Ecologic study of influenza vaccination uptake and COVID-19 death rate in New York City

BACKGROUND

The aim of this ecological study was to assess the area-level relationship between cumulative death rate for COVID-19 and historic influenza vaccination uptake in the New York City population.

METHODS

Predictors of COVID-19 death included self-reported influenza vaccination in 2017, as well as four CDC-defined risk factors of severe COVID-19 infection available at the ecological level, which were diabetes, asthma, BMI 30-100 (2 kg/m2) and hypertension, in addition to race and age (65 + years).

RESULTS

After adjusting for potential confounders, for every one-unit increase in influenza vaccination uptake for each zip code area, the rate of COVID-19 deaths decreased by 5.17 per 100,000 residents (p < 0.0001).

CONCLUSIONS

Zip codes with a higher prevalence of influenza vaccination had lower rates of COVID-19 mortality, inciting the need to further explore the relationship between influenza vaccination uptake and COVID-19 mortality at the individual level.

A Neighborhood Analysis of Time Trends in COVID-19 Infection in NYC

To understand how observed COVID-19 diagnostic testing disparities across New York City (NYC) have impacted infection rates and COVID-19 spread, we examined neighborhood-level factors associated with, and the spatial distribution of, antibody test and infection rates, and compared changes over time by NYC ZIP code tabulation area (ZCTA). Data were obtained from 2019 American Community Survey 5-year estimates to create an SES index by ZCTA. Other predictors obtained from 2018 census data were the proportions of white residents, Hispanic residents and residents ≥ 65 years old. Multivariable Poisson regressions were performed to assess the rate of change for antibody testing and positivity, and to assess the independent associations with SES, race and age. Results: There was a significant association between the rate of antibody tests and SES quartiles (Q1: β_adj = 0.04, Q2: β_adj = 0.03 and Q3: β_adj = - 0.03, compared to Q4), and the proportion of residents who are white (β_adj = 0.004, p < .0001), Hispanic   (β_adj = 0.001, p < .0001), and ≥ 65 years (β_adj = 0.01, p < .0001). Total number of positive antibody tests was significantly inversely associated with SES quartile (Q1: β_adj = 0.50, Q2: β_adj = 0.48 and Q3: β_adj = 0.29, compared to Q4), and proportion of white residents (β = - 0.001, p < .0001) and ≥ 65 years (β = - 0.02, p < .0001), and significantly positively associated with proportion of Hispanic residents (β = 0.003, p < .0001). There are disparities in antibody testing and positivity, reflecting disproportionate impacts and undercounts of COVID-19 infection across NYC ZCTAs. Future public health response should increase testing in these vulnerable areas to diminish infection spread.

Using Rapid Research Implementation and Collaborations to Assess the Mental Health Impact of the COVID-19 Pandemic Among Community and Clinical Cohorts

A research initiative was launched during the initial coronavirus disease (COVID-19) outbreak by 3 New York metropolitan area institutions. Collaborators recruited community members and patients from previous research studies to examine COVID-19 experiences and mental health symptoms through self-report surveys. The current report descriptively presents findings from the initial survey characterized by both community and clinical cohorts, and discusses challenges encountered with rapid implementation. The clinical cohort exhibited higher rates of symptoms of mental health difficulties (depression, anxiety, and posttraumatic stress disorder [PTSD]) as compared to the community cohort. COVID-19 positivity rates were similar among both groups and lower than the national average. While both groups reported low rates of job loss, community members reported higher rates of financial difficulty resulting from the pandemic. Findings indicate the need for further collaborative research on the mental health impact of COVID-19.