Urban-rural divide in COVID-19 infection and vaccination rates in healthcare workers in British Columbia, Canada.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL Canadian Journal of Rural Medicine Pub Date : 2023-04-01 DOI:10.4103/cjrm.cjrm_24_22
Annalee Yassi, Stephen Barker, Karen Lockhart, Deanne Taylor, Devin Harris, Harsh Hundal, Jennifer M Grant, Arnold Ikedichi Okpan, Sue Pollock, Stacy Sprague, Chad Kim Sing
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引用次数: 1

Abstract

Introduction: Healthcare workers (HCWs) play a critical role in responding to the COVID-19 pandemic. Early in the pandemic, urban centres were hit hardest globally; rural areas gradually became more impacted. We compared COVID-19 infection and vaccine uptake in HCWs living in urban versus rural locations within, and between, two health regions in British Columbia (BC), Canada. We also analysed the impact of a vaccine mandate for HCWs.

Methods: We tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates and vaccine uptake in all 29,021 HCWs in Interior Health (IH) and all 24,634 HCWs in Vancouver Coastal Health (VCH), by occupation, age and home location, comparing to the general population in that region. We then evaluated the impact of infection rates as well as the mandate on vaccination uptake.

Results: While we found an association between vaccine uptake by HCWs and HCW COVID-19 rates in the preceding 2-week period, the higher rates of COVID-19 infection in some occupational groups did not lead to increased vaccination in these groups. By 27 October 2021, the date that unvaccinated HCWs were prohibited from providing healthcare, only 1.6% in VCH compared with 6.5% in IH remained unvaccinated. Rural workers in both areas had significantly higher unvaccinated rates compared with urban dwellers. Over 1800 workers, comprising 6.7% of rural HCWs and 3.6% of urban HCWs, remained unvaccinated and set to be terminated from their employment. While the mandate prompted a significant increase in uptake of second doses, the impact on the unvaccinated was less clear.

Conclusions: As rural areas often suffer from under-staffing, loss of HCWs could have serious impacts on healthcare provision as well as on the livelihoods of unvaccinated HCWs. Greater efforts are needed to understand how to better address the drivers of rural-related vaccine hesitancy.

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加拿大不列颠哥伦比亚省医护人员COVID-19感染和疫苗接种率的城乡差异
导语:卫生保健工作者在应对COVID-19大流行方面发挥着关键作用。在大流行早期,全球城市中心受到的打击最为严重;农村地区受到的影响越来越大。我们比较了居住在加拿大不列颠哥伦比亚省(BC)两个卫生区域内和之间城市和农村地区的卫生保健员的COVID-19感染和疫苗接种情况。我们还分析了疫苗授权对卫生保健工作者的影响。方法:我们按职业、年龄和家庭位置跟踪了所有29,021名内陆卫生院(IH)和温哥华沿海卫生院(VCH)所有24,634名HCWs的实验室确诊SARS-CoV-2感染、阳性率和疫苗接种情况,并与该地区的一般人群进行了比较。然后,我们评估了感染率的影响以及对疫苗接种的授权。结果:虽然我们发现前2周内医护人员的疫苗接种率与HCW COVID-19感染率之间存在关联,但某些职业群体的COVID-19感染率较高并未导致这些群体的疫苗接种率增加。到2021年10月27日,即未接种疫苗的卫生保健员被禁止提供卫生保健之日,只有1.6%的VCH未接种疫苗,而IH为6.5%。与城市居民相比,这两个地区的农村工人未接种疫苗的比例明显更高。超过1800名工人,包括6.7%的农村卫生保健员和3.6%的城市卫生保健员,仍未接种疫苗,并将被终止就业。虽然该任务促使第二剂的吸收显著增加,但对未接种疫苗者的影响尚不清楚。结论:由于农村地区往往人手不足,卫生保健员的流失可能对医疗保健服务以及未接种疫苗的卫生保健员的生计产生严重影响。需要作出更大努力,了解如何更好地解决与农村有关的疫苗犹豫的驱动因素。
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来源期刊
Canadian Journal of Rural Medicine
Canadian Journal of Rural Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
18.20%
发文量
38
期刊介绍: The Canadian Journal of Rural Medicine (CJRM) is a quarterly peer-reviewed journal available in print form and on the Internet. It is the first rural medical journal in the world indexed in Index Medicus, as well as MEDLINE/PubMed databases. CJRM seeks to promote research into rural health issues, promote the health of rural and remote communities, support and inform rural practitioners, provide a forum for debate and discussion of rural medicine, provide practical clinical information to rural practitioners and influence rural health policy by publishing articles that inform decision-makers.
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