(529) Trends of social vulnerability and COVID-19 vaccination among pregnant persons in the United States

We used the Vizient®clinical database, which included data from 192 hospitals across 38 states between Jan 2021-April 2022 and included census-level data of CDC Social Vulnerability Index (SVI). Pregnant persons were categorized into two groups: unvaccinated/incompletely vaccinated or completely vaccinated. The SVI includes 4 domains: socioeconomic status (SES), household composition/disability, minority status/language, and housing type/transportation. SVI values range from 0-1, and higher SVI indicate greater social vulnerability. SVI was divided into quartiles, with the highest quartile representing greatest vulnerability. Demographics were analyzed using standard statistical tests. Multivariable logistic regression models were used to adjust for potential confounders.

Results:

Of 399,576 pregnant persons who met inclusion criteria, 4007 were vaccinated. Mean SVI scores differed between vaccinated and unvaccinated/incompletely vaccinated persons across all SVI domains (Table 1). Vaccinated persons were more likely to be older, white, nulliparous, and have comorbidities. Persons with SVI in the highest quartile in the SES domain and composite domain were 53% and 21% less likely to be completely vaccinated, respectively (SES aOR 0.47, 95% CI 0.40-0.58, p < 0.001 and composite aOR 0.79, 95% CI 0.70-0.90, p < 0.001) compared to persons in lowest respective quartiles (Table 2). The most socially vulnerable women in the minority and language domain were twice as likely to be vaccinated compared to the least vulnerable (aOR 2.00, 95% CI 1.55-2.60, p < 0.001).

Conclusion:

The most vulnerable pregnant persons, as described using the CDC social vulnerability indices (SVIs), were least likely to be vaccinated against COVID-19.