Objective To examine associations between area‐level socio‐economic factors and the incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infections in Victoria during 2020. Design, setting Population‐level ecological study of the incidence of SARS‐CoV‐2 infections in Victoria, by postcode, 1 March ‒ 13 August 2020. Main outcome measures Relationships between the incidence of SARS‐CoV‐2 infections by postcode (Department of Health and Human Services data published on The Age website), and demographic, education level, ethnic background, economic and employment‐related factors, housing‐related factors, and social disadvantage (Australian Bureau of Statistics data for 2014–19), expressed as incidence rate ratios (IRRs). Results During the study period, 15 482 SARS‐CoV‐2 infections with associated postcodes were recorded in Victoria. Incidence was higher for metropolitan than regional postcodes (418.3 v 62 infections per 100 000 population; IRR, 6.2; 95% CI, 4.6–8.2). In regional postcodes, incidence rose with mean household size (per person: IRR, 7.30; 95% CI, 4.37–12.2), unemployment proportion (per percentage point: IRR, 1.50; 95% CI, 1.33–1.69), and proportions for whom rent (IRR, 1.15; 95% CI, 1.07–1.22) or mortgage repayments (IRR, 1.22; 95% CI, 1.15–1.28) exceeded 30% of household income. In metropolitan areas, incidence increased with unemployment proportion (IRR, 1.14; 95% CI, 1.05–1.23) and proportion without paid leave (IRR, 1.22; 95% CI, 1.02–1.45). Incidence also increased with proportion speaking languages other than English at home (regional: IRR, 1.08; 95% CI, 1.06–1.11; metropolitan: IRR, 1.01; 95% CI, 1.002–1.02) and with Indigenous Australian proportion (metropolitan only: IRR, 1.91; 95% CI, 1.10–2.73). Conclusions Socio‐economic factors may have contributed to the non‐homogeneous incidence of SARS‐CoV‐2 infections across Victoria during 2020.

The Victorian Specialist Immunization Services (VicSIS) was established in Victoria, Australia, in February 2021, aiming to enhance vaccine safety services for Coronavirus disease (COVID-19) vaccines. VicSIS supports practitioners and patients with complex vaccine safety questions, including those who experience adverse events following immunization (AEFI) after COVID-19 vaccines. VicSIS provides individual vaccination recommendations, allergy testing, vaccine challenges, and vaccination under supervision. VicSIS initially comprised of eight adult COVID-19 specialist vaccination clinics, subsequently, expanding to better support pediatric patients as the Australian vaccine roll-out extended to adolescents and children. Since their establishment to September 2021, the inaugural VicSIS clinics received a total of 26,401 referrals and reviewed 6,079 patients. Consults were initially predominantly for pre-vaccination reviews, later predominantly becoming post-vaccination AEFI reviews as the program progressed. Regardless of the type of consult, the most common consult outcome was a recommendation for routine vaccination (73% and 55% of consult outcomes respectively). VicSIS is an integral component of the COVID-19 vaccination program and supports confidence in COVID-19 vaccine safety by providing consistent advice across the state. VicSIS aims to strengthen the health system through the pandemic, bolstering specialist immunization services beyond COVID-19 vaccines, including training the next generation of vaccinology experts.

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