Study shows limitations in vaccine distribution

Por The Star Staff

The Puerto Rico-Epidemiological Assessment and Prevention for COVID-19 and Influenza (PREPCOVI) of the Medical Sciences Campus of the University of Puerto Rico (UPR) on Monday revealed findings related to the prevalence and geographical distribution of COVID-19 and influenza over time.

The study addresses topics such as the social, economic and mental health impacts during the pandemic, as well as COVID-19 vaccinations.

PREPCOVI is a collaborative effort between the UPR’s Center for Clinical Research and Health Promotion (CCRHP:, the island Department of Health, Telecommunications Negotiator and telecommunications companies. The study uses novel and up-to-date technology approaches to enable large-scale ongoing surveillance, according to a statement.

“Among 4,655 participants recruited in PREPCOVI from November 2020 to March 31, 2021, we found 98 confirmed cases (RT-PCR positive) representing 2.1% of the study population and 292 total cases (confirmed/likely) (6.3%) from closing until March 31, 2021,” said Marijulie Martínez Lozano, an epidemiologist and biostatistician for PREPCOVI. “Because many potential cases may not have been evaluated or people may not know or report the type of test they were given, people were considered likely cases if they reported testing positive or having key symptoms, similar to a published study. Younger people (21-49) were more likely to have been classified as a positive case of COVID-19 compared to people over the age of 50, and there appeared to be a higher prevalence in the northeast region.”

Among the 2,884 participants evaluated from Jan. 1 to March 31, 2021 who provided vaccination information, 33% had received one or more doses (15% had received one dose and 18% had received two doses).

Despite risk-based phased distribution plans and free distribution of vaccines, there appear to be significant limitations on the equitable distribution of vaccines, the study found. People with an income of more than $60,000 per year were more than twice as likely to be vaccinated (46% vaccinated) compared to those who responded as having an income of less than $20,000 (19% vaccinated).

Among participants with a high school degree or more, 36.9% had been vaccinated compared to 18.7% who did not finish high school. The highest frequency of vaccination reported was in the Bayamón region, with 35.7% vaccinated, and the Mayagüez region with 35.1% vaccinated. The lowest percentage of vaccination was observed in the Fajardo region (23.9%).

After completing the primary survey, 1,234 (42.1%) PREPCOVI participants agreed to respond to one of three optional modules evaluating COVID-19 progression and risk/preventive factors; knowledge, attitudes and practices; and social, economic and mental health impact.

Among the 1,234 participants, 57% responded to the risk and preventive factors of COVID-19 and of these, 31.7% were vaccinated (15.9% one dose, 15.9% two doses). Most were vaccinated at a vaccination center (34.3%), or in a hospital or medical center (22.7%); 50.2% reported receiving the Pfizer vaccine and 48.4% Moderna. Of those vaccinated, 49.1% of participants reported short-term side effects, and 51.4% of respondents experienced side effects after the first dose, 29.5% after the second dose and 19.1% after both doses. Among all vaccinated, 26.8% reported pain at the injection site as the main side effect, said Kaumudi Joshipura, leading investigator and director of CCRHP.

Among the 320 participants who answered questions about knowledge, attitudes and practices on COVID-19 and influenza, 65.3% reported not being vaccinated. Of these, 71.8% are willing to be vaccinated against COVID-19, 19.9% were unsure and 6.8% were unwilling to be vaccinated against COVID-19. For those unwilling to be vaccinated, the main reason was concern about the health and safety impact of available COVID-19 vaccines. Of the unvaccinated participants, 44.9% said they qualified for the vaccine based on age, health or labor criteria. Among health workers, 78.4% of participants had received at least one dose of the COVID-19 vaccine, compared to 32.1% of other essential workers and 19% of other responders.

PREPCOVI has also been assessing the social, economic and mental health impact during the pandemic. A total of 211 participants responded to this module from January to March. Of these participants, 48.8% reported being moderately to extremely concerned about becoming infected with COVID-19 in the past 30 days.

In terms of self-informed mental health assessment over the past 30 days, 43.1% felt very to moderately anxious and 29.9% felt sad/depressed. In addition, 45.5% felt extremely to moderately nervous, and 40.3% felt exhausted.

Meanwhile, 50.5% of respondents reported that they or a family member had experienced a reduction in the ability to earn money due to the COVID-19 pandemic in the past 30 days. In addition, 17.6% reported that they or a family member lost their jobs or were fired in the past 30 days.

As part of the study, respondents were also asked about substance use in the past 30 days. Among the 211 participants, 44.1% do not drink alcohol, 98.6% have not used opioids and 92.4% have not used cannabis. However, 14.2% responded that in the past 30 days they drank alcohol several times a week or more and 4.8% said they used cannabis. Overall, 76.8% reported never havinb consumed legal/illegal substances or prescription drugs.

“The survey lasts only five minutes,” said Segundo Rodríguez Quilichini, chancellor of the UPR Medical Sciences Campus. “Participation in this study is safe and does not carry any risk, while some personal information of the participant, including his or her telephone number, is retained.”

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