American journal of infection control最新文献

英文中文

Presence of multidrug-resistant bacteria on ready-to-use laryngoscope blades and handles: A cross-sectional study

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-04 DOI: 10.1016/j.ajic.2024.12.018

Sara Ester Barbosa MSc , Angelica Zaninelli Schreiber PhD , Eliane Picoli Alves Bensi MSc , Patricia Cristiane Spirlandelli Teixeira BSc , Maria Isabel Pedreira de Freitas PhD , Henrique Ceretta Oliveira PhD , Vanessa Aparecida Vilas-Boas PhD

Background

The presence of microorganisms in laryngoscopes emphasizes the risk to patient safety during orotracheal intubations.

Methods

A cross-sectional study was carried out in university hospital in the inpatient, emergency, intensive care, and surgical center sectors. Microorganisms were recovered from the blades using a filter membrane and from the handles using swab. They were then sown on blood agar plates and incubated at 35 °C (± 2 °C) for a maximum of 5 days. Microorganisms were identified by mass spectrometry, antimicrobial susceptibility tests were carried out for pathogenic bacteria. Associations were made using χ² and Fisher exact tests, and Poisson regression model.

Results

A total of 158 blades and 45 handles were analyzed. Microbial growth was observed on 59.5% of the blades and 64.4% of the handles, with fungi and bacteria isolated, such as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter sp. Multidrug-resistant bacteria, producing extended-spectrum β-lactamases and carbapenemases, were found.

Conclusions

Multidrug-resistant bacteria were found on ready-to-use laryngoscopes. In the surgical center, there was lower probability of microbial growth, while the intensive care sector showed higher probability. This study reinforces the warning that this equipment is a potential source of transmission of microorganisms, especially multiresistant strains.

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引用次数: 0

Building a biocontainment unit: Infrastructure and organizational experiences of the 13 regional biocontainment units in the United States 建立生物安全单位：美国 13 个地区生物安全单位的基础设施和组织经验。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.06.021

Caroline Persson MPH, CPH, FAPIC , Corri B. Levine PhD, MS, MPH , Kara Marshall MPH , Sophia Shea MPH , Christa Arguinchona MSN, BSN, CCRN , Sharon Vanairsdale Carrasco DNP, APRN, FAEN, FAAN, FNAP , Lauren M. Sauer MSc , Jocelyn J. Herstein PhD, MPH

In the United States, the system for special pathogen patient care incorporates a network of federally funded US biocontainment units that maintain operational readiness to care for patients afflicted by high-consequence infectious diseases (HCIDs). This network has expanded in number of facilities and in scope, serving as a regional resource for special pathogen preparedness. Lessons learned for maintaining these units are shared with the intent of informing new and existing biocontainment units.

美国的特殊病原体救治系统始于 2014 年的分级结构，当时美国曾救治过埃博拉病毒病患者。在过去十年中，由联邦政府资助的美国生物隔离单位（BCUs）（称为区域新发特殊病原体治疗中心（RESPTCs））一直保持着运行状态，随时准备为罹患高后果传染病的患者提供治疗。区域新发特殊病原体治疗中心网络在设施数量和范围上都有所扩大，目前有 13 个区域新发特殊病原体治疗中心作为区域特殊病原体防备资源；随着国家特殊病原体系统（NSPS）的建立，区域新发特殊病原体治疗中心的作用最近得到了正式确定。这些中心分享了在维护基础设施和运行准备状态方面的经验教训，旨在为美国和全球新成立和现有的 BCU 提供信息。

引用次数: 0

Changes in the mumps vaccine coverage and incidence of mumps before and after the public subsidization program: A descriptive study using a population-based database in Japan 公共补贴计划前后腮腺炎疫苗覆盖率和腮腺炎发病率的变化：利用日本人口数据库进行的描述性研究。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.011

So Sato MD , Sachiko Ono DDS, MPH, PhD , Yusuke Sasabuchi MD, MPH, PhD , Kohei Uemura PhD , Hideo Yasunaga MD, PhD

Background

Continuous mumps vaccine coverage is essential for eradicating mumps. However, due to safety concerns, Japan’s mumps vaccination program transitioned from routine to voluntary. To improve coverage, some municipalities introduced subsidization programs, but the effects on vaccination rates and mumps incidence remain unclear.

