ArticleLancet regional health. Americas2023
Impact of healthcare capacity disparities on the COVID-19 vaccination coverage in the United States: A cross-sectional study.
Article in Lancet regional health. Americas, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Health system quality and COVID-19 vaccination: a cross-sectional analysis in 14 countries.The Lancet. Global health · 2024Pooled it
- Hesitancy and confidence in pediatric COVID-19 vaccination among diverse caregivers of unvaccinated children.Vaccine · 2025Trial
- Optimal timing for staged vaccination campaigns: Insights from scenario tree-based stochastic optimization.Infectious Disease Modelling · 2027Article
- Institutional drivers of newborn hepatitis B vaccine disparities: A multi-hospital analysis in Washington, DC, 2017-2023.Human vaccines & immunotherapeutics · 2026Article
- Utilizing the CFIR to Evaluate Rural COVID-19 Vaccine Uptake: Extension Personnel Perspectives.Vaccines · 2026Article
- Health, economic, and equity impact of a COVID-19 mobile vaccine clinic program in US: a cost-effectiveness analysis.Lancet regional health. Americas · 2026Article
- Associations of Social and Physical Isolation With Material Deprivation and Inadequate Use of Preventive Care in the United States.Annals of family medicine · 2026Article
- Effectiveness of mobile vaccine clinics on COVID-19 vaccination uptake in the USA: an observational study.BMJ public health · 2026Article
- Systematic review of evidence on feasibility of administering intranasal live attenuated influenza vaccine at home.NPJ vaccines · 2025Article
- Variation in COVID-19 vaccination and adverse outcomes: a state of Georgia case study.BMC public health · 2025Article
- Healthcare workers' attitudes toward influenza vaccine prescriptions in China.Global health research and policy · 2025Article
- Estimating behavioural relaxation induced by COVID-19 vaccines in the first months of their rollout.PLoS computational biology · 2025Article
- Construction of Development Scores to Analyze Inequalities in Childhood Immunization Coverage: A Global Analysis from 2000 to 2021.International journal of environmental research and public health · 2025Article
- Article
- Rural community pharmacists' willingness to receive, administer, and recommend COVID-19 vaccines after the First U.S. vaccine rollout.Exploratory research in clinical and social pharmacy · 2024Article
- Impact of Vaccination Rates, Pre-Pandemic Life Expectancy, Economic Status and Age on COVID-19 Excess Mortality Across United States.medRxiv : the preprint server for health sciences · 2024Article
- Locations of COVID-19 vaccination provision: Urban-rural differences.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- A population level study on the determinants of COVID-19 vaccination rates at the U.S. county level.Scientific reports · 2024Article
- Barriers and determinants of consistent offering of HPV vaccination by healthcare facilities.Human vaccines & immunotherapeutics · 2023Article
- Using wastewater to overcome health disparities among rural residents.Geoforum; journal of physical, human, and regional geosciences · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The impact of the COVID-19 vaccination campaign in the US has been hampered by a substantial geographical heterogeneity of the vaccination coverage. Several studies have proposed vaccination hesitancy as a key driver of the vaccination uptake disparities. However, the impact of other important structural determinants such as local disparities in healthcare capacity is virtually unknown. Methods: In this cross-sectional study, we conducted causal inference and geospatial analyses to assess the impact of healthcare capacity on the vaccination coverage disparity in the US. We evaluated the causal relationship between the healthcare system capacity of 2417 US counties and their COVID-19 vaccination rate. We also conducted geospatial analyses using spatial scan statistics to identify areas with low vaccination rates. Findings: We found a causal effect of the constraints in the healthcare capacity of a county and its low-vaccination uptake. Counties with higher constraints in their healthcare capacity were more probable to have COVID-19 vaccination rates ≤50, with 35% higher constraints in low-vaccinated areas (vaccination rates ≤ 50) compared to high-vaccinated areas (vaccination rates > 50). We also found that COVID-19 vaccination in the US exhibits a distinct spatial structure with defined "vaccination coldspots". Interpretation: We found that the healthcare capacity of a county is an important determinant of low vaccine uptake. Our study highlights that even in high-income nations, internal disparities in healthcare capacity play an important role in the health outcomes of the nation. Therefore, strengthening the funding and infrastructure of the healthcare system, particularly in rural underserved areas, should be intensified to help vulnerable communities. Funding: None.
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