This study analysed the evolution of the association of socioeconomic deprivation (SED) with SARS-CoV-2 infection and COVID-19 outcomes in urban Italy during the vaccine rollout in 2021. We conducted a retrospective cohort analysis between January and November 2021, comprising of 16,044,530 individuals aged ≥ 20 years, by linking national COVID-19 surveillance system data to the Italian SED index calculated at census block level. We estimated incidence rate ratios (IRRs) of infection and severe COVID-19 outcomes by SED tercile relative to the least deprived tercile, over three periods defined as low (0–10%); intermediate (> 10–60%) and high (> 60–74%) vaccination coverage. We found patterns of increasing relative socioeconomic inequalities in infection, hospitalisation and death as COVID-19 vaccination coverage increased. Between the low and high coverage periods, IRRs for the most deprived areas increased from 1.09 (95%CI 1.03–1.15) to 1.28 (95%CI 1.21–1.37) for infection; 1.48 (95%CI 1.36–1.61) to 2.02 (95%CI 1.82–2.25) for hospitalisation and 1.57 (95%CI 1.36–1.80) to 1.89 (95%CI 1.53–2.34) for death. Deprived populations in urban Italy should be considered as vulnerable groups in future pandemic preparedness plans to respond to COVID-19 in particular during mass vaccination roll out phases with gradual lifting of social distancing measures.

本研究分析了 2021 年疫苗推出期间意大利城市社会经济剥夺 (SED) 与 SARS-CoV-2 感染和 COVID-19 结果之间关系的演变。我们在 2021 年 1 月至 11 月期间进行了回顾性队列分析，包括通过将国家 COVID-19 监测系统数据与在人口普查区块级别计算的意大利 SED 指数联系起来，统计了 16,044,530 名 20 岁以上的个体。我们根据 SED tercile 相对于最不贫困的 tercile 估算了在定义为低 (0-10%) 的三个时期内感染和严重 COVID-19 结局的发生率比 (IRR)；中等（> 10–60%）和高（> 60–74%）疫苗接种覆盖率。我们发现，随着 COVID-19 疫苗接种覆盖率的增加，感染、住院和死亡方面的相对社会经济不平等现象日益加剧。在低覆盖率和高覆盖率期间，最贫困地区的感染 IRR 从 1.09 (95% CI 1.03–1.15) 上升至 1.28 (95% CI 1.21–1.37)；住院治疗为 1.48 (95% CI 1.36–1.61) 至 2.02 (95% CI 1.82–2.25)，死亡为 1.57 (95% CI 1.36–1.80) 至 1.89 (95% CI 1.53–2.34)。在未来应对 COVID-19 的大流行防备计划中，意大利城市的贫困人口应被视为弱势群体，特别是在大规模疫苗接种阶段以及逐步取消社交距离措施期间。