Methods

In April 2018, a city in Japan launched a subsidization program for the mumps vaccine for children aged 1–6 years. Using vaccination records and healthcare claims from July 2016 to December 2019, we analyzed changes in vaccination coverage and mumps incidence before and after the program’s initiation.

Results

At the program’s start, mumps vaccination coverage among eligible children was 3.3%, increasing by approximately 1.5% monthly to 38.4% after 21 months. Among 308,976 individuals, 145 mumps cases were identified: 92 cases (0.27 per 1,000 person-years) occurred before, and 53 (0.15 per 1,000 person-years) occurred after the program’s start.

Conclusions

Although the mumps vaccination coverage rate increased following the program’s initiation, it remained below the level required for eradication.

背景有证据表明，持续接种流行性腮腺炎疫苗可以根除流行性腮腺炎感染。然而，出于安全考虑，日本的流行性腮腺炎疫苗接种计划从常规转为自愿。为了提高疫苗接种覆盖率，一些市镇开始独立提供流行性腮腺炎疫苗补贴计划。然而，在启动补贴计划前后，疫苗接种覆盖率和流行性腮腺炎发病率的变化仍是未知数。方法2018年4月，日本某市启动了针对1-6岁儿童的流行性腮腺炎疫苗补贴计划。本研究使用了该市在 2016 年 7 月至 2019 年 12 月期间获得的疫苗接种记录和医疗报销数据。结果在该计划启动时，符合条件的儿童腮腺炎疫苗接种覆盖率为 3.3%；该覆盖率每月增加约 1.5%，在计划启动 21 个月后达到 38.4%。在 308,976 人中发现了 145 例流行性腮腺炎病例；其中 92 例（每千人年 0.27 例）发生在补贴计划启动之前，53 例（每千人年 0.15 例）发生在补贴计划启动之后。

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引用次数: 0

Factors associated with correction of personal protective equipment nonadherence in a multidisciplinary emergency department setting: A retrospective video review 在多学科急诊科环境中纠正不遵守个人防护装备规定的相关因素：回顾性视频回顾。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.001

Mary S. Kim MD , Aleksandra Sarcevic PhD , Genevieve J. Sippel BA , Kathleen H. McCarthy BS , Eleanor A. Wood BSE , Carmen Riley , Aaron H. Mun BS , Karen J. O’Connell MD, MEd , Peter T. LaPuma PhD, CIH, PE , Randall S. Burd MD, PhD

Background

Despite local and national recommendations, health care provider adherence to personal protective equipment (PPE) varied during the COVID-19 pandemic. Previous studies have identified factors influencing initial PPE adherence but did not address factors influencing behaviors leading to correction after initial nonadherence.

Methods

We conducted a retrospective video review of 18 pediatric resuscitations involving aerosol-generating procedures from March 2020 to December 2022 to identify factors associated with nonadherence correction. We quantified adherent and nonadherent providers, instances of PPE nonadherence, and time to correction. We also analyzed correction behaviors, including provider actions and correction locations.

Results

Among 434 providers, 362 (83%) were nonadherent with at least 1 PPE. Only 186 of 1,832 instances of nonadherence were corrected, primarily upon room entry and during patient care. Correction time varied by PPE type and nonadherence level (incomplete vs absent). Most corrections were self-initiated, with few reminders from other providers.

Discussion

Potential barriers to correction include a lack of social pressure and external reminders. Solutions include optimizing PPE availability, providing real-time feedback, and educating on double gloving.

Conclusions

Most providers were nonadherent to PPE requirements during high-risk infection transmission events. The low correction rate suggests challenges in promoting collective responsibility and maintaining protective behaviors during medical emergencies.

