biostudies-literatureDalton AFChildren&apos;s MinnesotaIndiana UniversityCenters for Disease Control and PreventionWestatKPNW Center for Health ResearchIntramural CDC HHS1615-1625https://www.ebi.ac.uk/biostudies/studies/S-EPMC10949185biostudies-literatureUnknown76(9)<h4>Background</h4>Coronavirus disease 2019 (COVID-19) vaccination coverage remains lower in communities with higher social vulnerability. Factors such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure risk and access to healthcare are often correlated with social vulnerability and may therefore contribute to a relationship between vulnerability and observed vaccine effectiveness (VE). Understanding whether these factors impact VE could contribute to our understanding of real-world VE.<h4>Methods</h4>We used electronic health record data from 7 health systems to assess vaccination coverage among patients with medically attended COVID-19-like illness. We then used a test-negative design to assess VE for 2- and 3-dose messenger RNA (mRNA) adult (≥18 years) vaccine reciClinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaRelationships Between Social Vulnerability and Coronavirus Disease 2019 Vaccination Coverage and Vaccine Effectiveness.PMC10949185CC999999Lazariu VSpark TLRao SDixon BEAllen KSGriggs EPLink-Gelles REmbi PJDascomb KNaleway ALMurthy KStenehjem EIrving SAOng TCBassett EGaglani MPatel PRaiyani CSloan-Aagard CTenforde MWWeber ZABeaton MGrannis SJDickerson MArndorfer JVazquez-Benitez GLiao ICDalton AFGrisel NBarron MARowley EAKKish MNSFadel WFValvi NRAdams KHartmann EKharbanda ABNanez JBall SReese SEZerbo ODeSilva MBfalseRelationships Between Social Vulnerability and Coronavirus Disease 2019 Vaccination Coverage and Vaccine Effectiveness.<h4>Background</h4>Coronavirus disease 2019 (COVID-19) vaccination coverage remains lower in communities with higher social vulnerability. Factors such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure risk and access to healthcare are often correlated with social vulnerability and may therefore contribute to a relationship between vulnerability and observed vaccine effectiveness (VE). Understanding whether these factors impact VE could contribute to our understanding of real-world VE.<h4>Methods</h4>We used electronic health record data from 7 health systems to assess vaccination coverage among patients with medically attended COVID-19-like illness. We then used a test-negative design to assess VE for 2- and 3-dose messenger RNA (mRNA) adult (≥18 years) vaccine reci2023-01-01T00:00:00Z2023 May2026-07-16T00:19:28.566Z2026-07-09T10:26:24.071ZS-EPMC109491853661125210.1093/cid/ciad003