Trends in Postpartum Depression before and during the COVID-19 Pandemic and Correlates of Treatment Choices: A Population-Based Retrospective Cohort Study

Objectives: COVID-19-related stressors - including social distancing, material hardship, increased intimate partner violence, and loss of childcare, among others - may result in a higher prevalence of depression among postpartum individuals. This study examines trends in postpartum depression in the US from 2018 to 2022, as well as correlates of treatment choices among women with postpartum depression. Method(s): 1,108,874 women aged 14-64 in the Komodo Healthcare Map with 1+ live birth between April 2018 and December 2021 and had continuous enrollment 2+ years before and 4+ months after the delivery date were included. Prevalence of depression during postpartum (within 3 months after delivery) was calculated before (April 2018-March 2020) and during (April 2020-March 2022) COVID-19. Multinomial logistic regression was used to investigate correlates of treatment choices (no treatment, medication-only, psychotherapy-only, or both). Result(s): The prevalence of postpartum depression increased from 9.7% pre-pandemic to 12.0% during the pandemic (p < 0.001). Among 119,788 women with postpartum depression in 2018-2022, 47.0% received no treatment, 35.0% received medication-only, 10.0% received psychotherapy-only, and 7.4% received both within one month following their first depression diagnosis. Factors associated with an increase in the odds of receiving medication-psychotherapy treatment (vs. no treatment) included older ages;commercial insurance coverage;lower social vulnerability index;history of anxiety or mood disorder during and before pregnancy;and being diagnosed by a nurse practitioner, physician assistant, or behavioral care practitioner (vs. physician). Similar patterns were observed for medication-only and psychotherapy-only treatments. Conclusion(s): In this large, nationally representative sample of US insured population, the prevalence of postpartum depression increased significantly by 2.3 percentage-points during the pandemic (or a relative increase of 23.7%). Nonetheless, almost half of women with postpartum depression received no treatment, and only 7.5% received both medication and psychotherapy. The study highlighted potential socioeconomic and provider variation in postpartum depression treatment.Copyright © 2023

Should population density be used to rank social vulnerability in disaster preparedness planning?

The CDC Social Vulnerability Index (SVI) was developed to help public health officials and policymakers to identify geospatial variations in social vulnerability for each community to better respond to hazardous events, including disease outbreaks. However, the SVI does not include information on population density, which is a significant omission when considering the usefulness of the index in allocating scarce resources such as medical supplies and personnel, bedding, food, and water to locations they are most needed. Using county-level data from the initial U.S. COVID-19 outbreak, we provide empirical evidence that the existing SVI underestimates (overestimates) county-level infection rates in densely (sparsely) populated counties if population density is not accounted for. Population density remains significant even after allowing for spatial spillover effects. Going forward, the inclusion of population density to construct SVI can improve its usefulness in aiding policymakers in allocating scarce resources for future disasters, especially those with spatial dependence. © 2022 Elsevier B.V.

Utilization of Telemedicine among Medicare beneficiaries undergoing Hepatopancreatic Surgery during the COVID-19 Pandemic.