背景：尽管地方和国家都提出了建议，但在 COVID-19 大流行期间，医疗服务提供者对个人防护设备 (PPE) 的依从性各不相同。以前的研究确定了影响最初坚持使用个人防护设备的因素，但没有涉及影响最初不坚持使用后改正行为的因素：我们对 2020 年 3 月至 2022 年 12 月期间涉及气溶胶产生程序 (AGP) 的 18 例儿科复苏进行了回顾性视频审查，以确定与纠正不依从性相关的因素。我们对坚持和不坚持的提供者、不坚持使用个人防护设备的情况以及纠正时间进行了量化。我们还分析了纠正行为，包括医疗服务提供者的行动和纠正地点：在 434 名医疗服务提供者中，有 362 人（83%）不遵守至少一项 PPE。在 1,832 次不遵守行为中，只有 186 次得到了纠正，主要是在进入病房和护理病人期间。纠正时间因个人防护设备类型和不遵守级别（不完全遵守与未遵守）而异。大多数纠正都是自己主动进行的，很少有来自其他医疗服务提供者的提醒：讨论：纠正的潜在障碍包括缺乏社会压力和外部提醒。解决方案包括优化个人防护设备的可用性、提供实时反馈以及开展双层手套教育：大多数医疗服务提供者在高危感染传播事件中未遵守个人防护设备要求。低纠正率表明，在医疗紧急情况下促进集体责任和保持防护行为面临挑战。

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引用次数: 0

Challenges and trends in Gram-negative bacterial infections in critically neonates: A seven-and-a-half-year observational study 重症新生儿革兰氏阴性菌感染的挑战与趋势：一项为期七年半的观察研究。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.004

Isadora Caixeta da Silveira Ferreira , Izabella Clara de Brito Machado , Ralciane de Paula Menezes , Thiago Alves de Jesus , Mallu Santos Mendonça Lopes , Lúcio Borges de Araújo , Daniela Marques de Lima Mota Ferreira , Denise Von Dolinger de Brito Röder

Background

Analyze the incidence, risk factors, and fatality rates of bloodstream infections by Gram-negative bacteria (GNB-BSIs) in a Neonatal Intensive Care Unit.

Methods

This study employs a retrospective cohort design utilizing records of neonates admitted to the Neonatal Intensive Care Unit between January 2015 and June 2022.

Results

Among 1,495 neonates, 5.2% developed GNB-BSIs. The average incidence of infection per 1,000 patient-days was 2.9. Primary risk factors for infection that included preceeding carbapenem use were significant risk factors (odds ratio = 514.4; P < .01) and fourth-generation cephalosporins (odds ratio = 66; P < .01). Among the 85 GNB, 75.3% were fermenters, and 24.7% were non-fermenters. Of the isolates, 14.1% produced extended-spectrum beta-lactamase, and 2.3% carbapenem-resistant. Infection correlated with prolonged hospital stays (10-39 days) and increased mortality (10%-29.9%).

Conclusions

The high incidence of GNB-BSIs was exacerbated by the preceeding use of broad-spectrum antimicrobials, increasing the presence of multidrug-resistant isolates and fatality rates. These findings emphasize the importance of active surveillance.

目的分析新生儿重症监护室（NICU）中革兰氏阴性菌血流感染（GNB-BSIs）的发病率、风险因素和死亡率：本研究采用回顾性队列设计，利用2015年1月至2022年6月期间新生儿重症监护室收治的新生儿记录：结果：1495 名新生儿中有 5.2% 感染了 GNB-BSI。每千个患者日的平均感染率为 2.9。感染的主要风险因素包括：使用碳青霉烯类药物之前是重要的风险因素（OR=514.4；第四代头孢菌素（OR=66；PC）结论：GNB-BSI 的高发病率对新生儿的影响非常大：在使用广谱抗菌药物之前，GNB-BSI 的高发病率加剧，增加了耐多药分离株的存在和死亡率。这些发现强调了积极监测的重要性。

