ABSTRACT
In 2019, 2020, and 2021, Sendero Health Plans, an ACA health insurance company, implemented Hepatitis C Virus (HCV) health education and outreach screening campaigns. Chi-square goodness-of-fit and tests of independence were performed to assess and compare the uptake of HCV screening among baby boomers in 2019, 2020, and 2021. In 2019, 2020, and 2021, 17.9% (308/1,718), 10.9% (93/852), and 8.5% (37/435) of eligible members were screened, respectively. Individuals were more likely to be screened for HCV in 2019 than in 2020 and 2021 (p < 0.0001). In 2019, 2020, and 2021, 39.9%, 26.9%, and 48.6% of annual screenings occurred during the health campaign months, respectively. Annual HCV screening rates were lower during the COVID-19 pandemic period than in the pre-pandemic cohort. However, screening rates during the months of outreach and education contributed to nearly 50% of annual screenings in the pandemic year 2021, thus representing a positive impact on preventive screening uptake despite the pandemic. Missed screening opportunities affect HCV transmission, diagnosis, and treatment. Yet, health education and outreach continue to work, even during a pandemic.
ABSTRACT
COVID-19 has caused excessive morbidity and mortality worldwide. COVID-19 vaccines, including the two mRNA vaccines, were developed to help mitigate COVID-19 and to move society towards herd immunity. Despite the strong efficacy and effectiveness profile of these vaccines, there remains a degree of vaccine hesitancy among the population. To better understand hesitancy associated with COVID-19 vaccines and to delineate between those who are vaccine acceptors, vaccine refusers, and the moveable middle, we conducted a cross-sectional survey to understand respondents' decision to receive, or not, a COVID-19 vaccine at the onset of mRNA vaccine availability in Central Texas. A total of 737 individuals responded, with 685 responses classified to one of eight domains: A: End to the Pandemic (n = 48); B: Trust in Medical Community (n = 27); C: Illness-Focused Perceptions (n = 331); D: Social Motivation (n = 54); E: Vaccine-Focused Perceptions (n = 183); F: Knowledge Gap (n = 14); G: Underlying Health Concern (n = 9); and H: Undecided (n = 19). Vaccine acceptors (n = 535) were primarily represented in domains A-E, while vaccine refusers (n = 26) were primarily represented in domains C, E, G, and H. The moveable middle (n = 124) was primarily represented by domains C-H. These findings show clear delineations between vaccine acceptors, vaccine refusers, and the moveable middle across eight domains that can assist public health professionals in addressing vaccine hesitancy.
ABSTRACT
Vaccine-induced herd immunity remains the best opportunity for ending the COVID-19 pandemic. However, COVID-19 vaccine hesitancy is a real concern. In this paper, we report on vaccine hesitancy in Central Texas immediately prior to the release of the two mRNA COVID-19 vaccines in late December 2020. A total of 1648 individuals 18 years or older with health insurance living in Central Texas completed a survey on sociodemographic factors and plans to obtain the COVID-19 vaccine. Of the respondents, 64.1% planned to obtain the COVID-19 vaccine. Logistic regression identified the following sociodemographic factors associated with vaccine hesitancy: Black or African American race (POR: 0.351, p < 0.001, 95% CI: 0.211, 0.584), female sex (POR: 0.650, p < 0.001, 95% CI: 0.518, 0.816), age of 35-49 years old (POR: 0.689, p = 0.004, 95% CI: 0.534, 0.890), annual household income of less than US$10,000 (POR: 0.565, p = 0.041, 95% CI: 0.327, 0.976), a high school education or less (POR: 0.565, p = 0.001, 95% CI: 0.401, 0.795), and a high school education but less than a 4-year college degree (POR: 0.572, p < 0.001, 95% CI: 0.442, 0.739). Real-world evidence provided by individuals on plans to get vaccinated can reveal COVID-19 vaccine hesitancy associated heterogeneity.
Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Female , Humans , Middle Aged , Pandemics , SARS-CoV-2 , Sociodemographic Factors , Texas , Vaccination , Vaccination HesitancyABSTRACT
Objective: Mass vaccination planning is occurring at all levels of government in advance of regulatory approval and manufacture of a SARS-CoV-2 vaccine for distribution sometime in 2021. We outline a methodology in which both health insurance provider network data and publicly available data sources can be used to identify and plan for SARS-CoV-2 vaccinator capacity at the county level. Methods: Sendero Health Plans, Inc. provider network data, Texas State Board of Pharmacy data, US Census Bureau data, and H1N1 monovalent vaccine data were utilized to identify providers with demonstrated capacity to vaccinate the population in Travis County, Texas to achieve an estimated SARS-CoV-2 herd immunity target of 67%. Results: Within the Sendero network, 2,356 non-pharmacy providers were identified with 788 (33.4%) practicing in primary care and 1,569 (66.6%) practicing as specialists. Of the total, 686 (29.1%) provided at least one immunization between January 1, 2019 and September 30, 2020. There are 300 pharmacies with active licenses in Travis County with 161 (53.7%) classified as community pharmacies. We estimate that 1,707,098 doses of a 2-dose SARS-CoV-2 vaccine series will need to be administered within Travis County, Texas to achieve the estimated 67% herd immunity threshold to disrupt person-to-person transmission of the SARS-CoV-2 virus based on 2020 census data. Conclusion: A community-based health insurance plan can use data from its provider network and public data sources to support the CDC call to action to identify SARS-CoV-2 vaccinators in the community, including physicians, nurse practitioners, physician assistants, and pharmacies in order to provide macro level estimates of SARS-CoV-2 administration and throughput.