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. 2022 Aug 15;2(8):e0000647.
doi: 10.1371/journal.pgph.0000647. eCollection 2022.

Health inequities in SARS-CoV-2 infection, seroprevalence, and COVID-19 vaccination: Results from the East Bay COVID-19 study

Cameron Adams  1 , Mary Horton  1 , Olivia Solomon  1 , Marcus Wong  1 , Sean L Wu  2 , Sophia Fuller  1 , Xiaorong Shao  1 , Indro Fedrigo  1 , Hong L Quach  1 , Diana L Quach  1 , Michelle Meas  1 , Luis Lopez  1 , Abigail Broughton  1 , Anna L Barcellos  1 , Joan Shim  1 , Yusef Seymens  1 , Samantha Hernandez  1 , Magelda Montoya  1 , Darrell M Johnson  3 , Kenneth B Beckman  3 , Michael P Busch  4 , Josefina Coloma  1 , Joseph A Lewnard  1 , Eva Harris  1 , Lisa F Barcellos  1
Affiliations

Health inequities in SARS-CoV-2 infection, seroprevalence, and COVID-19 vaccination: Results from the East Bay COVID-19 study

Cameron Adams et al. PLOS Glob Public Health. .

Abstract

Comprehensive data on transmission mitigation behaviors and both SARS-CoV-2 infection and serostatus are needed from large, community-based cohorts to identify COVID-19 risk factors and the impact of public health measures. We conducted a longitudinal, population-based study in the East Bay Area of Northern California. From July 2020-March 2021, approximately 5,500 adults were recruited and followed over three data collection rounds to investigate the association between geographic and demographic characteristics and transmission mitigation behavior with SARS-CoV-2 prevalence. We estimated the populated-adjusted prevalence of antibodies from SARS-CoV-2 infection and COVID-19 vaccination, and self-reported COVID-19 test positivity. Population-adjusted SARS-CoV-2 seroprevalence was low, increasing from 1.03% (95% CI: 0.50-1.96) in Round 1 (July-September 2020), to 1.37% (95% CI: 0.75-2.39) in Round 2 (October-December 2020), to 2.18% (95% CI: 1.48-3.17) in Round 3 (February-March 2021). Population-adjusted seroprevalence of COVID-19 vaccination was 21.64% (95% CI: 19.20-24.34) in Round 3, with White individuals having 4.35% (95% CI: 0.35-8.32) higher COVID-19 vaccine seroprevalence than individuals identifying as African American or Black, American Indian or Alaskan Native, Asian, Hispanic, two or more races, or other. No evidence for an association between transmission mitigation behavior and seroprevalence was observed. Despite >99% of participants reporting wearing masks individuals identifying as African American or Black, American Indian or Alaskan Native, Asian, Hispanic, two or more races, or other, as well as those in lower-income households, and lower-educated individuals had the highest SARS-CoV-2 seroprevalence and lowest vaccination seroprevalence. Results demonstrate that more effective policies are needed to address these disparities and inequities.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: JAL reports receipt of grants unrelated to this study from Pfizer and Merck, Sharpe & Dohme, and consulting fees from Pfizer, Merck, Sharpe & Dohme, VaxCyte, and Kaiser Permanente. All other authors report no competing interests. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS policies on sharing data and materials.

Figures

Fig 1
Fig 1. Study flow chart.
Fig 2
Fig 2. Population-adjusted prevalence of SARS-CoV-2 outcomes within study region ZIP codes.
(A) Cumulative seroprevalence of SARS-CoV-2 antibodies to natural infection. (B) Prevalence of self-reported COVID-19 test positivity across the study region. Data collected in three rounds: Round 1, July-September 2020; Round 2, October-December 2020), and Round 3, February-March 2021. Base map and data from OpenStreetMap and OpenStreetMap Foundation (https://www.openstreetmap.org/copyright).
Fig 3
Fig 3. Cumulative populated-adjusted seroprevalence of SARS-CoV-2 antibodies to natural infection among demographic groups.
A) Sex, B) Age, C) Race/ethnicity, D) Income, E) Educational attainment, and F) Household size. Abbreviations: AA, African American; AMI, American Indian or Alaskan Native; PI, Pacific Islander.
See this image and copyright information in PMC

References

    1. Eby K. Coronavirus Timeline: Tracking major moments of COVID-19 pandemic in San Francisco Bay Area. In: ABC7 San Francisco [Internet]. 27 Mar 2020 [cited 2021 Nov 29]. https://abc7news.com/6047519/.
    1. United States. Agency for Toxic Substances and Disease Registry. Geospatial Research A and SP, editor. CDC COVID data tracker. 2020 [cited 2021 Dec 29]. https://stacks.cdc.gov/view/cdc/96118.
    1. Njoku A, Joseph M, Felix R. Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination. International Journal of Environmental Research and Public Health. 2021;18: 9904. doi: 10.3390/ijerph18189904 - DOI - PMC - PubMed
    1. Qualls N. Community Mitigation Guidelines to Prevent Pandemic Influenza—United States, 2017. MMWR Recomm Rep. 2017;66. doi: 10.15585/mmwr.rr6601a1 - DOI - PMC - PubMed
    1. CDC. Interim pre-pandemic planning guidance: community strategy for pandemic influenza mitigation in the United States: early, targeted, layered use of nonpharmaceutical interventions. [cited 2021 Nov 10]. https://stacks.cdc.gov/view/cdc/11425.