INTRODUCTION: Telemedicine may serve as an important avenue to address disparities in access to cancer care. We sought to define factors associated with telemedicine use among Medicare beneficiaries who underwent hepatopancreatic (HP) surgery, as well as characterize trends in telemedicine usage relative to community vulnerability based on the enactment of the Medicare telemedicine coverage waiver. METHODS: Patients who underwent HP surgery between 2013-2020 were identified from the Medicare Standard Analytic Files (SAF). Telemedicine utilization was assessed pre- versus post- implementation of the Medicare telemedicine coverage waiver; the county-level social vulnerability index (SVI) was obtained from the Center for Disease Control. Interrupted time series analysis with negative binomial and multivariable logistic regression methods were used to assess changes in telemedicine utilization after the implementation of the Medicare telemedicine coverage waiver relative to SVI. RESULTS: Pre-waiver telemedicine visits were scarce among 16,690 patients (0.2%, n = 28), while post-waiver telemedicine adoption was substantial among 3,301 patients (45.8%, n = 1,388). Post-waiver, the median patient age was 70 years (IQR, 66-74) with the majority of patients being age 65-69 (n = 994, 32.8%); 1,599 (52.8%) were female. Most patients self-identified as White (n = 2641, 87.1%), while a minority of patients self-identified as Black (n = 190, 6.3%), Asian (n = 18, 0.6%), Hispanic (n = 35, 1.2%), or Other/unknown (n = 147, 4.9%). On multivariable regression analysis, patients who lived in highly vulnerable counties (referent Low SVI; moderate SVI: OR 1.09, 95% CI 0.86-1.39, p = 0.449; high SVI: OR 0.72, 95% CI 0.55-0.94, p = 0.001) and individuals with advancing age (referent 18-64; 65-69, OR 0.68, 95%CI 0.54-0.86; 70-74, OR 0.56, 95%CI 0.44-0.71; 75-79, OR 0.57, 95%CI 0.44-0.75; 80-84, OR 0.43, 95%CI 0.30-0.61; 85 + , OR 0.25, 95%CI 0.13-0.49) had lower odds of utilizing telemedicine. In contrast, Black patients (referent White; OR 2.26, 95% CI 1.65-3.10) and patients with a higher CCI score > 2 (referent ≤ 2; OR 1.49, 95% CI 1.28-1.71) were more likely to use telemedicine (all p < 0.001). CONCLUSIONS: Medicare beneficiaries residing in counties with extreme vulnerability, as well as elderly individuals, were markedly less likely to use telemedicine services related to HP surgical episodes of care. The lower utilization of telemedicine in areas of high social vulnerability was attributable to concomitant lower rates of internet access in these areas.

The COVID-19 pandemic, an environmental neurology perspective.

Neurologists have a particular interest in SARS-CoV-2 because the nervous system is a major participant in COVID-19, both in its acute phase and in its persistent post-COVID phase. The global spread of SARS-CoV-2 infection has revealed most of the challenges and risk factors that humanity will face in the future. We review from an environmental neurology perspective some characteristics that have underpinned the pandemic. We consider the agent, SARS-CoV-2, the spread of SARS-CoV-2 as influenced by environmental factors, its impact on the brain and some containment measures on brain health. Several questions remain, including the differential clinical impact of variants, the impact of SARS-CoV-2 on sleep and wakefulness, and the neurological components of Long-COVID syndrome. We touch on the role of national leaders and public health policies that have underpinned management of the COVID-19 pandemic. Increased awareness, anticipation and preparedness are needed to address comparable future challenges.

Using the social vulnerability index to assess COVID-19 vaccine uptake in Louisiana.

Using data from the Louisiana Department of Public Health, we explored the spatial relationships between the Social Vulnerability Index (SVI) and COVID-19-related vaccination and mortality rates. Publicly available COVID-19 vaccination and mortality data accrued from December 2020 to October 2021 was downloaded from the Louisiana Department of Health website and merged with the SVI data; geospatial analysis was then performed to identify the spatial association between the SVI and vaccine uptake and mortality rate. Bivariate Moran's I analysis revealed significant clustering of high SVI ranking with low COVID-19 vaccination rates (1.00, p < 0.001) and high smoothed mortality rates (0.61, p < 0.001). Regression revealed that for each 10% increase in SVI ranking, COVID-19 vaccination rates decreased by 3.02-fold (95% CI = 3.73-2.30), and mortality rates increased by a factor of 1.19 (95% CI = 0.99-1.43). SVI values are spatially linked and significantly associated with Louisiana's COVID-19-related vaccination and mortality rates. We also found that vaccination uptake was higher in whites than in blacks. These findings can help identify regions with low vaccination rates and high mortality, enabling the necessary steps to increase vaccination rates in disadvantaged neighborhoods.

