COVID-19 vaccines coverage and effectiveness against SARS-CoV-2 infection among residents in the largest Health Authority of Lazio region (Italy): a population-based cohort study

Fano, Valeria; Coviello, Enzo; Consonni, Dario; Agresta, Alessandro; Orsini, Nicola; Crielesi, Alessia; Miglietta, Antonio; Pasqua, Caterina; Vairo, Francesco; Vivaldi, Fabio; Angelis, Giuseppe De; Colaiocco, Giovanni; Fabiani, Massimo

doi:10.1080/14760584.2022.2080057

Cited by 3 publications

(6 citation statements)

References 26 publications

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“…The results indicate the vulnerability of migrants residing in Rome concerning COVID-19 vaccination access in 2021 and suggest inequalities in health. Lower vaccination uptake has also been observed in an Italian study conducted in Lazio, the administrative region of Rome, which found that foreign residents have a triple probability of Italians not accessing the vaccine 12 , and in a study conducted in a Local Health Authority in Rome 13 . Furthermore, a lower vaccination coverage among foreigners has also been observed in a study conducted in Brescia Province, one of the most dramatically hit by COVID-19 at the beginning of the pandemic 15 .…”

Section: Discussionmentioning

confidence: 66%

“…Among these, later diagnoses and poorer outcomes in COVID cases among foreigners compared to Italians were reported 10 , 11 . In the study conducted by a Local Health Authority in Rome, HMPC citizens were younger than Italians, less likely to be frail and more likely to receive the less effective brand of vaccine (Janssen) 13 . However, we do not have striking evidence of different risks of infection among immigrants in Italy, though it is possible to argue that the lack of findings is the consequence of the lower access to diagnostic tests 16 , 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Multicentric Italian studies have documented the impact of the pandemic on migrants: compared to Italians, migrants have had higher overall and intensive care unit hospitalization rates 7 , as well as higher incidence and mortality, but only in some phases of the pandemic 8 , 9 . Other Italian studies found higher hospitalization and mortality among non-Italian nationals with COVID-19 10 , 11 , a much higher proportion of not vaccinated in foreign-born (25.4%) than in Italian-born (9.0%) 12 , and a three-fold COVID-19 adjusted vaccination coverage among Italians plus foreigners from Advanced Developed Countries compared to HMPCs 13 . In Rome, there is a high percentage of foreign residents (13.3%) 14 , in particular migrants coming from HMPCs, which are the most prevalent and disadvantaged component of the foreign population, deserving attention from a public health perspective.…”

Section: Introductionmentioning

confidence: 86%

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Covid-19 vaccination among migrants in Rome, Italy

Cacciani,

Cesaroni,

Calandrini

et al. 2023

Sci Rep

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Migrants may be susceptible to vaccine barriers and hesitancy. We evaluated the association between migrant status, as measured by the citizenship from a High Migratory Pressure Country (HMPC), and COVID-19 vaccination uptake in the resident population in Rome, Italy. We also investigated sex differences. We followed participants for vaccination against COVID-19 in 2021. We calculated crude- and adjusted-vaccination rates and Cox hazard ratios of vaccination for migrants compared to Italians. Among migrants from HMPCs, we estimated HRs for females compared to males, stratifying by geographical area of origin. Models were adjusted for age and deprivation index and stratified by infection history. In 2021, among 1,731,832 18–64-year-olds, migrants were 55% less likely to uptake at least one COVID-19 vaccine dose than their Italian counterpart. Past SARS-CoV-2 infection reduced the difference between migrants and Italians to 27%. Among migrants from HMPCs, we observed a slight excess of vaccination uptake among females compared to males. Focusing on geographical areas, we observed that only females from central-western Asia were 9% less likely to uptake vaccination than males. Health communication strategies oriented to migrants and considering their different languages, cultures, and health literacy should be adopted for prevention before emergencies.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

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Covid-19 vaccination among migrants in Rome, Italy

Cacciani,

Cesaroni,

Calandrini

et al. 2023

Sci Rep

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“…In 2020, all-cause mortality increased substantially more among people who migrated to the United Kingdom from several global regions than among people who were born in the United Kingdom 4 . Moreover, migrant populations on the whole are known to be an under-immunized group in Europe for routine vaccines 5 , 6 , and evidence of low COVID-19 vaccine uptake in some migrant groups is emerging from several European countries 7 – 10 .…”

Section: Mainmentioning

confidence: 99%

COVID-19 vaccination coverage for half a million non-EU migrants and refugees in England

