80 - Effects of location optimization of mobile health clinics on COVID vaccination among pediatric populations in the greater Boston area.

Poster Number: 80
Publication Number: 80.149

Priya Sarin Gupta, Massachusetts General Hospital / Harvard Medical School, Boston, MA, United States; Miriam Deukmejian, Massachusetts General Hospital, Charlestown, MA, United States; Amir M. Mohareb, Harvard Medical School, Boston, MA, United States; Cesar Guerra Castillo, Mass General Brigham, East Boston, MA, United States; Karla Chamorro Garcia, Massachusetts General Hospital, East Boston, MA, United States; Alexy Aruaz Boudreau, Harvard Medical School, Boston, MA, United States

Background: Barriers to COVID-19 vaccination exist among pediatric populations disproportionately burdened by health-related social needs.   By decreasing access barriers, mobile health units have shown promise to address social inequities for adult at-risk populations, but few studies have examined the use of mobile health units to improve pediatric vaccine completion.

Objective: We assessed the impact of mobile COVID-19 vaccine clinics implemented with community partnership and schools in vulnerable communities in the Greater Boston area.

Design/Methods: We implemented mobile health clinics for pediatric COVID-19 vaccination in the Greater Boston Area using a free, low barrier, walk-in model.   We serviced communities with high social vulnerability index.  We situated the clinics in one of three settings:  high-traffic community settings unrelated to schools; at schools, during school hours; or at schools after school hours.  We collected sociodemographic and vaccination data on participants aged 5-11 years old who received COVID-19 vaccination from November 1, 2021 to March 15, 2022.  We used logistic regression to assess factors associated with school-based vaccination.  We also evaluated factors associated with timely (i.e. within 6 weeks) completion of the primary, two-dose vaccine series.

Results: The mobile health unit vaccinated 1303 children during the 4.5-month study period (mean age, 7.8 years; mean vaccination rate, 62 patients / week).  Racial identities of participants were:  19.4% White, 5.5% Asian, 5.1% Black, and 69.9 % Other or Unavailable.  The majority of children ( >85%) identified as an ethnicity other than "European" or "American".   Only 17.7% of the participants had private health insurance, and 44.1% did not identify a primary care provider.  Participants vaccinated in school-based clinics were more likely to be non-white (Black or African American race, OR 7.03, 95% CI :  2.47-29.63;  Other/Unavailable race, OR 2.21, 95% CI:  1.45-3.08);  to not have a PCP (OR 1.59, 95% 1.09-2.36); and to not have private health insurance (public health insurance, OR 2.41, 95%CI:  1.64-3.52; no insurance, OR 2.45, 95%CI:  1.36-4.55).   Overall, 71.9% of children received a timely second vaccine dose (i.e. within six weeks).  Compared with community sites, children vaccinated in school-based clinics were not less likely to have timely completion of the vaccine series (OR 1.10, 95%CI: 0.76-1.57).

Conclusion(s): Mobile health clinics, particularly those co-located in schools, were effective in reaching children who identify as racial minorities and who lacked a PCP and insurance.