Abstract
Background
Children living with sickle cell disease (SCD) are at a higher risk of hospitalization and mortality from COVID-19 compared to children without SCD. COVID-19 immunization reduces the risk of severe illness, but there are no population-level coverage estimates among children with SCD in the US.Objective
Our objectives were to 1) describe COVID-19 immunization coverage among children with SCD in Michigan; and 2) compare to Michigan children without SCD.Methods
Data sources included Michigan Care Improvement Registry (MCIR), Michigan Sickle Cell Data Collection(MiSCDC) program, and 2019 US Census. MCIR is a lifespan immunization registry that contains data on allCOVID-19 immunizations administered in Michigan. MiSCDC is a surveillance system which combines data sources to identify the population of people with SCD in Michigan. COVID-19 immunization doses for all individuals aged 5-17 years in MCIR were obtained as of 8/1/2022. Dates of COVID-19 vaccine series initiation (≥1 dose) and completion (≥1 dose for Johnson and Johnson, ≥2 doses for others) were determined for each individual. Individuals with SCD were identified using validated case definitions in MiSCDC. Denominators to calculate immunization coverage came from MiSCDC for people with SCD and the 2019Census for non-SCD. Proportions of each group (SCD, non-SCD) who had initiated and completed at anytime during the study period were calculated overall and by age group (5-11 years, 12-17 years) and compared using chi-square tests.Results
There were 825 children with SCD and 1,576,666 children without SCD in the study population. As of8/1/2022, COVID-19 immunization initiation coverage was 26% among those with SCD, and 36% among those without SCD (p< 0.001); COVID-19 immunization completion coverage was 23% among those with SCD and33% among those without SCD (p< 0.001). For people with and without SCD, initiation was higher among adolescents 12-17 years (SCD: 35%; non-SCD: 45%), than children 5-11 years (SCD: 19%; non-SCD: 27%); completion followed similar patterns for adolescents (SCD: 31%; non-SCD: 41%) and children (SCD: 17%; non-SCD: 25%).Conclusion
COVID-19 immunization coverage was 1.4 times lower for children with SCD compared to children without SCD, in both initiation and completion. Given that COVID-19 can lead to severe outcomes in people with SCD, it is particularly important to consider targeted interventions to increase uptake of COVID-19 immunization in this historically marginalized population.Categories: Conference Abstracts/Posters