A Biting Problem: Use of Rabies Post-Exposure Prophylaxis and Household Income in DeKalb County
Abstract
Background
According to the CDC, in 2019, the average cost of rabies post-exposure prophylaxis (PEP) in the U.S. was approximately $3,800, excluding the cost of hospital treatment. To explore the possible relationship between PEP’s high cost and completion of the vaccination regimen, we analyzed the completion rate of DeKalb County residents who were recommended to receive PEP by their ZIP code areas’ median household income.
Methods
Animal bite incident data were obtained from Georgia’s State Electronic Notifiable Disease Surveillance System. Cases eligible for inclusion were those that involved a DeKalb County resident in 2017 through 2022. PEP completion was determined using the Georgia Registry of Immunization Transactions and Services. ZIP code areas’ population and median household incomes were obtained from the 2021 U.S. Census’ American Community Survey. Of the 34 ZIP codes, four were excluded due to falling primarily outside DeKalb County. Data cleaning was completed in R Studio and Excel, and descriptive analyses were performed in Excel.
Results
Of the 572 cases recommended to receive PEP, 74.0% did not complete the regimen. In the 13 ZIP codes where the median household income was lower than the county median ($69,423), residents of eight (61.5%) ZIP codes completed PEP less frequently than county residents did on average overall. In the 17 ZIP codes with a median household income higher than the county median, residents of only six ZIP codes (35.3%) completed PEP less frequently than the county’s overall average.
Conclusion
Our analysis shows that, in DeKalb County, those residing in ZIP codes with lower household incomes completed PEP less often than those living in ZIP codes with higher household incomes. This suggests that household income may play a role in an individual’s completion of PEP. Additional research should be conducted to examine the possible impact of household income on PEP completion.
Keywords
Rabies, PEP, animal bites, household income, DeKalb County, healthcare access
A Biting Problem: Use of Rabies Post-Exposure Prophylaxis and Household Income in DeKalb County
Background
According to the CDC, in 2019, the average cost of rabies post-exposure prophylaxis (PEP) in the U.S. was approximately $3,800, excluding the cost of hospital treatment. To explore the possible relationship between PEP’s high cost and completion of the vaccination regimen, we analyzed the completion rate of DeKalb County residents who were recommended to receive PEP by their ZIP code areas’ median household income.
Methods
Animal bite incident data were obtained from Georgia’s State Electronic Notifiable Disease Surveillance System. Cases eligible for inclusion were those that involved a DeKalb County resident in 2017 through 2022. PEP completion was determined using the Georgia Registry of Immunization Transactions and Services. ZIP code areas’ population and median household incomes were obtained from the 2021 U.S. Census’ American Community Survey. Of the 34 ZIP codes, four were excluded due to falling primarily outside DeKalb County. Data cleaning was completed in R Studio and Excel, and descriptive analyses were performed in Excel.
Results
Of the 572 cases recommended to receive PEP, 74.0% did not complete the regimen. In the 13 ZIP codes where the median household income was lower than the county median ($69,423), residents of eight (61.5%) ZIP codes completed PEP less frequently than county residents did on average overall. In the 17 ZIP codes with a median household income higher than the county median, residents of only six ZIP codes (35.3%) completed PEP less frequently than the county’s overall average.
Conclusion
Our analysis shows that, in DeKalb County, those residing in ZIP codes with lower household incomes completed PEP less often than those living in ZIP codes with higher household incomes. This suggests that household income may play a role in an individual’s completion of PEP. Additional research should be conducted to examine the possible impact of household income on PEP completion.
