
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
The Effect of Mobile Vaccination Units on Vaccine Uptake with COVID-19 Vaccines: A Within-Neighbourhood Analysis Using National Registration Data
27 Pages Posted: 25 Aug 2023
More...Abstract
Background: Mobile vaccination units (MV-units) were deployed by municipal health services in neighbourhoods with low uptake of COVID-19 vaccines. This study estimates their impact on vaccine uptake in those typically more socially vulnerable neighbourhoods.
Methods: Dutch national-level register of COVID-19 vaccinations (CIMS) and MV-Unit deployment registrations were used to assess the increase of first dose COVID-19 vaccines in 253 neighbourhoods where MV-units were deployed and 890 contiguous neighbourhoods (total observations = 88,543 neighbourhood-days). A Negative Binomial regression with neighbourhood-specific temporal effects using splines was used to assess the effect of MV-units on vaccine uptake.
Findings: During deployment, the daily uptake in targeted neighbourhoods increased with a factor 2·0 (95% CI: 1·8 - 2·2) in urbanised neighbourhoods and a factor 14·5 (95% CI:11·6 - 18·0) in rural neighbourhoods. Effects were larger in neighbourhoods with more voters for right-wing Christian parties and positive but smaller in neighbourhoods with a higher proportion people with migration backgrounds. The absolute increase in uptake over the complete intervention period ranged from 0·22 percentage points (95% CI: 0·18-0·26) in the most urbanised neighbourhoods to 0·33 percentage point (95% CI: 0·28-0·37) in rural neighbourhoods.
Interpretation: Deployment of MV-units substantially increased daily vaccine uptake, particularly in rural neighbourhoods, with longer travel distance to permanent locations. This public health intervention shows substantial promise, also to reduce geographic and social health inequalities, but more proactive and long-term deployment is required to identify its potential to substantially contribute to overall vaccination rates at country level.
Funding: The research was funded by the Dutch ministry of Public Health, Welfare and Sport.
Declaration of Interest: All authors declare no conflict of interests.
Ethical Approval: All methods in this study were carried out in accordance with relevant guidelines and regulations of the Declaration of Helsinki. The Centre for Clinical Expertise at the RIVM assessed the above-mentioned research proposal and verified whether the work complies with the specific conditions as stated in article 1 of the Dutch law on Medical Research Involving Human Subjects (WMO) (https://wetten.overheid.nl/BWBR0009408/2022-07-01). They are of the opinion that the research does not fulfil one or both of the conditions and therefore conclude that approval from the ethical research committee was deemed unnecessary, as the study was based on ecological data. Data was only included for vaccinated individuals who have consented for this information to be registered in CIMS. No administrative permissions were required to access the raw data used in our study, since the data about vaccine uptake from CIMS for which consent was given are owned by RIVM and data on determinants were publicly available.
Keywords: Vaccination Uptake, Mobile Vaccination Units, Public Health, Corona Pandemic
Suggested Citation: Suggested Citation