1836. Disparities in COVID-19 Vaccination Coverage Among a Large Patient Population in a Network of Community-Based Healthcare Organizations

BACKGROUND: There are known disparities in U.S. COVID-19 vaccination by race, ethnicity, and rurality, but there is limited information on national trends in vaccine uptake in a large, racially diverse population spanning all ages. Here we describe COVID-19 vaccination coverage in a large US population accessing care in a national network of community-based healthcare organizations (OCHIN). METHODS: Within the OCHIN network, we identified all individuals aged 6 months and older who had at least one completed encounter in an OCHIN facility across 26 U.S. states since becoming age-eligible for the COVID-19 vaccine, through 2022. Patients’ COVID-19 vaccination status was assessed from the OCHIN Electronic Health Record which includes data from state immunization information systems. Individuals were categorized as vaccinated with the primary series if ≥2 appropriately spaced doses of either mRNA monovalent product, or a single dose of Johnson & Johnson® vaccine, were documented. Coverage was assessed by age groups based on the roll-out of COVID-19 vaccine recommendations (6 months-4 years; 5-11 years, 12-15 years, 16+ years). RESULTS: The cohort of over 3.3 million identified as Hispanics (37%), non-Hispanic (NH) Whites (31%), NH Blacks (15%), and NH Asians (7%); 44% of whom were Medicaid-enrolled, 19% without health insurance, and 53% with a household income below 100% of the federal poverty level. The proportion fully vaccinated increased incrementally with age and ranges from a low of 7.2% (6 months through 4 years) to a high of 63.4% (75 years and older); consistently lower than national coverage estimates across age groups (Figure 1). Patterns are consistent across age groups, where coverage is highest among NH Asians (range: 13%-64%) and lowest for NH Blacks (3%-40%) (Figure 2); and lowest among the people without insurance (7%-41%). Those with ≥ 1 prior influenza vaccine since 2019 had higher coverage than those without, most notably among those aged 16+ years (71% vs. 16% fully vaccinated, respectively). (Figure 3) [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: We identified disparities in primary series COVID-19 vaccine coverage by age, race and ethnicity, household income, insurance status, and by prior influenza vaccination within this large, diverse population accessing care in community-based healthcare organizations. DISCLOSURES: All Authors: No reported disclosures