Regional Differences in COVID-19 Vaccination and Breakthrough Infection Rates by U.S. Census Region Using Cerner Real-World Data [ID: 1363147]

Abstract

INTRODUCTION: The rate of COVID-19 infection varies across different regions in the United States. However, there are limited data evaluating the vaccination rates and subsequent infection among the pregnant population with regard to geographical location. The primary aim of the study was to determine the COVID-19 vaccination rate and subsequent infection rate among pregnant people in each U.S. census region. METHODS: A retrospective data collection of pregnant people from January 2020 to March 2022 was performed using the Cerner Real-World Data from 106 centers. The four census regions were defined by the U.S. Census Bureau. Breakthrough infection was defined as a positive COVID-19 test during or after pregnancy among immunized mothers. Because the database was fully de-identified, IRB approval was not required. RESULTS: The study included 389,764 pregnant persons, of which 44,846 were vaccinated. The rate of vaccination against COVID-19 was 14.57%, 11.80%, 11.71%, and 5.24% in the South, West, Northeast, and Midwest census regions, respectively. The COVID-19 infection rate after vaccination was 1.70%, 1.31%, 0.36%, and 0.06% in the Northeast, South, Midwest, and West census regions, respectively. CONCLUSION: The reported 11% vaccination rate suggests low utilization among pregnant people; that said, breakthrough infections rates appeared extremely low, suggesting robust protection. The study is limited in that it queried hospital-based vaccinations and breakthrough infections and is unable to capture larger community-based data. Further studies may compare vaccination and infection trends with nonpregnant patient populations.