Association of Vaccine Type and Prior SARS-CoV-2 Infection With Symptoms and Antibody Measurements Following Vaccination Among Health Care Workers

Abstract

Discussion | In the United States in 2020, we found that the proportion of community-dwelling homebound adults aged 70 years or older substantially increased, particularly among Black non-Hispanic and Hispanic/Latino individuals. Although our study could not establish the reasons for this first major increase in the homebound population in a decade, a likely explanation is compliance with social distancing and other public health recommendations to minimize the risk of infection with SARS-CoV-2. Our study also found notable racial and ethnic differences. For example, White non-Hispanic individuals were more likely to reside alone, which may have left them without caregiving assistance. In contrast, Black non-Hispanic and Hispanic/Latino individuals were more likely to live in multiperson households, which may have increased their risk of being exposed to SARS-CoV-2. Although the reason for higher rates of being homebound among Black non-Hispanic and Hispanic/Latino populations is unknown, it may be due to greater regional incidence of SARS-CoV-2 or reduced resources to safely navigate leaving home (eg, private transportation and safe grocery shopping options). The respondents, particularly Black non-Hispanic and Hispanic/Latino individuals, infrequently used digital technologies, a finding that is consistent with results of a prior study and has implications for equity regarding expanded telemedicine use. 6 Other limitations of our study include that homebound rates may have fluctuated during the pandemic and by region, which we did not capture. The extent to which the increased prevalence of homebound older adults that we observed in 2020 will continue in 2021 as the COVID-19 pandemic abates, as well as the likely social, psychological, and physical effects, remains to be seen.