Changes in Social and Clinical Determinants of COVID-19 Outcomes Achieved by the Vaccination Program: A Nationwide Cohort Study

Oliver Ibarrondo, Maíra Aguiar, Nico Stollenwerk, Rubén Blasco-Aguado, Igor Larrañaga, Joseba Bidaurrazaga, Carlo Delfin S. Estadilla and Javier Mar ()
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Oliver Ibarrondo: Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, 20500 Arrasate-Mondragón, Spain
Maíra Aguiar: Basque Center for Applied Mathematics, 48009 Bilbao, Spain
Nico Stollenwerk: Basque Center for Applied Mathematics, 48009 Bilbao, Spain
Rubén Blasco-Aguado: Basque Center for Applied Mathematics, 48009 Bilbao, Spain
Igor Larrañaga: Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, 20500 Arrasate-Mondragón, Spain
Joseba Bidaurrazaga: Public Health, Basque Health Department, 48008 Bilbao, Spain
Carlo Delfin S. Estadilla: Basque Center for Applied Mathematics, 48009 Bilbao, Spain
Javier Mar: Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, 20500 Arrasate-Mondragón, Spain

IJERPH, 2022, vol. 19, issue 19, 1-12

Abstract: Background: The objective of this study was to assess changes in social and clinical determinants of COVID-19 outcomes associated with the first year of COVID-19 vaccination rollout in the Basque population. Methods: A retrospective study was performed using the complete database of the Basque Health Service (n = 2,343,858). We analyzed data on age, sex, socioeconomic status, the Charlson comorbidity index (CCI), hospitalization and intensive care unit (ICU) admission, and COVID-19 infection by Cox regression models and Kaplan–Meier curves. Results: Women had a higher hazard ratio (HR) of infection (1.1) and a much lower rate of hospitalization (0.7). With older age, the risk of infection fell, but the risks of hospitalization and ICU admission increased. The higher the CCI, the higher the risks of infection and hospitalization. The risk of infection was higher in high-income individuals in all periods (HR = 1.2–1.4) while their risk of hospitalization was lower in the post-vaccination period (HR = 0.451). Conclusion: Despite the lifting of many control measures during the second half of 2021, restoring human mobility patterns, the situation could not be defined as syndemic, clinical determinants seeming to have more influence than social ones on COVID-19 outcomes, both before and after vaccination program implementation.

Keywords: COVID-19; vaccines; infection; hospitalization; socioeconomic status; Charlson index (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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