COVID-19 vaccination dynamics in the US: coverage velocity and carrying capacity based on socio-demographic vulnerability indices in California's pediatric population.

Introduction: COVID-19 vaccine inequities have been widespread across California, the United States, and globally. As COVID-19 vaccine inequities have not been fully understood in the youth population, it is vital to determine possible factors that drive inequities to enable actionable change that promotes vaccine equity among vulnerable minor populations. Methods: The present study used the social vulnerability index (SVI) and daily vaccination numbers within the age groups of 12-17, 5-11, and under 5 years old across all 58 California counties to model the growth velocity and the anticipated maximum proportion of population vaccinated. Results: Overall, highly vulnerable counties, when compared to low and moderately vulnerable counties, experienced a lower vaccination rate in the 12-17 and 5-11 year-old age groups. For age groups 5-11 and under 5 years old, highly vulnerable counties are expected to achieve a lower overall total proportion of residents vaccinated. In highly vulnerable counties in terms of socioeconomic status and household composition and disability, the 12-17 and 5-11 year-old age groups experienced lower vaccination rates. Additionally, in the 12-17 age group, high vulnerability counties are expected to achieve a higher proportion of residents vaccinated compared to less vulnerable counterparts. Discussion: These findings elucidate shortcomings in vaccine uptake in certain pediatric populations across California and may help guide health policies and future allocation of vaccines, with special emphasis placed on vulnerable populations, especially with respect to socioeconomic status and household composition and disability.

Spatial Dimensions of Vulnerability: Meatpacking, Socioeconomics, and the Outbreak of COVID-19 in the High Plains of Texas

In May 2020, 2 months after COVID-19 arrived in the High Plains of Texas, meatpacking plant workers were discovered to be contracting the virus in large numbers. Working conditions in the plants-close spacing on the disassembly lines, cold temperatures, noise (shouting to be heard), etc.;along with congregant settings among the immigrant workers before and after work-were all implicated in the infections. Although much has been written on the vulnerabilities of meatpacking workers, little research has investigated the spatial spread of the virus. In this study we analyze COVID-19 case rates for May 15 (the first spike in daily case numbers), for the 41 counties of the region in relation to meat-packing influence, ethnicity, and socioeconomic structure of the counties. We find that meatpacking influence had the strongest relationship to COVID-19 rates across the counties;that the presence of Asian and African immigrants was also significant;and that rurality and isolation insulated more than half the counties from high virus rates. Further analysis, for later spikes in cases (July 1 and November 25), revealed a decline in meatpacking influence, a surge in COVID-19‘s infection of counties with large domestic minorities, and an amplification of low COVID-19 cases for rural, older, Anglo counties. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

The Social Vulnerability Index: A Literature Review

This chapter provides a non-exhaustive review of the literature on the Social Vulnerability Index in order to share with Disaster Studies scholars and other professionals a general overview of the subject. This work analyzes selected case studies on the construction of a Social Vulnerability Index at national and local scales, and then specifically focuses on cases concerning social vulnerability to climate change, natural hazards, and COVID-19. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Vulnerability, Infection, and Anti-discrimination Among Asian Americans and COVID-19: Explorations into Race and Health Intersections in California

The purpose of this chapter is to report and analyze the double victimization among Asians/Asian Americans during COVID-19, including their vulnerability to infection and anti-Asian racism. We first test the validity of the CDC's SVI (Social Vulnerability Index) in analyzing COVID-19 infections, then construct an Asian-specific Social Vulnerability Index (ASVI) to compare with the CDC SVI, mapping them out nationally to visualize the differential geographical patterns. We then conduct an empirical study of the state of California with correlation analysis, analysis of variance, and GIS mapping to explore the association of ASVI with Asian COVID-19 infection incidence rate, and anti-Asian discrimination incidents. We conclude that the method of constructing ASVI may be applied to other vulnerable groups. The findings contribute to our knowledge of the unequal social outcomes of pandemics across people and place. The chapter ends with summarizing findings and contributions, revealing data limitations, providing policy suggestions and suggesting future research directions. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Mechanisms behind COVID-19 scepticism among socially marginalised individuals in Europe

