Overcoming health inequities: spatial analysis of seroprevalence and vaccination against COVID-19 in Chile

Abstract

Background: In unequal economies, the spread of the first waves of the COVID-19 was usually associated with low socioeconomic status of individuals and their families. Chile exemplified this. By mid-2020, Chile had one of the highest SARS-CoV-2 infection rates in the world predominantly in poorer areas. A year later, the country launched a universal vaccination campaign based on the national strategy of immunization established in 1975. By 2022, Chile presented one of the highest COVID-19 vaccination coverages globally, reaching 94.3% of the population with the primary scheme by the end of 2022. Objective: This study analyzes the spatial distribution of SARS-CoV-2 seroprevalence at the beginning of the pandemic (2020) compared with the seroprevalence after 2 years of ongoing epidemic and COVID-19 vaccination campaigns (2022). Methods: Two population-based random samples of individuals aged 7 years and older from two Chilean cities were studied. Utilizing an enzyme-linked immunosorbent assay test, IgG antibodies were measured in serum of 1061 participants in 2020, and 853 in 2022. Results: Using the Global Moran’s Index, the seroprevalence distribution pattern for the year 2020 showed clustering in the two cities. Conversely, seroprevalence and vaccinations were homogeneously distributed in 2022. These results show the success of the vaccination campaign in Chile, not only in coverage but also because it widely reached all individuals. Conclusions: The uptake of this preventive measure is high, regardless of the social and economic factors, achieving broad population immunity. The extensive deployment of the primary health care network contributed to reducing health inequities and promoting to universal health access.