Socioeconomic Differences in SARS-CoV-2 Infection and Vaccination in Germany: A Seroepidemiological Study After One Year of COVID-19 Vaccination Campaign

Overview

Journal Int J Public Health

Specialty Public Health

Date 2023 Oct 2

PMID 37780135

Authors

Susanne Bartig

Florian Beese

Benjamin Wachtler

Markus M Grabka

Elisabetta Mercuri

Lorenz Schmid

Nora Katharina Schmid-Kupke

Madlen Schranz

Laura Gossner

Wenke Niehues

Sabine Zinn

Christina Poethko-Muller

Lars Schaade

Claudia Hovener

Antje Gosswald

Jens Hoebel

Affiliations

Soon will be listed here.

Abstract

To evaluate the socioeconomic patterns of SARS-CoV-2 antigen contacts through infection, vaccination or both ("hybrid immunity") after 1 year of vaccination campaign. Data were derived from the German seroepidemiological Corona Monitoring Nationwide study (RKI-SOEP-2; = 10,448; November 2021-February 2022). Combining serological and self-report data, we estimated adjusted prevalence ratios (PR) of SARS-CoV-2 infection, COVID-19 vaccination, basic immunization (at least two SARS-CoV-2 antigen contacts through vaccination and/or infection), and three antigen contacts by education and income. Low-education groups had 1.35-times (95% CI 1.01-1.82) the risk of SARS-CoV-2 infection compared to high-education groups. COVID-19 vaccination (at least one dose) and basic immunization decreased with lower education and income. Low-education and low-income groups were less likely to have had at least three antigen contacts (PR low vs. high education: 0.74, 95% CI 0.65-0.84; PR low vs. high income: 0.66, 95% CI 0.57-0.77). The results suggest a lower level of protection against severe COVID-19 for individuals from low and medium socioeconomic groups. Pandemic response and vaccination campaigns should address the specific needs and barriers of these groups.

Citing Articles

Reconsidering inequalities in COVID-19 vaccine uptake in Germany: a spatiotemporal analysis combining individual educational level and area-level socioeconomic deprivation.

Reis M, Michalski N, Bartig S, Wulkotte E, Poethko-Muller C, Graeber D Sci Rep. 2024; 14(1):23904.

PMID: 39397164 PMC: 11471867. DOI: 10.1038/s41598-024-75273-9.

Recruiting people with selected citizenships for the health interview survey GEDA Fokus throughout Germany: evaluation of recruitment efforts and recommendations for future research.

Koschollek C, Gaertner B, Geerlings J, Kuhnert R, Mauz E, Hovener C BMC Med Res Methodol. 2024; 24(1):200.

PMID: 39266952 PMC: 11391769. DOI: 10.1186/s12874-024-02328-w.

Participatory, Virologic, and Wastewater Surveillance Data to Assess Underestimation of COVID-19 Incidence, Germany, 2020-2024.

Loenenbach A, Lehfeld A, Puetz P, Biere B, Abunijela S, Buda S Emerg Infect Dis. 2024; 30(9):1939-1943.

PMID: 39174033 PMC: 11346976. DOI: 10.3201/eid3009.240640.

Life Science 2.0: reframing the life science sector for 'the benefit on mankind'.

Vallin M, Tomson G, Kampmann B, Engebretsen E, Swartling Peterson S, Wanyenze R Glob Health Action. 2024; 17(1):2330758.

PMID: 38577884 PMC: 11000595. DOI: 10.1080/16549716.2024.2330758.

Social Inequalities in Long-Term Health Effects After COVID-19-A Scoping Review.

Lammers N, Beese F, Hoebel J, Poethko-Muller C, Wachtler B Int J Public Health. 2024; 69:1606739.

PMID: 38384747 PMC: 10878999. DOI: 10.3389/ijph.2024.1606739.

References

Pfortner T, Hower K . Educational inequalities in risk perception, perceived effectiveness, trust and preventive behaviour in the onset of the COVID-19 pandemic in Germany. Public Health. 2022; 206:83-86. PMC: 8923896. DOI: 10.1016/j.puhe.2022.02.021. View

Bobrovitz N, Ware H, Ma X, Li Z, Hosseini R, Cao C . Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: a systematic review and meta-regression. Lancet Infect Dis. 2023; 23(5):556-567. PMC: 10014083. DOI: 10.1016/S1473-3099(22)00801-5. View

Fernandez-Martinez N, Ruiz-Montero R, Gomez-Barroso D, Rodriguez-Torronteras A, Lorusso N, Salcedo-Leal I . Socioeconomic differences in COVID-19 infection, hospitalisation and mortality in urban areas in a region in the South of Europe. BMC Public Health. 2022; 22(1):2316. PMC: 9742010. DOI: 10.1186/s12889-022-14774-6. View

