Characteristics associated with COVID-19 vaccine uptake among adults in England (08 December – 17 May 2021)

Tessier, Elise; Rai, Yuma; Clarke, Eleanor; Lakhani, Anissa; Tsang, Camille; Makwana, Ashley; Heard, Heather; Rickeard, Tim; Lakhani, Shreya; Roy, Partho; Edelstein, Michael; Ramsay, Mary; White, Joanne; Andrews, Nick; Campbell, Colin; Stowe, Julia

doi:10.1101/2021.08.27.21262422

Cited by 3 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our finding that COVID-19 vaccine uptake was lower amongst almost all minority ethnic groups, and particularly low amongst people belonging to Black or Black British ethnic groups, is broadly consistent with existing reports [ 9 – 14 ]. However, previous studies have not analysed uptake inequalities for Arab individuals, so these inequalities were not previously recognised [ 9 – 14 ].…”

Section: Discussionsupporting

confidence: 92%

“…Existing evidence from England indicates early COVID-19 vaccine uptake has been lower amongst minority ethnic groups in older adults and healthcare workers [ 9 – 14 ]. However, these studies focused on specific population groups, lacked granularity in ethnic group definitions, and did not compare inequalities in uptake to those of other vaccination programmes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study

et al. 2022

View full text Add to dashboard Cite

Background COVID-19 vaccine uptake is lower amongst most minority ethnic groups compared to the White British group in England, despite higher COVID-19 mortality rates. Here, we add to existing evidence by estimating inequalities for 16 minority ethnic groups, examining ethnic inequalities within population subgroups, and comparing the magnitudes of ethnic inequalities in COVID-19 vaccine uptake to those for routine seasonal influenza vaccine uptake. Methods and findings We conducted a retrospective cohort study using the Greater Manchester Care Record, which contains de-identified electronic health record data for the population of Greater Manchester, England. We used Cox proportional hazards models to estimate ethnic inequalities in time to COVID-19 vaccination amongst people eligible for vaccination on health or age (50+ years) criteria between 1 December 2020 and 18 April 2021 (138 days of follow-up). We included vaccination with any approved COVID-19 vaccine, and analysed first-dose vaccination only. We compared inequalities between COVID-19 and influenza vaccine uptake adjusting by age group and clinical risk, and used subgroup analysis to identify populations where inequalities were widest. The majority of individuals (871,231; 79.24%) were White British. The largest minority ethnic groups were Pakistani (50,268; 4.75%), ‘other White background’ (43,195; 3.93%), ‘other ethnic group’ (34,568; 3.14%), and Black African (18,802; 1.71%). In total, 83.64% (919,636/1,099,503) of eligible individuals received a COVID-19 vaccine. Uptake was lower compared to the White British group for 15 of 16 minority ethnic groups, with particularly wide inequalities amongst the groups ‘other Black background’ (hazard ratio [HR] 0.42, 95% CI 0.40 to 0.44), Black African (HR 0.43, 95% CI 0.42 to 0.44), Arab (HR 0.43, 95% CI 0.40 to 0.48), and Black Caribbean (HR 0.43, 95% CI 0.42 to 0.45). In total, 55.71% (419,314/752,715) of eligible individuals took up influenza vaccination. Compared to the White British group, inequalities in influenza vaccine uptake were widest amongst the groups ‘White and Black Caribbean’ (HR 0.63, 95% CI 0.58 to 0.68) and ‘White and Black African’ (HR 0.67, 95% CI 0.63 to 0.72). In contrast, uptake was slightly higher than the White British group amongst the groups ‘other ethnic group’ (HR 1.11, 95% CI 1.09 to 1.12) and Bangladeshi (HR 1.08, 95% CI 1.05 to 1.11). Overall, ethnic inequalities in vaccine uptake were wider for COVID-19 than influenza vaccination for 15 of 16 minority ethnic groups. COVID-19 vaccine uptake inequalities also existed amongst individuals who previously took up influenza vaccination. Ethnic inequalities in COVID-19 vaccine uptake were concentrated amongst older and extremely clinically vulnerable adults, and the most income-deprived. A limitation of this study is the focus on uptake of the first dose of COVID-19 vaccination, rather than full COVID-19 vaccination. Conclusions Ethnic inequalities in COVID-19 vaccine uptake exceeded those for influenza vaccine uptake, existed amongst those recently vaccinated against influenza, and were widest amongst those with greatest COVID-19 risk. This suggests the COVID-19 vaccination programme has created additional and different inequalities beyond pre-existing health inequalities. We suggest that further research and policy action is needed to understand and remove barriers to vaccine uptake, and to build trust and confidence amongst minority ethnic communities.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The large number of children who were secondary cases in these clusters were likely to be siblings of the school-aged index case, raising the prospect for further transmission in other schools or year groups since the requirement for household contacts to self-isolate has been suspended [18]. Furthermore, secondary household cases were seen across all age groups including elderly people; while most adults are afforded protection from vaccination, this is not universally or uniformly the case [19].…”

