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Infectious Diseases

Association of Demographic, Clinical, and Social Determinants of Health With COVID-19 Vaccination Booster Dose Completion Among US Veterans

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Network Open

Published Online: July 19, 2022

Research Letter

Article Information and Disclosures

Karen H. Seal, MD, MPH^1,2;

Daniel Bertenthal, MPH¹;

Jennifer K. Manuel, PhD^1,3;

Jeffrey M. Pyne, MD^4,5

Author Affiliations

¹San Francisco Veterans Affairs (VA) Healthcare System, San Francisco, California
²Departments of Medicine and Psychiatry, University of California, San Francisco
³Department of Psychiatry, University of California, San Francisco
⁴Mental Health Service, Central Arkansas VA Healthcare System, Little Rock
⁵Department of Psychiatry, University of Arkansas School of Medicine, Little Rock

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COVID-19 vaccination markedly decreases serious illness, hospitalization, and mortality due to SARS-CoV-2 infection, but immunity wanes, leaving individuals susceptible to COVID-19.¹ Thus, the Centers for Disease Control and Prevention recommend vaccine boosters. Some subpopulations have lower rates of primary COVID-19 vaccination than others,² suggesting that increasing numbers of individuals will lack protection against COVID-19 should booster-eligible individuals fail to receive boosters.

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Article Information

Accepted for Publication: May 26, 2022.

Published: July 19, 2022. doi:10.1001/jamanetworkopen.2022.22635

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Seal KH et al. JAMA Network Open.

Corresponding Author: Karen H. Seal, MD, MPH, San Francisco VA Health Care System, 4150 Clement St, Box 111A-1, San Francisco, CA 94121 (karen.seal@va.gov; karen.seal@ucsf.edu).

Author Contributions: Dr Seal and Mr Bertenthal had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Seal, Bertenthal, Manuel.

Acquisition, analysis, or interpretation of data: Seal, Bertenthal, Pyne.

Drafting of the manuscript: Seal, Bertenthal, Manuel.

Critical revision of the manuscript for important intellectual content: Seal, Bertenthal, Pyne.

Statistical analysis: Bertenthal.

Obtained funding: Seal, Manuel, Pyne.

Administrative, technical, or material support: Seal, Pyne.

Supervision: Seal.

Conflict of Interest Disclosures: Dr Seal reported receiving grants from VA Health Services Research and Development during the conduct of the study. Mr Bertenthal reported receiving salary support from VA Health Services Research and Development from a grant to Dr Seal during the conduct of the study. Dr Manuel reported receiving grants from VA Health Services Research and Development during the conduct of the study. Dr Pyne reported receiving grants from the VA Health Services Research and Development during the conduct of the study. No other disclosures were reported.

Funding/Support: This study was supported by grant SDR 21-141 from the VA Health Services Research and Development (principal investigators, Drs Seal, Manuel, and Pyne).

Role of the Funder/Sponsor: The sponsor had no role in the design or conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript or the decision to submit for publication.

Additional Contributions: Yasmin Jolly, BS, Nicole Woodruff-Giarbini, BS, and Nicole McCamish, MA, of the San Francisco VA Health Care System provided administrative assistance to this project, for which they were compensated.

References

Accorsi EK , Britton A , Fleming-Dutra KE , et al. Association between 3 doses of mRNA COVID-19 vaccine and symptomatic infection caused by the SARS-CoV-2 omicron and delta variants. JAMA. 2022;327(7):639-651. doi:10.1001/jama.2022.0470 PubMed Google Scholar Crossref

Young-Xu Y , Korves C , Roberts J , et al. Coverage and estimated effectiveness of mRNA COVID-19 vaccines among US Veterans. JAMA Netw Open. 2021;4(10):e2128391. doi:10.1001/jamanetworkopen.2021.28391 PubMed Google Scholar Crossref

Centers for Disease Control and Prevention. Demographic characteristics of people receiving COVID-19 vaccinations in the United States. Updated daily. Accessed February 26, 2022. https://covid.cdc.gov/covid-data-tracker/#vaccinationdemographic

Graham-Steed T , Uchio E , Wells CK , Aslan M , Ko J , Concato J . “Race” and prostate cancer mortality in equal-access healthcare systems. Am J Med. 2013;126(12):1084-1088. doi:10.1016/j.amjmed.2013.08.012 PubMed Google Scholar Crossref

Haderlein TP , Wong MS , Jones KT , Moy EM , Yuan AH , Washington DL . Racial/ethnic variation in Veterans Health Administration COVID-19 vaccine uptake. Am J Prev Med. 2022;62(4):596-601. doi:10.1016/j.amepre.2021.08.027 PubMed Google Scholar Crossref

Nguyen KH , Yankey D , Lu PJ , et al. Report of health care provider recommendation for COVID-19 vaccination among adults, by recipient COVID-19 vaccination status and attitudes—United States, April-September 2021. MMWR Morb Mortal Wkly Rep. 2021;70(50):1723-1730. doi:10.15585/mmwr.mm7050a1 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.