Federally qualified centers helped address COVID vaccine gaps: report
US Federally qualified health centers (FQHCs) have been critical to providing COVID-19 vaccinations to low-income and racial minority populations, finds a study yesterday in JAMA Network Open.
Boston University researchers led the analysis of data from national COVID-19 surveys and 1,096 FQHCs that served 25.9 million US patients from Jan 8 to Jul 2, 2021. The Health Center COVID-19 Vaccine Program gave FQHCs, which provide primary care to underserved communities, large numbers of vaccines to help address vaccine disparities.
Of the 25.9 million patients, 0.7% were American Indian or Alaska Native, 2.9% were Asian, 17.5% were Black, 42.0% were Hispanic, 34.9% were White, and 2.0% were of other races. The proportion of Black and Hispanic patients who sought vaccines at FQHCs increased over time.
COVID-19 vaccines were equitably given to American Indian, Alaska Native, Asian, and Hispanic patients (statistical equity ratio, 1.0 or higher), and 61.4% of vaccines were administered to people of color, compared with 40% of those given to racial minorities in the general US population.
Disparities among Black patients persisted (statistical equity ratio, 0.94), but they were smaller than those in the rest of the US Black population.
"These populations may not otherwise have easy access to a vaccine clinic, or may not trust other types of institutions with histories of racism or that have systematically failed them," lead author Megan Cole Brahim, PhD, MPH, said in a Boston University press release.
The authors noted that addressing COVID-19 vaccine racial disparities is vital to curbing disease transmission. To that end, they said, the government should continue to fund and prioritize the use of FQHCs as vaccine providers.
"This includes direct allocation of vaccines; use of FQHC-based mobile clinics, pop-up vaccination sites, and school-based sites; and targeted outreach for Black and Hispanic patients, including pediatric populations," the researchers concluded.
Jan 10 JAMA Netw Open research letter
Jan 10 Boston University press release
Fourth COVID vaccine dose boosts immunity in kidney transplant patients
A fourth dose of an mRNA-based COVID-19 vaccine produces a good antibody response in half of kidney transplant recipients who did not respond adequately after three doses, according to a study involving 92 transplant patients yesterday in Annals of Internal Medicine.
Researchers from the University Hospital of Strasbourg, France, gave a fourth vaccine dose to patients who had low (less than 143 binding antibody units per milliliter [BAU/mL]) anti-spike immunoglobulin G (IgG) titers 1 month after a third dose. Fifty-eight received the Moderna vaccine and 34 the Pfizer-BioNTech vaccine.
The investigators then measured anti-spike IgG titers 2 to 6 weeks later. They reported that, after a median of 29 days, median anti-spike IgG levels increased from 16.4 BAU/mL (interquartile range, 5.9 to 62.3 BAU/mL) to 145 BAU/mL (interquartile range, 27.6 to 243 BAU/mL), suggesting that a fourth dose of vaccine may be warranted in these patients.
Half the patients reached the threshold of 143 BAU/mL, and those who received Moderna had higher IgG titers (median, 150 vs 122 BAU/mL). The researchers also found no safety concerns with the additional dose.
Only one patient was subsequently diagnosed with mild COVID-19, and he had an anti-spike IgG level of only 28 BAU/mL 1 month after the fourth dose.
The study authors conclude, "We recognize that an increase in antispike IgG titers does not invariably provide protection from infection and disease, which is why we encourage longitudinal studies with a sufficient duration of follow-up."
Jan 10 Ann Intern Med study