Homeless and materially disadvantaged people are considered particularly vulnerable to COVID-19 infection. So far, there is no systematic knowledge about how the homeless and materially disadvantaged people perceive the risks of COVID-19 and what factors influence the development of sceptical views and underestimation of dangers posed by the virus. The aim of our study is therefore to: (1) Explore COVID-19 risk perception of socially marginalised individuals, focusing on their assessment of the probability of getting infected by the virus and the perceived harmful consequences of the disease;and (2) examine the factors influencing COVID-19 risk beliefs of these individuals. We use cross-sectional survey data with 273 participants from eight countries and data from 32 interviews and five workshops with managers and staff of social care organisations in ten European countries. Our results indicate that among survey participants, 49% can be labelled COVID-19 sceptics with regard to probability of getting infected, and 38% with regard to harmful consequences of the disease. We find that COVID-19 scepticism is related to low levels of all types of social capital, low trust in information from authorities and being a minority. However, the most important predictor is the respondents' general lack of concern about health risks. Additionally, the qualitative data indicates the multifaceted nature of COVID-19 scepticism, as it may relate to the origins of COVID-19, the probability of infection, its consequences and protective measures, among others. Improved understanding about factors influencing COVID-19 scepticism in these groups contributes to a better understanding of the information disorder during crises, and the ways in which this could be managed through policies against marginalisation, including in disaster risk reduction.

Exclusion Processes Associated with COVID-19 Lockdowns

Lockdown has been the quintessential non-pharmacological measure to combat the spread of COVID-19. Virtually all countries have resorted to home confinement at some point during the pandemic. Although it has not been sufficient to stop the spread of the disease, its implementation has prevented countless deaths. This chapter studies both the strengths and weaknesses of the measure, exploring possible adverse effects that it has caused, in order to achieve a better implementation of the measure in the face of future pandemic catastrophes. The methodological strategy consisted of a review of the literature on the measure applied both in the COVID-19 pandemic and in past epidemic catastrophes. The results of the research report that the lockdown has had serious effects on the population. These effects have often not been evenly distributed among the population, with the most vulnerable bearing the greatest costs. The research shows that it is necessary to learn from experience in order to refine strategies for future pandemic catastrophes. © 2023 by Nova Science Publishers, Inc. All rights reserved.

Transgender Women Baseline Profile in Transcitar: Transspecific Cohort in Argentina

Background: Transgender women (TGW) are among the population most affected by the HIV epidemic in Argentina, despite a progressive legal framework. TransCITAR is a trans-specific cohort in Argentina that aims to assess physical and mental health among transgender and non-binary people (TGNBP). We present baseline characteristics of TGW. Method(s): TGW attending a trans-friendly clinic to receive HIV/STIs prevention/ treatment, mental health care and/or gender-affirming hormone therapy (GHT) were invited to participate. Semiannual visits including clinical assessments, laboratory tests, and psychosocial interviews were performed. Oral PrEP was offered as part of a combined prevention strategy since September 2021. Result(s): Between September/2019 and August/2022, 500 TGNBP were enrolled, 416 were TGW (median age: 30 years, IQR 25-37). High social vulnerability was observed (Table 1). Regarding trans-specific characteristics, 49.8% reported industrial silicone injections and 36.8% were receiving GHT. 76.9% were sex workers. Baseline STIs prevalence were: HIV 42.3% (10.2% diagnosed at enrolment), syphilis 40% (defined as positive nontreponemal test VDRL with titers of at least 1/8), past HBV 18.5%, chronic HBV 3.8%, HCV antibody positive 2.6%. Only 57% presented HBV protective antibodies titers (HBVsAb>=10UI/ml), 8 TGW were on PreP. For those with HIV, median CD4+ cell count was 602 cells/mm3 (IQR 378-933), 66.5% were on ART at enrolment (53.6% were virally suppressed) and 14.8% initiated at baseline. During 36 months of follow up, 4 TGW died (one AIDS-related and one COVID-19-related). Bivariate analyses showed that a positive HIV diagnosis was independently associated with migration, low level of education, unstable housing, silicone injecion and sex work, while was negatively associated with being on GHT. In multivariable logistic regression, only sociodemographic variables remain associated: migrant (aOR=.487, 95% CI=.304-.768);incomplete high school (aOR=.463, 95% CI=.300=.714);unstable housing (aOR=.614, 95% CI=.401- .940);and sex work (aOR=.324, 95% CI=.177-.593). Conclusion(s): TGW from TransCITAR presented poor health outcomes: high prevalence of HIV/syphilis, high proportion with incomplete/no HBV vaccine and high levels of depression and violence. A comprehensive approach to care and addressing social determinants of health is pivotal to reduce HIV burden in this population.

