Table 1.
Descriptive Attributes of the Study Cohort
| Characteristic | No. (%) of Individuals | |
|---|---|---|
| PCV13 Received per ACIP Guidelinesa | PCV13 Not Received | |
| (n = 451 068) | (n = 80 600) | |
| Age on 1 March 2020 | ||
| 65–69 y | 96 812 (21.5) | 42 898 (53.2) |
| 70–74 y | 136 556 (30.3) | 18 982 (23.6) |
| 75–79 y | 94 209 (20.9) | 9482 (11.8) |
| 80–84 y | 63 650 (14.1) | 5031 (6.2) |
| 85–89 y | 38 473 (8.5) | 2569 (3.2) |
| ≥90 y | 21 368 (4.7) | 1638 (2.0) |
| Sex | ||
| Female | 250 005 (55.4) | 44 662 (55.4) |
| Male | 201 063 (44.6) | 35 938 (44.6) |
| Race/ethnicity | ||
| White, non-Hispanic | 222 100 (49.2) | 37 664 (46.7) |
| Black, non-Hispanic | 39 483 (8.8) | 10 415 (12.9) |
| Asian or Pacific Islander, non-Hispanic | 56 331 (12.5) | 6585 (8.2) |
| Hispanic (any race) | 122 540 (27.2) | 17 664 (21.9) |
| Other, mixed, or unknown race | 10 614 (2.4) | 8272 (10.3) |
| Tobacco smoking | ||
| Current smoker | 14 080 (3.1) | 2982 (3.7) |
| Former smoker | 156 177 (34.6) | 16 196 (20.1) |
| Never smoker | 261 103 (57.9) | 38 383 (47.6) |
| Unknown | 19 708 (4.4) | 23 039 (28.6) |
| Body mass index, kg/m2 | ||
| <18.5 (underweight) | 8253 (1.8) | 1112 (1.4) |
| 18.5–24.9 (normal weight) | 129 518 (28.7) | 16 711 (20.7) |
| 25.0–29.9 (overweight) | 162 049 (35.9) | 20 200 (25.1) |
| 30.0–39.9 (obese) | 114 448 (25.4) | 14 532 (18.0) |
| ≥40.0 (morbidly obese) | 13 786 (3.1) | 1954 (2.4) |
| Unknown | 23 014 (5.1) | 26 091 (32.4) |
| Comorbid conditions | ||
| Myocardial infarction | 22 589 (5.0) | 1664 (2.1) |
| Congestive heart failure | 35 647 (7.9) | 1977 (2.5) |
| Peripheral vascular disease | 181 756 (40.3) | 11 123 (13.8) |
| Cerebrovascular disease | 31 028 (6.9) | 2240 (2.8) |
| Hypertension | 291 730 (64.7) | 28 304 (35.1) |
| Hyperlipidemia | 317 967 (70.5) | 30 758 (38.2) |
| Diabetes | 127 981 (28.4) | 9761 (12.1) |
| COPD | 80 680 (17.9) | 5487 (6.8) |
| Renal disease | 91 274 (20.2) | 5543 (6.9) |
| Moderate or severe liver disease | 1682 (0.4) | 94 (0.1) |
| Malignancy | 26 844 (6.0) | 2398 (3.0) |
| Metastatic solid tumor | 8184 (1.8) | 803 (1.0) |
| Asthma | 45 130 (10.0) | 3249 (4.0) |
| Obstructive sleep apnea | 31 469 (7.0) | 2270 (2.8) |
| HIV/AIDS | 174 (<0.1) | 7 (<0.1) |
| Organ transplant | 556 (0.1) | 33 (<0.1) |
| Other immunocompromising condition | 22 059 (4.9) | 1894 (2.3) |
| Hypothyroidism | 66 156 (14.7) | 6238 (7.7) |
| Rheumatologic/inflammatory condition | 11 579 (2.6) | 964 (1.2) |
| Depression | 66 030 (14.6) | 4844 (6.0) |
| Zoster vaccinationb | ||
| Any zoster vaccine dose received | 224 317 (49.7) | 9625 (11.9) |
| Influenza vaccination | ||
| Vaccinated in 2019–2020 season | 390 322 (86.5) | 20 617 (25.6) |
| PPSV23 vaccination | ||
| PPSV23 ever received | 404 730 (89.7) | 13 743 (17.1) |
| Prior year outpatient visits | ||
| 0–9 | 98 005 (21.7) | 43 533 (54.0) |
| 10–19 | 137 344 (30.4) | 19 172 (23.8) |
| 20–29 | 89 508 (19.8) | 8839 (11.0) |
| 30–39 | 51 813 (11.5) | 4241 (5.3) |
| ≥40 | 74 398 (16.5) | 4815 (6.0) |
| Prior year inpatient visits | ||
| 0 | 411 875 (91.3) | 77 679 (96.4) |
| 1 | 30 152 (6.7) | 2391 (3.0) |
| 2 | 6186 (1.4) | 361 (0.4) |
| ≥3 | 2855 (0.6) | 169 (0.2) |
| Prior year emergency department visits | ||
| 0 | 339 108 (75.2) | 69 482 (86.2) |
| 1 | 70 527 (15.6) | 7954 (9.9) |
| 2 | 22 915 (5.1) | 1945 (2.4) |
| ≥3 | 18 518 (4.1) | 1219 (1.5) |
| Census tract median household income | ||
| $0–$29 999 | 5460 (1.2) | 1173 (1.5) |
| $30 000–$49 999 | 67 197 (14.9) | 12 848 (15.9) |
| $50 000–$69 999 | 100 439 (22.3) | 18 458 (22.9) |
| $70 000–$89 999 | 105 416 (23.4) | 18 570 (23.0) |
| $90 000–$109 999 | 77 593 (17.2) | 13 705 (17.0) |
| $110 000–$129 999 | 52 644 (11.7) | 8538 (10.6) |
| ≥$130 000 | 41 645 (9.2) | 6965 (8.6) |
| Unknown | 674 (0.1) | 343 (0.4) |
| Receipt of antibiotics | ||
| At any point during study period | 2064 (0.5) | 232 (0.3) |
| ≥1 d before COVID-19, if ever diagnosed | 1406 (0.3) | 169 (0.2) |
Values show the number of individuals with each risk factor who belonged at any point during follow-up to the exposure groups. We indicate incidence of COVID-19 outcomes associated with each attribute in Supplementary Table 1. We present reweighted estimates in Figure 1 and Supplementary Table 2.
Abbreviations: ACIP, Advisory Committee on Immunization Practices; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; HIV, human immunodeficiency virus; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccine.
aReceipt of PCV13 ≥1 year before PPSV23 for immunocompetent individuals, or ≥8 weeks before PPSV23 for immunocompromised individuals; or, for individuals who had previously received PPSV23, receipt of PCV13 ≥1 year after the most recent PPSV23 dose.
bReceipt of ≥1 dose of live or recombinant zoster vaccine.