Burns,

Wyke,

Eyre

et al. 2023

Nat Hum Behav

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Despite evidence suggesting that some migrants are at risk of under-immunization and have experienced severe health inequities during the pandemic, data are limited on migrants’ COVID-19 vaccine coverage globally. Here we linked data from non-European Union migrants and resettled refugees to the national COVID-19 vaccination dataset in England. We estimated patterns in second and third dose delays and overdue doses between 12 December 2020 and 20 April 2022 by age, visa type and ethnicity. Of the 465,470 linked records, 91.8% (427,073/465,470) of migrants received a second dose and 51.3% (238,721/465,470) received a third. Refugees had the highest risk of delayed second (adjusted odds ratio 1.66; 95% confidence interval 1.55–1.79) and third dose (1.55; 1.43–1.69). Black migrants were twice as likely to have a second dose delayed (2.37; 2.23–2.54) than white migrants, but this trend reversed for the third dose. Older migrants (>65 years) were four times less likely to have received their second or third dose compared with the general population in England aged >65 or older. Policymakers, researchers and practitioners should work to understand and address personal and structural barriers to vaccination for diverse migrant populations.

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“…We hypothesized that: (i) overall and within strata of characteristics, immigrants would be less likely to receive both second and third doses compared to other Ontarians; (ii) overall and within strata of characteristics, differences in vaccination coverage between immigrants and other Ontarians would be smaller for two than three doses, (iii) those residing in higher neighborhood SARS-CoV-2 risk deciles would have the highest primary series coverage, and (iv) among immigrants, region of birth, duration of residence, refugee status, and primary care enrollment would be important determinants of vaccination. To the best of our knowledge, this is one of six (5)(6)(7)(8)(9) published studies examining COVID-19 vaccination among immigrants in high-income countries, and the first to report on the primary series and first booster using a total population-based denominator.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccine equity: a retrospective population-based cohort study examining primary series and first booster coverage among persons with a history of immigration and other residents of Ontario, Canada

Wanigaratne,

Lu,

Gandhi

et al. 2023

Front. Public Health

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IntroductionImmigrants were disproportionately impacted by COVID-19 and experience unique vaccination barriers. In Canada (37 million people), 23% of the population is foreign-born. Immigrants constitute 60% of the country’s racialized (non-white) population and over half of immigrants reside in Ontario, the country’s most populous province. Ontario had several strategies aimed at improving vaccine equity including geographic targeting of vaccine supply and clinics, as well as numerous community-led efforts. Our objectives were to (1) compare primary series vaccine coverage after it was widely available, and first booster coverage 6 months after its availability, between immigrants and other Ontario residents and (2) identify subgroups experiencing low coverage.Materials and methodsUsing linked immigration and health administrative data, we conducted a retrospective population-based cohort study including all community-dwelling adults in Ontario, Canada as of January 1, 2021. We compared primary series (two-dose) vaccine coverage by September 2021, and first booster (three-dose) coverage by March 2022 among immigrants and other Ontarians, and across sociodemographic and immigration characteristics. We used multivariable log-binomial regression to estimate adjusted risk ratios (aRR).ResultsOf 11,844,221 adults, 22% were immigrants. By September 2021, 72.6% of immigrants received two doses (vs. 76.4%, other Ontarians) and by March 2022 46.1% received three doses (vs. 58.2%). Across characteristics, two-dose coverage was similar or slightly lower, while three-dose coverage was much lower, among immigrants compared to other Ontarians. Across neighborhood SARS-CoV-2 risk deciles, differences in two-dose coverage were smaller in higher risk deciles and larger in the lower risk deciles; with larger differences across all deciles for three-dose coverage. Compared to other Ontarians, immigrants from Central Africa had the lowest two-dose (aRR = 0.60 [95% CI 0.58–0.61]) and three-dose coverage (aRR = 0.36 [95% CI 0.34–0.37]) followed by Eastern Europeans and Caribbeans, while Southeast Asians were more likely to receive both doses. Compared to economic immigrants, resettled refugees and successful asylum-claimants had the lowest three-dose coverage (aRR = 0.68 [95% CI 0.68–0.68] and aRR = 0.78 [95% CI 0.77–0.78], respectively).ConclusionTwo dose coverage was more equitable than 3. Differences by immigrant region of birth were substantial. Community-engaged approaches should be re-invigorated to close gaps and promote the bivalent booster.

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COVID-19 vaccines coverage and effectiveness against SARS-CoV-2 infection among residents in the largest Health Authority of Lazio region (Italy): a population-based cohort study

Cited by 3 publications

References 26 publications

Covid-19 vaccination among migrants in Rome, Italy

Covid-19 vaccination among migrants in Rome, Italy

COVID-19 vaccination coverage for half a million non-EU migrants and refugees in England

COVID-19 vaccine equity: a retrospective population-based cohort study examining primary series and first booster coverage among persons with a history of immigration and other residents of Ontario, Canada

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