Using sero-epidemiology to monitor disparities in vaccination and infection with SARS-CoV-2.

Journal

medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986

Informations de publication

Date de publication:
20 Oct 2021
Historique:
pubmed: 14 10 2021
medline: 14 10 2021
entrez: 13 10 2021
Statut: epublish

Résumé

As COVID-19 vaccines continue to be rolled-out, the "double burden" of health disparities in both exposure to infection and vaccination coverage intersect to determine the current and future patterns of infection, immunity, and mortality. Serology provides a unique opportunity to measure biomarkers of infection and vaccination simultaneously, and to relate these metrics to demographic and geographic factors. Leveraging algorithmically selected residual serum samples from two hospital networks in San Francisco, we sampled 1014 individuals during February 2021, capturing transmission during the first 11 months of the epidemic and the early roll out of vaccination. These samples were tested using two serologic assays: one detecting antibodies elicited by infection, and not by vaccines, and one detecting antibodies elicited by both infection and vaccination. We used Bayesian statistical models to estimate the proportion of the population that was naturally infected and the proportion protected due to vaccination. We estimated that the risk of prior infection of Latinx residents was 5.3 (95% CI: 3.2 - 10.3) times greater than the risk of white residents aged 18-64 and that white San Francisco residents over the age of 65 were twice as likely (2.0, 95% CI: 1.1 - 4.6) to be vaccinated as Black residents. We also found socioeconomically deprived zipcodes in the city had high probabilities of natural infections and lower vaccination coverage than wealthier zipcodes. Using a platform we created for SARS-CoV-2 serologic data collection in San Francisco, we characterized and quantified the stark disparities in infection rates and vaccine coverage by demographic groups over the first year of the pandemic. While the arrival of the SARS-CoV-2 vaccine has created a 'light at the end of the tunnel' for this pandemic, ongoing challenges in achieving and maintaining equity must also be considered. NIH, NIGMS, Schmidt Science Fellows in partnership with the Rhodes Trust and the Chan Zuckerberg Biohub.

Sections du résumé

BACKGROUND BACKGROUND
As COVID-19 vaccines continue to be rolled-out, the "double burden" of health disparities in both exposure to infection and vaccination coverage intersect to determine the current and future patterns of infection, immunity, and mortality. Serology provides a unique opportunity to measure biomarkers of infection and vaccination simultaneously, and to relate these metrics to demographic and geographic factors.
METHODS METHODS
Leveraging algorithmically selected residual serum samples from two hospital networks in San Francisco, we sampled 1014 individuals during February 2021, capturing transmission during the first 11 months of the epidemic and the early roll out of vaccination. These samples were tested using two serologic assays: one detecting antibodies elicited by infection, and not by vaccines, and one detecting antibodies elicited by both infection and vaccination. We used Bayesian statistical models to estimate the proportion of the population that was naturally infected and the proportion protected due to vaccination.
FINDINGS RESULTS
We estimated that the risk of prior infection of Latinx residents was 5.3 (95% CI: 3.2 - 10.3) times greater than the risk of white residents aged 18-64 and that white San Francisco residents over the age of 65 were twice as likely (2.0, 95% CI: 1.1 - 4.6) to be vaccinated as Black residents. We also found socioeconomically deprived zipcodes in the city had high probabilities of natural infections and lower vaccination coverage than wealthier zipcodes.
INTERPRETATION CONCLUSIONS
Using a platform we created for SARS-CoV-2 serologic data collection in San Francisco, we characterized and quantified the stark disparities in infection rates and vaccine coverage by demographic groups over the first year of the pandemic. While the arrival of the SARS-CoV-2 vaccine has created a 'light at the end of the tunnel' for this pandemic, ongoing challenges in achieving and maintaining equity must also be considered.
FUNDING BACKGROUND
NIH, NIGMS, Schmidt Science Fellows in partnership with the Rhodes Trust and the Chan Zuckerberg Biohub.

Identifiants

DOI: 10.1101/2021.10.06.21264573 PMID: 34642695 PMC: PMC8509086
pubmed: 34642695
doi: 10.1101/2021.10.06.21264573
pmc: PMC8509086
pii:
doi:

Types de publication

Preprint

Langues

eng

Subventions

Organisme : NIAID NIH HHS
ID : K24 AI144048
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM138361
Pays : United States
Organisme : NIGMS NIH HHS
ID : U24 GM132013
Pays : United States

Commentaires et corrections

Type : UpdateIn

Déclaration de conflit d'intérêts

Declaration of Interests The authors have no conflicts of interest to declare.

Auteurs

Isobel Routledge (I)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Saki Takahashi (S)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Adrienne Epstein (A)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Jill Hakim (J)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Owen Janson (O)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Keirstinne Turcios (K)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Jo Vinden (J)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Infectious Disease and Immunity Graduate Group, University of California Berkeley, Berkeley, California, USA.

John Tomas Risos (JT)

Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.

Margaret Rose Baniqued (MR)

Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.

Lori Pham (L)

Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.

Clara Di Germanio (C)

Vitalant Research Institute, San Francisco, California, USA.

Michael Busch (M)

Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.
Vitalant Research Institute, San Francisco, California, USA.

Margot Kushel (M)

Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, USA.

Bryan Greenhouse (B)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Isabel Rodríguez-Barraquer (I)

Department of Medicine, University of California San Francisco, San Francisco, California, USA.

Classifications MeSH