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引用次数: 0

Long-lasting effects of control measures on trends in incidence in neonatal late-onset sepsis due to multiresistant bacteria in a Brazilian neonatal unit 巴西新生儿病房多重耐药菌引起的新生儿晚期败血症发病率趋势的长期控制措施效果。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.007

Ivan Gilberto Macolla Bazan MD , Barbara Barros Pereira Lobo MD , Angelica Zaninelli Schreiber PhD , Roseli Calil PhD , Sergio Tadeu Martins Marba PhD , Jamil Pedro de Siqueira Caldas PhD

Background

In response to a 1995 outbreak of sepsis caused by multidrug-resistant (MR) Gram-negative bacteria (GNB), a Brazilian level III neonatal unit established a series of control and prevention measures. This study evaluated the long-term effects of these measures on late-onset neonatal sepsis (LONS) caused by MR bacteria from 2000 to 2020 and examined their impact on in-hospital mortality.

Methods

Newborns with LONS and positive cultures for Staphylococcus aureus, GNB, and Enterococcus sp were selected, adhering to Center for Desease Control and Prevention and local criteria. Joinpoint regression analysis was used to assess annual trends.

Results

Over the 21-year period, the overall LONS rate was 4.6%, showing a significant decline from 2000 to 2016 (P < .0001, slope -0.36). However, from 2016 to 2020, there was a non-significant increase in sepsis rates (slope +0.92, P = .08). MR sepsis were in 15.8% of sepsis cases and displayed a non-significant upward trend (slope +0.50, P = .08) with no major shifts. In-hospital mortality rates for MR and non-MR LONS showed no significant differences (P = .413).

Discussion

The study indicates a low prevalence of MR sepsis due to effective antimicrobial use and educational interventions.

Conclusions

MR sepsis prevalence remained low and stable, not increasing in-hospital mortality.

背景：1995 年，由于爆发了由多重耐药革兰氏阴性菌（GNB）引起的败血症，我们的新生儿科制定了一系列控制和预防措施。本研究评估了这些措施在 2000 年至 2020 年期间对巴西一家三级新生儿科内由多重耐药菌引起的迟发型新生儿败血症（LONS）的长期影响，并研究了其与院内死亡之间的关系：分析了由金黄色葡萄球菌、GNB 和肠球菌引起的经血液和/或脑脊液培养阳性证实的 LONS 新生儿。MR标准遵循美国疾病预防控制中心和当地传染病指南。采用连接点回归分析法对每年的败血症趋势进行了评估：21年间，确诊的LONS率为4.6%，从2000年到2016年出现了显著下降（P 讨论）：研究表明，由于抗菌药物的有效使用和教育干预措施，MR 败血症的发病率较低：结论：MR 败血症的发病率仍然较低且稳定，不会增加院内死亡率。

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引用次数: 0

Effectiveness of sensing gloves–applied virtual reality education system on hand hygiene practice: A randomized controlled trial 感知手套应用虚拟现实教育系统对手部卫生实践的效果：随机对照试验

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.08.003

Mahiro Izumi , Hideharu Hagiya MD, PhD , Yuki Otsuka MD, PhD , Yoshiaki Soejima MD, PhD , Shinnosuke Fukushima MD, PhD , Mitsunobu Shibata , Satoshi Hirota , Toshihiro Koyama PhD , Fumio Otsuka MD, PhD , Akio Gofuku PhD

Background

We developed a virtual reality (VR) education system and evaluated its clinical utility for promoting hand hygiene practices.

