The Role of Testing and Vaccination in Mediating Social Vulnerability and COVID-19 Prevalence in Southern Nevada

Andrea Lopez, Lung-Chang Chien (), L.-W. Antony Chen, Courtney Coughenour, Erika Marquez and Szu-Ping Lee
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Andrea Lopez: Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA
Lung-Chang Chien: Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA
L.-W. Antony Chen: Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA
Courtney Coughenour: Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA
Erika Marquez: Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA
Szu-Ping Lee: Department of Physical Therapy, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89110, USA

IJERPH, 2025, vol. 22, issue 7, 1-14

Abstract: The COVID-19 pandemic is a catastrophic event highlighting numerous health disparities. The social vulnerability index (SVI) has been widely utilized in COVID-19 research to assess vulnerable communities and to examine how social determinants influence various COVID-19 outcomes. This population-based study aims to determine whether COVID-19 testing and vaccination rates mediate the relationship between the SVI and COVID-19 prevalence. Mediation analysis was conducted using data from 535 census tracts in Clark County, Nevada. Findings indicate that COVID-19 testing rates were lower in areas with high SVI scores, potentially leading to more undetected cases. Moreover, COVID-19 testing, full vaccination, and follow-up vaccination rates significantly mediated the relationship between SVI and COVID-19 prevalence. These results suggest that greater location-based social vulnerability is associated with a sequential pathway of reduced testing and vaccination rates, contributing to underreported COVID-19 cases.

Keywords: COVID-19; prevalence rate; testing rate; vaccination rate; serial mediation; social vulnerability (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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