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The Role of Testing and Vaccination in Mediating Social Vulnerability and COVID-19 Prevalence in Southern Nevada

Author

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  • Andrea Lopez

    (Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA)

  • Lung-Chang Chien

    (Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA)

  • L.-W. Antony Chen

    (Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA)

  • Courtney Coughenour

    (Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA)

  • Erika Marquez

    (Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89110, USA)

  • Szu-Ping Lee

    (Department of Physical Therapy, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89110, USA)

Abstract

The COVID-19 pandemic is a catastrophic event highlighting numerous health disparities. The social vulnerability index (SVI) has been widely utilized in COVID-19 research to assess vulnerable communities and to examine how social determinants influence various COVID-19 outcomes. This population-based study aims to determine whether COVID-19 testing and vaccination rates mediate the relationship between the SVI and COVID-19 prevalence. Mediation analysis was conducted using data from 535 census tracts in Clark County, Nevada. Findings indicate that COVID-19 testing rates were lower in areas with high SVI scores, potentially leading to more undetected cases. Moreover, COVID-19 testing, full vaccination, and follow-up vaccination rates significantly mediated the relationship between SVI and COVID-19 prevalence. These results suggest that greater location-based social vulnerability is associated with a sequential pathway of reduced testing and vaccination rates, contributing to underreported COVID-19 cases.

Suggested Citation

  • Andrea Lopez & Lung-Chang Chien & L.-W. Antony Chen & Courtney Coughenour & Erika Marquez & Szu-Ping Lee, 2025. "The Role of Testing and Vaccination in Mediating Social Vulnerability and COVID-19 Prevalence in Southern Nevada," IJERPH, MDPI, vol. 22(7), pages 1-14, June.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:980-:d:1684325
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    References listed on IDEAS

    as
    1. Zengwang Xu & Bin Jiang, 2022. "Effects of Social Vulnerability and Spatial Accessibility on COVID-19 Vaccination Coverage: A Census-Tract Level Study in Milwaukee County, USA," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    2. Mullachery, Pricila H. & Li, Ran & Melly, Steven & Kolker, Jennifer & Barber, Sharrelle & Diez Roux, Ana V. & Bilal, Usama, 2022. "Inequities in spatial accessibility to COVID-19 testing in 30 large US cities," Social Science & Medicine, Elsevier, vol. 310(C).
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