Hettich N, Krakau L, Ruckert K, Brahler E, Zahn D, Yilmaz S . Willingness to be Vaccinated Against SARS-CoV-2 in the German Population During the Second Wave of the Pandemic. Dtsch Arztebl Int. 2022; 118(42):720-721. PMC: 8767152. DOI: 10.3238/arztebl.m2021.0350. View

Beese F, Waldhauer J, Wollgast L, Pfortner T, Wahrendorf M, Haller S . Temporal Dynamics of Socioeconomic Inequalities in COVID-19 Outcomes Over the Course of the Pandemic-A Scoping Review. Int J Public Health. 2022; 67:1605128. PMC: 9464808. DOI: 10.3389/ijph.2022.1605128. View

Hossain M, Alam M, Islam M, Sultan S, Faysal M, Rima S . Health Belief Model, Theory of Planned Behavior, or Psychological Antecedents: What Predicts COVID-19 Vaccine Hesitancy Better Among the Bangladeshi Adults?. Front Public Health. 2021; 9:711066. PMC: 8418098. DOI: 10.3389/fpubh.2021.711066. View

Bambra C . Pandemic inequalities: emerging infectious diseases and health equity. Int J Equity Health. 2022; 21(1):6. PMC: 8759056. DOI: 10.1186/s12939-021-01611-2. View

Bayati M, Noroozi R, Ghanbari-Jahromi M, Jalali F . Inequality in the distribution of Covid-19 vaccine: a systematic review. Int J Equity Health. 2022; 21(1):122. PMC: 9425802. DOI: 10.1186/s12939-022-01729-x. View

Cucinotta D, Vanelli M . WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020; 91(1):157-160. PMC: 7569573. DOI: 10.23750/abm.v91i1.9397. View

10.

Kulper-Schiek W, Piechotta V, Pilic A, Batke M, Dreveton L, Geurts B . Facing the Omicron variant-how well do vaccines protect against mild and severe COVID-19? Third interim analysis of a living systematic review. Front Immunol. 2022; 13:940562. PMC: 9449804. DOI: 10.3389/fimmu.2022.940562. View

11.

Modenese A, Mazzoli T, Berselli N, Ferrari D, Bargellini A, Borella P . Frequency of Anti-SARS-CoV-2 Antibodies in Various Occupational Sectors in an Industrialized Area of Northern Italy from May to October 2020. Int J Environ Res Public Health. 2021; 18(15). PMC: 8345498. DOI: 10.3390/ijerph18157948. View

12.

Lin C, Tu P, Beitsch L . Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review. Vaccines (Basel). 2021; 9(1). PMC: 7823859. DOI: 10.3390/vaccines9010016. View

13.

Wachtler B, Michalski N, Nowossadeck E, Diercke M, Wahrendorf M, Santos-Hovener C . Socioeconomic inequalities in the risk of SARS-CoV-2 infection - First results from an analysis of surveillance data from Germany. J Health Monit. 2022; 5(Suppl 7):18-29. PMC: 8734178. DOI: 10.25646/7057. View

14.

Wratil P, Stern M, Priller A, Willmann A, Almanzar G, Vogel E . Three exposures to the spike protein of SARS-CoV-2 by either infection or vaccination elicit superior neutralizing immunity to all variants of concern. Nat Med. 2022; 28(3):496-503. DOI: 10.1038/s41591-022-01715-4. View

15.

Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Bohm R . Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PLoS One. 2018; 13(12):e0208601. PMC: 6285469. DOI: 10.1371/journal.pone.0208601. View

16.

Robinson E, Jones A, Lesser I, Daly M . International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. Vaccine. 2021; 39(15):2024-2034. PMC: 7867398. DOI: 10.1016/j.vaccine.2021.02.005. View

17.

Laajaj R, Webb D, Aristizabal D, Behrentz E, Bernal R, Buitrago G . Understanding how socioeconomic inequalities drive inequalities in COVID-19 infections. Sci Rep. 2022; 12(1):8269. PMC: 9117199. DOI: 10.1038/s41598-022-11706-7. View

18.

Waldhauer J, Beese F, Wachtler B, Haller S, Koschollek C, Pfortner T . Socioeconomic differences in the reduction of face-to-face contacts in the first wave of the COVID-19 pandemic in Germany. BMC Public Health. 2022; 22(1):2419. PMC: 9780616. DOI: 10.1186/s12889-022-14811-4. View

19.

Riou J, Panczak R, Althaus C, Junker C, Perisa D, Schneider K . Socioeconomic position and the COVID-19 care cascade from testing to mortality in Switzerland: a population-based analysis. Lancet Public Health. 2021; 6(9):e683-e691. PMC: 8270761. DOI: 10.1016/S2468-2667(21)00160-2. View

20.

McGowan V, Bambra C . COVID-19 mortality and deprivation: pandemic, syndemic, and endemic health inequalities. Lancet Public Health. 2022; 7(11):e966-e975. PMC: 9629845. DOI: 10.1016/S2468-2667(22)00223-7. View