass clinic to those vaccinated in the community remote-site clinics. Results. The remote-site COVID-19 vaccination clinics commenced in February 2021. From February 1 until April 30, 2021, 24,808 individuals were vaccinated in the LLU mass clinic with a first dose (Pfizer or Moderna) or single dose (Janssen) of a COVID-19 vaccine, however, only 908 (3.7%) were Black vaccinees. Contrastingly, the LLU remote site clinics vaccinated 1,542 individuals with a first or single dose of a COVID-19 vaccine. Of those vaccinees, 675 (44%) were Black. Conclusion. The multi-tiered community approach (remote-site vaccination clinics) resulted in a necessary overrepresentation of Black vaccinees, previously underrepresented in the LLU traditional mass vaccination clinic effort (44% vs. 3.7%, respectively). Further research is warranted to examine the key elements to increase vaccinations amongst minoritized groups.
ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) is responsible for a global pandemic. A concern with COVID-19 are co-infections. Studies have reported between 5.8-8.1% of COVID-19 patients having documented co-infection(s);however, no study has reported the prevalence of co-infections during the early pandemic in Detroit, one of the first “hot spots.” While the number of patients with COVID-19 and co-infections is low, there is limited to no information on the impact of acquiring these virulent and/or multidrug-resistant (MDR) pathogens. Research Question or Hypothesis: Investigate the prevalence of coinfections in the early pandemic in patients diagnosed with COVID-19 in Detroit. Study Design: Single-center, retrospective, descriptive study. Methods: All adult patients diagnosed with COVID-19 and admitted to Medical Center were screened from March to April 2020. Any patients with a documented co-infection with any pathogen were included. Descriptive statistics were utilized for analysis. Results: A total of 309 COVID-19 patients were screened, and 45 (14.6%) were found to have ≥1 co-infection (thus, total percentage > 100%;bacterial: 88.9%, fungal: 11.1%, viral: 8.9%). The majority of patients were male (62.2%) and African American (75.6%), while median age and weight were 67 (57-74) years and 85.0 (72.7-104.5) kg, respectively. Of the 40 (88.9%) patients with a bacterial co-infection, 9 (22.5%) were infected with multiple bacteria, and 3 (7.5%) also had fungal and viral 1 (2.5%) co-infections. The majority of bacterial co-infections included Pseudomonas aeruginosa(15.0%), Staphylococcus aureus(12.5%), and Enterococcus faecalis(10.0%). Three (6.7%) and 2 (4.4%) patients had Candida albicans and Candida glabrata, respectively, and 3 (6.7%) patients had influenza. The pathogens were cultured from the blood (46.7%), sputum and/or bronchoalveolar lavage (42.2%), or urine (11.1%). Conclusion: Patients with COVID-19 and documented co-infections were more prevalent in Detroit compared to previous studies. Further studies should be conducted to efficiently identify the presence and impact of co-infections in patients diagnosed with COVID-19 to optimize patient outcomes.