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.