@article{TEXTUAL,
      recid = {11209},
      author = {Zeng, Sharon and Pelzer, Kenley M. and Gibbons, Robert D.  and Peek, Monica E. and Parker, William F.},
      title = {Association of Zip Code Vaccination Rate with COVID-19  Mortality in Chicago, Illinois},
      journal = {JAMA Network Open},
      address = {2022-05-27},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Importance: There has been large geographic inequity in  vaccination coverage across Chicago, Illinois, with higher  vaccination rates in zip codes with residents who  predominantly have high incomes and are White. Objective:  To determine the association between inequitable zip  code-level vaccination coverage and COVID-19 mortality in  Chicago.&lt;/p&gt;&lt;p&gt;Design, Setting, and Participants: This  retrospective cohort study used Chicago Department of  Public Health vaccination and mortality data and Cook  County Medical Examiner mortality data from March 1, 2020,  through November 6, 2021, to assess the association of  COVID-19 mortality with zip code-level vaccination rates.  Data were analyzed from June 1, 2021, to April 13, 2022.  Exposures: Zip code-level first-dose vaccination rates  before the Alpha and Delta waves of COVID-19.&lt;/p&gt;&lt;p&gt;Main  Outcomes and Measures: The primary outcome was deaths from  COVID-19 during the Alpha and Delta waves. The association  of a marginal increase in zip code-level vaccination rate  with weekly mortality rates was estimated with a  mixed-effects Poisson regression model, and the total  number of preventable deaths in the least vaccinated  quartile of zip codes was estimated with a linear  difference-in-difference design.&lt;/p&gt;&lt;p&gt;Results: The study  population was 2686355 Chicago residents in 52 zip codes  (median [IQR] age 34 [32-38] years; 1378658 [51%] women;  773938 Hispanic residents [29%]; 783916 non-Hispanic Black  residents [29%]; 894555 non-Hispanic White residents  [33%]). Among residents in the least vaccinated quartile,  80% were non-Hispanic Black, compared with 8% of residents  identifying as non-Hispanic Black in the most vaccinated  quartile (P &lt;.001). After controlling for age distribution  and recovery from COVID-19, a 10-percentage point increase  in zip code-level vaccination 6 weeks before the peak of  the Alpha wave was associated with a 39% lower relative  risk of death from COVID-19 (incidence rate ratio [IRR],  0.61 [95% CI, 0.52-0.72]). A 10-percentage point increase  in zip code vaccination rate 6 weeks before the peak of the  Delta wave was associated with a 24% lower relative risk of  death (IRR, 0.76 [95% CI, 0.66-0.87]). The  difference-in-difference estimate was that 119 Alpha wave  deaths (72% [95% CI, 63%-81%]) and 108 Delta wave deaths  (75% [95% CI, 66%-84%]) might have been prevented in the  least vaccinated quartile of zip codes if it had had the  vaccination coverage of the most vaccinated  quartile.&lt;/p&gt;&lt;p&gt;Conclusions and Relevance: These findings  suggest that low zip code-level vaccination rates in  Chicago were associated with more deaths during the Alpha  and Delta waves of COVID-19 and that inequitable  vaccination coverage exacerbated existing racial and ethnic  disparities in COVID-19 deaths.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/11209},
}