Objectives. To assess multilevel factors associated with variation in COVID-19 vaccination rates in a US network of community health centers. Methods. Using multilevel logistic regression with electronic health record data from ADVANCE (Accelerating Data Value Across a National Community Health Center Network; January 1, 2022-December 31, 2022), we assessed associations between health care delivery site-level (n = 1219) and patient-level (n = 1 864 007) characteristics and COVID-19 primary vaccine series uptake. Results. A total of 1 337 440 patients completed the COVID-19 primary vaccine series. Health care delivery site characteristics were significantly associated with lower series completion rates, including being located in non-Medicaid expansion states and isolated or rural communities and serving fewer patients. Patient characteristics associated with significantly lower likelihood of completing the vaccine series included being Black/African American or American Indian/Alaska Native (vs White), younger age, lower income, being uninsured or publicly insured (vs using private insurance), and having fewer visits. Conclusions. Both health care delivery site- and patient-level factors were significantly associated with lower COVID-19 vaccine uptake. Community health centers have been a critical resource for vaccination during the pandemic. (Am J Public Health. 2024;114(11):1242-1251. https://doi.org/10.2105/AJPH.2024.307773).

中文翻译：

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与全国社区卫生中心网络中完成 COVID-19 初级疫苗系列相关的医疗保健交付地点和患者水平因素。


目标。评估与美国社区卫生中心网络中 COVID-19 疫苗接种率变化相关的多层次因素。方法。对来自 ADVANCE 的电子健康记录数据使用多级 logistic 回归（在全国社区卫生中心网络中加速数据价值;2022 年 1 月 1 日至 2022 年 12 月 31 日），我们评估了医疗保健交付站点级别 （n = 1219） 和患者级别 （n = 1 864 007） 特征与 COVID-19 初级疫苗系列接种之间的关联。结果。共有 1 337 440 名患者完成了 COVID-19 基础疫苗系列。医疗保健交付站点特征与较低的系列完成率显著相关，包括位于非 Medicaid 扩展州和偏远或农村社区以及为较少的患者提供服务。与完成疫苗系列的可能性显著降低相关的患者特征包括黑人/非裔美国人或美洲印第安人/阿拉斯加原住民（与白人相比）、年龄较小、收入较低、没有保险或公共保险（与使用私人保险相比）以及就诊次数较少。结论。医疗保健交付地点和患者层面的因素都与较低的 COVID-19 疫苗接种率显着相关。社区卫生中心一直是大流行期间疫苗接种的重要资源。（美国公共卫生杂志，2024 年;114(11):1242-1251.https://doi.org/10.2105/AJPH.2024.307773）。