Methods

This prospective, 2-week, randomized controlled study conducted at Okayama University Hospital, Japan, from November 2023 to January 2024, involved 22 participants (18 medical students and 4 residents). A fully immersive 360° VR system (VIVE Pro Eye) using a head-mounted display and sensing gloves was used to develop 3 health care tasks in a virtual patient room—Environmental Cleaning, Gauze Exchange, and Urine Collection. After monitoring all participants' baseline usage data of portable hand-rubbing alcohol in the first week, we randomly assigned them into 1:1 groups (VR training and video lecture groups). The primary outcome was differences in hand-rubbed alcohol use before and after intervention.

Results

Before the intervention, alcohol use did not significantly differ between both groups. After the intervention, a significant increase in alcohol use was observed in the VR training group (median: 8.2 g vs 16.2 g; P = .019) but not in the video lecture group.

Conclusions

Our immersive 360° VR education system enhanced hand hygiene practices. Infection prevention and control practitioners and digital technology experts must collaborate to advance the development of superior educational devices and content.

简介：我们开发了一套虚拟现实（VR）教育系统，并评估了其在促进手部卫生实践方面的临床实用性：我们开发了一套虚拟现实（VR）教育系统，并对其在促进手部卫生实践方面的临床实用性进行了评估：这项前瞻性、为期两周的随机对照研究于 2023 年 11 月至 2024 年 1 月在日本冈山大学医院进行，共有 22 名参与者（18 名医学生和 4 名住院医师）。该研究使用了一个完全沉浸式 360° VR 系统（VIVE Pro Eye），该系统使用了头戴式显示器和传感手套，在虚拟病房中开发了三项医疗保健任务--环境清洁、纱布交换和尿液收集。在第一周监测所有参与者使用便携式擦手酒精的基线数据后，我们将他们随机分配到 1:1 组（VR 培训组和视频讲座组）。主要结果是干预前后手擦酒精使用量的差异：结果：干预前，两组的酒精使用量没有明显差异。干预后，观察到 VR 培训组的酒精使用量明显增加（中位数：8.2 克 vs. 16.2 克；P=0.019），但视频讲座组没有增加：我们的沉浸式 360° VR 教育系统增强了手部卫生实践。感染预防与控制从业人员和数字技术专家必须通力合作，共同推进优质教育设备和内容的开发。

{"title":"Effectiveness of sensing gloves–applied virtual reality education system on hand hygiene practice: A randomized controlled trial","authors":"Mahiro Izumi , Hideharu Hagiya MD, PhD , Yuki Otsuka MD, PhD , Yoshiaki Soejima MD, PhD , Shinnosuke Fukushima MD, PhD , Mitsunobu Shibata , Satoshi Hirota , Toshihiro Koyama PhD , Fumio Otsuka MD, PhD , Akio Gofuku PhD","doi":"10.1016/j.ajic.2024.08.003","DOIUrl":"10.1016/j.ajic.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>We developed a virtual reality (VR) education system and evaluated its clinical utility for promoting hand hygiene practices.</div></div><div><h3>Methods</h3><div>This prospective, 2-week, randomized controlled study conducted at Okayama University Hospital, Japan, from November 2023 to January 2024, involved 22 participants (18 medical students and 4 residents). A fully immersive 360° VR system (VIVE Pro Eye) using a head-mounted display and sensing gloves was used to develop 3 health care tasks in a virtual patient room—Environmental Cleaning, Gauze Exchange, and Urine Collection. After monitoring all participants' baseline usage data of portable hand-rubbing alcohol in the first week, we randomly assigned them into 1:1 groups (VR training and video lecture groups). The primary outcome was differences in hand-rubbed alcohol use before and after intervention.</div></div><div><h3>Results</h3><div>Before the intervention, alcohol use did not significantly differ between both groups. After the intervention, a significant increase in alcohol use was observed in the VR training group (median: 8.2 g vs 16.2 g; <em>P</em> = .019) but not in the video lecture group.</div></div><div><h3>Conclusions</h3><div>Our immersive 360° VR education system enhanced hand hygiene practices. Infection prevention and control practitioners and digital technology experts must collaborate to advance the development of superior educational devices and content.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 1","pages":"Pages 65-69"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to the letter to the editor regarding “The efficacy of an alcohol-based nasal antiseptic versus mupirocin or an iodophor for preventing SSIs using a meta-analysis” 回复关于“基于酒精的鼻腔杀菌剂与莫匹罗星或碘伏预防ssi的meta分析效果”的致编辑的信。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.018