Can psychological distress account for the associations between COVID-19 vaccination acceptance and socio-economic vulnerability?

Socially disadvantaged individuals and communities consistently showed lower COVID-19 vaccination acceptance. We aimed to examine the psychological mechanisms that could explain such vaccination disparities. This study used data from serial population-based surveys conducted since the COVID-19 vaccination programme being launched in Hong Kong (N = 28,734). We first assessed the correlations of community-level and individual-level social vulnerability with COVID-19 vaccination acceptance. Structural equation modelling (SEM) was then conducted to test whether psychological distress measured by PHQ-4 can account for the associations between participants' socio-economic vulnerability and COVID-19 vaccination acceptance. The third part analysis examined whether perceived negativity of vaccine-related news and affect towards COVID-19 vaccines accounted for the association between psychological distress and COVID-19 vaccination. Communities with higher social vulnerability scores and participants who had more vulnerable socio-economic status showed lower COVID-19 vaccination acceptance. Individuals with more vulnerable socio-economic status reported higher psychological distress, which lowered COVID-19 vaccination acceptance. Furthermore, higher psychological distress was associated with lower vaccination acceptance through its psychological mechanisms of processing vaccine-related information. We proposed a renewed focus on tackling psychological distress rather than merely increasing vaccine accessibility in more socio-economic-disadvantaged groups for promoting COVID-19 vaccination acceptance.

Impact of the COVID-19 pandemic on cardiovascular disease mortality in a major metropolitan area.

Background: The mortality from COVID-19 alone cannot account for the impact of the pandemic. Cardiovascular disease (CVD) mortality has increased disproportionately in specific racial/ethnic populations. Objective: This study aimed to characterize how the COVID-19 pandemic impacted the association between CVD mortality and social and demographic factors as characterized by the Social Vulnerability Index (SVI). Methods: Medical Examiner Case Archive of Cook County, Illinois was utilized to identify CVD deaths in 2019 (pre-pandemic) and 2020 (pandemic). Rate ratios (RRs) were used to compare age-adjusted mortality rates (AAMRs). Addresses of deaths were geocoded to Chicago Community Areas. The Spearman's rank correlation coefficient (ρ) test was used to identify the association between SVI and CVD mortality. Results: AAMRs of CVD deaths significantly increased among non-Hispanic Black individuals (AAMRR, 1.1; 95 % CI, 1.1-1.2) and Hispanic individuals (AAMRR, 1.8; 95 % CI, 1.5-2.1) from 2019 to 2020. Among non-Hispanic White individuals, the AAMR did not significantly increase (AAMRR, 1.0; 95 % CI, 0.9-1.1). A significant positive association was observed between SVI and the percentage of non-Hispanic Black residents (ρ = 0.45; P < 0.05), while the inverse was observed with the percentage of non-Hispanic White residents (ρ = -0.77; P < 0.05). A significant positive association between SVI and CVD mortality rate increased (ρ = 0.24 and 0.28; P < 0.05). Conclusions: Significant association between SVI and CVD mortality was strengthened from 2019 to 2020, and CVD mortality increased among non-Hispanic Black and Hispanic populations. These findings demonstrate that the COVID-19 pandemic has led to an exacerbation of health inequities among different racial/ethnic populations resulting in increased CVD mortality.

