Characteristics associated with COVID-19 vaccine uptake among adults aged 50 years and above in England (8 December 2020–17 May 2021): a population-level observational study

Abstract

ObjectiveTo determine characteristics associated with COVID-19 vaccine coverage among individuals aged 50 years and above in England since the beginning of the programme.DesignObservational cross-sectional study assessed by logistic regression and mean prevalence margins.SettingCOVID-19 vaccinations delivered in England from 8 December 2020 to 17 May 2021.Participants30 624 257/61 967 781 (49.4%) and 17 360 045/61 967 781 (28.1%) individuals in England were recorded as vaccinated in the National Immunisation Management System with a first dose and a second dose of a COVID-19 vaccine, respectively.InterventionsVaccination status with COVID-19 vaccinations.Main outcome measuresProportion, adjusted ORs and mean prevalence margins for individuals not vaccinated with dose 1 among those aged 50–69 years and dose 1 and 2 among those aged 70 years and above.ResultsOf individuals aged 50 years and above, black/African/Caribbean ethnic group was the least likely of all ethnic groups to be vaccinated with dose 1 of the COVID-19 vaccine. However, of those aged 70 years and above, the odds of not having dose 2 was 5.53 (95% CI 5.42 to 5.63) and 5.36 (95% CI 5.29 to 5.43) greater among Pakistani and black/African/Caribbean compared with white British ethnicity, respectively. The odds of not receiving dose 2 was 1.18 (95% CI 1.16 to 1.20) higher among individuals who lived in a care home compared with those who did not. This was the opposite to that observed for dose 1, where the odds of being unvaccinated was significantly higher among those not living in a care home (0.89 (95% CI 0.87 to 0.91)).ConclusionsWe found that there are characteristics associated with low COVID-19 vaccine coverage. Inequalities, such as ethnicity are a major contributor to suboptimal coverage and tailored interventions are required to improve coverage and protect the population from SARS-CoV-2.

Attitudes towards coronavirus (COVID-19) vaccine and sources of information across diverse ethnic groups in the UK: a qualitative study from June to October 2020

“…We found that views towards COVID-19 vaccination were generally similar across ethnic groups between June and October 2020, while larger UK quantitative studies conducted within the first year after vaccine rollout demonstrated lower uptake in certain ethnic minority groups, and there were sometimes further inequalities by age, gender, religion, area deprivation, disability status, English language proficiency, socioeconomic position and educational attainment 21–24. Surveillance data demonstrate that COVID-19 vaccination rates in the UK and Israel were lowest among certain ethnic minority groups 25 26.…”

“…Attitudes, intentions and uptake We found that views towards COVID-19 vaccination were generally similar across ethnic groups between June and October 2020, while larger UK quantitative studies conducted within the first year after vaccine rollout demonstrated lower uptake in certain ethnic minority groups, and there were sometimes further inequalities by age, gender, religion, area deprivation, disability status, English language proficiency, socioeconomic position and educational attainment. [21][22][23][24] Surveillance data demonstrate that COVID-19 vaccination rates in the UK and Israel were lowest among certain ethnic minority groups. 25 26 For UK healthcare workers between December 2020 and February 2021, studies found that some ethnic minority groups were more likely to be COVID-19 vaccine hesitant in comparison with white British groups, 12 and that COVID-19 vaccine uptake was lower among some ethnic minority groups compared with white people.…”

Effect of COVID-19 vaccination on mortality by COVID-19 and on mortality by other causes, the Netherlands, January 2021- January 2022

“…People with a fragile health might be more inclined to get vaccinated, and also have a higher risk of death from other causes than COVID-19 (Malesza, M., & Bozym, M., 2021). However, frail health can be associated with lower socio-economic status, which is also associated with poor access to health care and lower vaccine uptake (Perry, M., 2021;Tessier et al, 2022).…”

Compliant citizens, defiant rebels or neither? Exploring changing COVID-19 vaccine attitudes and decisions in Bradford, UK: Findings from a follow-up qualitative study

“…Vaccine uptake was found to be lowest in some of the communities for whom COVID-19 has the biggest risk, including the Pakistani, Black Caribbean, Black African and Bangladeshi communities, undocumented migrants, and studies have found a strong negative association between socioeconomic deprivation and the rate of declining COVID-19 vaccinations. 11-15 Conversely, higher vaccine acceptance was associated with being White British, older and more educated. 14 Since the COVID-19 vaccines were first rolled out there have been serious concerns about widening health inequalities as a result of uneven uptake and there is emerging evidence to suggest that is the case.…”