Karen K. Hoffmann MS, BSN, RN , Connie Steed MSN, RN , David Kremelberg PhD, MA , Richard Wenzel MD, MSc

引用次数: 0

Information for Authors

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/S0196-6553(24)00867-8

引用次数: 0

COVID-19 vaccine uptake inequality among older adults: A multidimensional demographic analysis COVID-19 老年人疫苗接种率不平等：多维人口分析。

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control

Pub Date : 2025-01-01 DOI: 10.1016/j.ajic.2024.09.007

Seyed M. Karimi PhD , Md Yasin Ali Parh MS , Shaminul H. Shakib PhD , Hamid Zarei MS , Venetia Aranha MPH , Angela Graham MPH , Trey Allen PhD , Sirajum Munira Khan MS , Mana Moghadami MD , Demetra Antimisiaris PharmD , William Paul McKinney PhD , Bert Little PhD , YuTing Chen MPH, MS , Taylor Ingram MPH

Background

Age, race, ethnicity, and sex are important determinants of coronavirus disease of 2019 (COVID-19) outcomes. Older adults (65 years and older) are at the highest risk of COVID-19 morbidity and mortality. Analyzing their vaccine uptake by subclassifying demographics is rare and can assist vaccination policies. This study investigates COVID-19 dose 1 and 2 vaccine uptakes among them by race, ethnicity, and sex.

Methods

Immunization registry data were used to calculate temporal changes in older adults’ COVID-19 vaccine uptake by race, ethnicity, race-sex, and ethnicity-sex in Kentucky’s most populous county, Jefferson County, during the first 6 quarters of the COVID-19 vaccination program.

Results

By May 2022, the county’s Asian residents had the highest dose 1 and 2 vaccination rates (97.0% and 80.4%), then White residents (90.0% and 80.2%). Black residents had one of the lowest COVID-19 vaccination rates (87.3% and 77.3%). The rate among Hispanic residents (82.0% and 66.4%) was considerably lower than non-Hispanic residents (90.2% and 80.1%). The rates were consistently lower in males.

Conclusions

Racial, ethnic, and sex-based COVID-19 vaccine inequalities were largely maintained during the study period. Vaccine rollout practices and promotional programs should aim to boost the uptake of the COVID-19 vaccination among racial minority and male older adults.

背景：年龄、种族、民族和性别是 COVID-19 结果的重要决定因素。老年人（65 岁及以上）是 COVID-19 发病率和死亡率的高危人群。通过对人口统计学进行细分来分析他们的疫苗接种情况是非常罕见的，而且有助于制定疫苗接种政策。本研究按种族、民族和性别调查了他们对 COVID-19 第一剂和第二剂疫苗的接种情况：方法：使用免疫登记数据计算肯塔基州人口最多的县杰斐逊县在 COVID-19 疫苗接种计划的前六个季度中按种族、民族、种族-性别和民族-性别划分的老年人 COVID-19 疫苗接种率的时间变化：截至 2022 年 5 月，该县亚裔居民的第一剂和第二剂疫苗接种率最高（分别为 97.0% 和 80.4%），其次是白人居民（分别为 90.0% 和 80.2%）。黑人居民的 COVID-19 疫苗接种率最低（87.3% 和 77.3%）。西班牙裔居民的接种率（82.0% 和 66.4%）大大低于非西班牙裔居民（90.2% 和 80.1%）。男性的比例一直较低：结论：在研究期间，基于种族、民族和性别的 COVID-19 疫苗不平等现象在很大程度上得以维持。疫苗推广实践和宣传计划应旨在提高少数民族和男性老年人对 COVID-19 疫苗的接种率。

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