Working in territory during pandemic times. Impacts of community work laboureres on the territorial approach of drug abuse in Argentina

This article focuses on the impact that the social and health-related crisis caused by COVID 19 produced on the public-run community service, whose workers do their jobs from a territorial approach of drug abuse in vulnerable areas in the Metropolitan Area of Buenos Aires (AMBA), Argentina. By means of interviews to these workers, the aim is to describe and analize the experience of having worked in territory during the social and health-related critical context caused by the pandemic COVID 19 as well as understand the individual and collective impact on the teams. In this context, some issues are raised as to the impact produced by the sudden bursting of the pandemic on the territorial work, the strategies developed when restructuring working modalities, and also which contributions can be provided by a system of collective reflexivity in these contexts.

Societal smart city: Definition and principles for post-pandemic urban policy and practice

Smart cities are expected to address global challenges and increase the quality of life. However, due to the overemphasis on physical and technological aspects, social rights and democratic values have often been neglected in smart city projects. In this paper, we introduce the concept of 'societal smart city' and discuss how and why it should be prioritized in the post-pandemic era. We argue that a societal smart city is a city that integrates social rights and democratic values with technological innovations. Six major dimensions of a societal smart city are: social sustainability, citizen-centeredness, e-democracy, social justice, participatory governance, and cultural resilience. We encourage urban planners and policymakers to pay attention to these dimensions and caution against physical and technological determinism.

An LSTM1 Model for Managing Epidemics: Using Population Mobility and Vulnerability for Forecasting COVID-19 Hospital Admissions

Worldwide epidemics, such as corona virus disease 2019 (COVID-19), cause unprecedented challenges for society and its healthcare systems. Governments attempt to mitigate those challenges by either reducing healthcare demand ("flattening the curve" by imposing restrictions, e.g., on travel or social gatherings) or by increasing healthcare capacity, for example, by canceling elective procedures or setting up field hospitals. To implement these mitigation procedures efficiently, accurate and timely forecasts of the epidemic's progression are necessary. In this paper, we develop an innovative forecasting methodology based on the ideas of long short-term memory (LSTM) recurrent neural networks. LSTM models are shown to outperform traditional forecasting models, especially when the relationship between input and output is complex and not available in closed form. However, whereas LSTM models perform well for data that changes dynamically over time, one shortcoming is that they are not directly applicable when the data also includes static, nontemporal components. In this work, we propose an LSTM+ model that overcomes this limitation. Our model leverages a private partnership with a mobile data company in order to capture population mobility (using mobility indices derived from mobile device data), which allows us to anticipate an epidemic's spread early and accurately. In addition, we also leverage a public partnership with a consortium of hospitals. Using hospital admissions (rather than, say, positive caseload) results in an unbiased measure of the severity of an epidemic because patients seek and are admitted to hospital care only when symptoms worsen beyond a critical point. We illustrate the effectiveness of our method on forecasting COVID-19 for a major U.S. metropolitan area where it has aided decision makers of the emergency policy group. Our model improves the predictive accuracy of hospital admission by a factor of 2.5x as compared with competing models in the same analytical space.

COVID-19 spread prediction using socio-demographic and mobility-related data.