Section: Discussionmentioning

confidence: 99%

“…With over 80% of adults above the age of 50 years in receipt of two vaccine doses [1], a stepwise easing of national coronavirus disease (COVID- 19) restrictions was implemented in England in the summer of 2021. The easing of restrictions included the removal of physical distancing measures, mandatory face coverings or masks from 19 July 2021 and the requirement for self-isolation of close contacts of cases who are children (below the age of 18 years 6 months) or fully vaccinated from 16 August 2021.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

Chudasama¹,

Tessier²,

Flannagan³

et al. 2021

Eurosurveillance

Self Cite

View full text Add to dashboard Cite

Easing of COVID-19 restrictions in England in the summer of 2021 was followed by a sharp rise in cases among school-aged children. Weekly rates of SARS-CoV-2 infection in primary and secondary school children reached 733.3 and 1,664.7/100,000 population, respectively, by week 39 2021. A surge in household clusters with school-aged index cases was noted at the start of the school term, with secondary cases predominantly in children aged 5–15 years and adults aged 30–49 years.

show abstract

Determinants of COVID-19 booster uptake in the Netherlands, autumn 2022: how well were those at risk for severe disease reached?

van Roekel,

Labuschagne,

Pijpers

et al. 2023

Preprint

View full text Add to dashboard Cite

BackgroundA booster with bivalent COVID-19 vaccine was offered in the Netherlands in autumn, 2022. We aimed to investigate vaccine uptake during the autumn 2022 booster round among the population subgroups at risk for severe COVID-19 that were specifically targeted by this campaign: the medical risk group aged 18-59 years and individuals ≥60 years. We calculated booster uptake in both populations and analyzed determinants of booster uptake among those who had received at least one prior COVID-19 vaccination.MethodsHaving had an autumn 2022 booster dose was defined as having received a COVID-19 vaccination between 19 September 2022 and 7 March 2023. The study population included individuals who received at least one previous COVID-19 vaccination. National registries of sociodemographic determinants and COVID-19 vaccination were linked by a unique person identifier. Voting proportions for political parties were included at neighborhood level. Determinants of COVID-19 vaccine autumn booster uptake were ranked by importance by random forest analyses.ResultsBooster uptake was 68% among those aged ≥60 and 30% among those aged 18-59 years with a medical risk factor for severe disease. For both target groups the most important determinant for booster uptake was age (15% in 18-29 years to 72% in 80+ years). Voting proportions for progressive liberal political parties ranked second in the random forest analysis in both groups, with an increasing proportion of votes associated with higher uptake. In the 60+ group, household type ranked third, with highest vaccine uptake among married couples without children (72%) and the lowest uptake among unmarried couples with children (47%). In the medical risk group, migration status ranked third. Migrants with two parents born abroad had the lowest uptake (18%), whereas migrants with both parents born in the Netherlands had the highest uptake (35%).ConclusionAmong individuals who had received at least one prior COVID-19 vaccination, the autumn 2022 COVID-19 booster uptake was 68% in people ≥60 years and 30% in in the medical risk group aged 18-59 years. The most important determinant of booster uptake was age, followed by political preference and household type (60+ group) or migration status (medical risk group). Uptake varied considerably among subgroups in both target groups. Further research should be aimed at understanding the drivers and barriers of vaccine uptake among the subgroups with notably low uptake.

show abstract

Characteristics associated with COVID-19 vaccine uptake among adults in England (08 December – 17 May 2021)

Cited by 3 publications

References 11 publications

Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study

Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study

Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

Determinants of COVID-19 booster uptake in the Netherlands, autumn 2022: how well were those at risk for severe disease reached?

Contact Info

Product

Resources

About