Abstract
Overview: This study contributes to the literature by examining a comprehensive operationalization of vaccination status among working-age (21-49 years), immigrant and non-immigrant adults.
Background: The commonly used outcome, obtained any vaccination versus not, tends to overestimate COVID-19 vaccination utilization, distorting the associations found with covariates/predictors. More recent studies have used a three-variable COVID-19 status outcome of any, partial or complete vaccinations. However, they lacked a theoretical framework and focused on older and non-immigrant populations. This study examined working-age immigrants and non-immigrants, used the three-variable operationalization of COVID-19 vaccination, and was guided by Andersen’s Behavioral Model with its three factors to assess covariates/predictors: predisposing (demographic characteristics/attitudes), enabling (facilitating/impeding circumstances) and need (risk factors).
Methods: A randomly selected cohort (n=119,373) was drawn from Israel's second largest health maintenance organization. Logistic regression models were used to examine five groups: the total cohort (n=119,373), native-born adults (n=105,100), and Russia/USSR-born (n=10,561), USA-born (n=658), and France-born immigrant adults (n=781). Several measures tested model fit.
Results: Obtaining any vaccinations versus not, the commonly used operationalization of COVID-19 vaccination status, exhibited the strongest model for all five groups (p< 0.0001), while the rarely tested dependent variables of partially and unvaccinated exhibited the weakest models, particularly for immigrant groups. Only the enabling factor’s covariates of socioeconomic status and/or family physician contact were consistently linked to all levels of COVID-19 vaccination for all five groups (p< 0.001). Among immigrants, the predisposing and need factor’s covariates either had low prevalence rates or were unassociated with COVID-19 vaccination levels.
Discussion: Predictors indicating utilization of COVID-19 vaccination for older, native-born adult populations may be ineffective predictors of COVID-19 vaccination levels for younger, immigrant populations. Identifying relevant predictors/covariates is essential to improve our ability to assess risk factors linked to vaccination status. With this information, healthcare providers can develop programs that aid nurses and other healthcare providers to improve the disease prevention and health promotion services.
Sigma Membership
Omega Lambda
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cohort
Research Approach
Other
Keywords:
Primary Care, Health Equity or Social Determinants of Health, Public and Community Health, COVID-19, Vaccination Status, Immigrant and Non-immigrant Adults
Recommended Citation
Zlotnick, Cheryl and Cohen Castel, Orit, "Predictors for Different Levels of COVID-19 Vaccination Among Immigrant and Non-Immigrant Adults" (2025). International Nursing Research Congress (INRC). 174.
https://www.sigmarepository.org/inrc/2025/presentations_2025/174
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Predictors for Different Levels of COVID-19 Vaccination Among Immigrant and Non-Immigrant Adults
Seattle, Washington, USA
Overview: This study contributes to the literature by examining a comprehensive operationalization of vaccination status among working-age (21-49 years), immigrant and non-immigrant adults.
Background: The commonly used outcome, obtained any vaccination versus not, tends to overestimate COVID-19 vaccination utilization, distorting the associations found with covariates/predictors. More recent studies have used a three-variable COVID-19 status outcome of any, partial or complete vaccinations. However, they lacked a theoretical framework and focused on older and non-immigrant populations. This study examined working-age immigrants and non-immigrants, used the three-variable operationalization of COVID-19 vaccination, and was guided by Andersen’s Behavioral Model with its three factors to assess covariates/predictors: predisposing (demographic characteristics/attitudes), enabling (facilitating/impeding circumstances) and need (risk factors).
Methods: A randomly selected cohort (n=119,373) was drawn from Israel's second largest health maintenance organization. Logistic regression models were used to examine five groups: the total cohort (n=119,373), native-born adults (n=105,100), and Russia/USSR-born (n=10,561), USA-born (n=658), and France-born immigrant adults (n=781). Several measures tested model fit.
Results: Obtaining any vaccinations versus not, the commonly used operationalization of COVID-19 vaccination status, exhibited the strongest model for all five groups (p< 0.0001), while the rarely tested dependent variables of partially and unvaccinated exhibited the weakest models, particularly for immigrant groups. Only the enabling factor’s covariates of socioeconomic status and/or family physician contact were consistently linked to all levels of COVID-19 vaccination for all five groups (p< 0.001). Among immigrants, the predisposing and need factor’s covariates either had low prevalence rates or were unassociated with COVID-19 vaccination levels.
Discussion: Predictors indicating utilization of COVID-19 vaccination for older, native-born adult populations may be ineffective predictors of COVID-19 vaccination levels for younger, immigrant populations. Identifying relevant predictors/covariates is essential to improve our ability to assess risk factors linked to vaccination status. With this information, healthcare providers can develop programs that aid nurses and other healthcare providers to improve the disease prevention and health promotion services.
Description
In this large, randomly selected cohort of working-age adults (n=119,373), the variables linked to obtaining any COVID-19 vaccination had the expected associations for non-immigrants but not for immigrants. Targeted studies are needed to identify the characteristics linked to vaccination status for immigrants. Without this information, healthcare providers are hindered from developing programs that facilitate access to vaccinations for immigrants.