Studying the impacts of factors that may vary spatially and temporally as infectious disease progresses is critical for the prediction and intervention of COVID-19. This study aimed to quantitatively assess the spatiotemporal impacts of socio-demographic and mobility-related factors to predict the spread of COVID-19. We designed two different schemes that enhanced temporal and spatial features respectively, and both with the geographically and temporally weighted regression (GTWR) model adopted to consider the heterogeneity and non-stationarity problems, to reveal the spatiotemporal associations between the factors and the spread of COVID-19 pandemic. Results indicate that our two schemes are effective in facilitating the accuracy of predicting the spread of COVID-19. In particular, the temporally enhanced scheme quantifies the impacts of the factors on the temporal spreading trend of the epidemic at the city level. Simultaneously, the spatially enhanced scheme figures out how the spatial variances of the factors determine the spatial distribution of the COVID-19 cases among districts, particularly between the urban area and the surrounding suburbs. Findings provide potential policy implications in terms of dynamic and adaptive anti-epidemic.

Older adults' behavioral health during the COVID-19 pandemic

COVID-19's effects go beyond physical health, including impacts to behavioral health such as documented increases in loneliness, depression, anxiety, and alcohol misuse. Research on other disaster and mass trauma events suggests that behavioral health impacts may persist for many years after the initial onset of the event and could be compounded with other disasters. These impacts have not, and will not, be distributed evenly across the population. Of note, evidence from early in the pandemic suggests that older adults' (adults aged 65 and older) behavioral health may not be as adversely affected as expected, given past research on age and disasters. © 2023 The authors.

Socially Vulnerable Patients with Inflammatory Bowel Disease Are at Increased Risk for Vaccine Preventable Illness

INTRODUCTION: Inflammatory bowel disease (IBD) affects patients across diverse ethnic, minority, cultural, and socioeconomic backgrounds;however, the relationship between these social determinants of health (SDOH) and IBD outcomes is not well-studied. SDOH have a known impact on disparities in vaccination, but these effects may be more salient in the IBD population where patients are at greater risk for vaccine-preventable illness from immunosuppressive therapies. The social vulnerability index (SVI) is a tool provided by Centers for Disease Control that can identify individuals at risk for health care disparities by estimating neighborhood-level social need on a 0-1 scale (higher scores indicating greater social vulnerability). Utilizing census tract-level SVI data, we aimed to identify the relationship between the SDOH and vaccination rates in patients with IBD. METHOD(S): We used a retrospective cohort design of patients seen at a single IBD center between 01/01/2015 and 08/31/2022. Using the current address listed in the electronic medical record, we geocoded patients to individual census tracts and linked them to corresponding SVI and subscales (Figure 1). Controlling a priori for age, gender, race, ethnicity, marital status, English proficiency, electoral district, and religious affiliation, we used multivariable linear regression to examine the relationship between SVI and vaccination against influenza, Covid-19, pneumococcal pneumonia (conjugate and polysaccharide), and Zoster. RESULT(S): 15,245 patients with IBD were included and the percent of unvaccinated individuals was high across all vaccine types: flu (42.8%), Covid-19 (50.9%), pneumonia (62.4%), and Zoster (89.6%). High total levels of social vulnerability were associated with lower vaccination rates across all vaccine groups: flu (B -1.3, 95% CI -1.5, -1.2, p<0.001), Covid-19 (B -0.99, 95% CI -1.1, -0.88), p<0.001), pneumonia (B -0.21, 95% CI -0.27, -0.14, p<0.001), Zoster (B -0.23, 95% CI -0.27, -0.19, p<0.001). On SVI sub-scales, high scores in Socioeconomic Status, Household Composition, and Housing/Transportation were important predictors of vaccine uptake while Minority Status/Language was non-significant (Table 1). CONCLUSION(S): Living in a socially vulnerable community is associated with lower vaccination rates across all vaccine types. Higher scores on neighborhood level Socioeconomic Status, Household Composition, and Housing/Transportation were also associated with lower vaccine uptake. Many factors may affect why socially vulnerable patients are under-vaccinated, including a lack of patient and provider knowledge of routine vaccines, lack of access to care, and poor trust in vaccines and healthcare system. Further research is needed improve IBD health maintenance in gastroenterology clinics and ensure equitable distribution of vaccines to socially vulnerable patients. [Formula presented] [Formula presented]Copyright © 2023