Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK

Abstract

The COVID-19 pandemic has highlighted existing health inequalities for ethnic minority groups and those living in more socioeconomically deprived areas in the UK. With higher levels of severe outcomes in these groups, equitable vaccination coverage should be prioritised. The aim of this study was to identify inequalities in coverage of COVID-19 vaccination in Wales, UK and to highlight areas which may benefit from routine enhanced surveillance and targeted interventions. Records within the Wales Immunisation System (WIS) population register were linked to the Welsh Demographic Service Dataset (WDSD) and central list of shielding patients, held within the Secure Anonymised Information Linkage (SAIL) Databank. Ethnic group was derived from the 2011 census and over 20 administrative electronic health record (EHR) data sources. Uptake of first dose of any COVID-19 vaccine was analysed over time, with the odds of being vaccinated as at 25 th April 2021 by sex, health board of residence, rural/urban classification, deprivation quintile and ethnic group presented. Using logistic regression models, analyses were adjusted for age group, care home resident status, health and social care worker status and shielding status. This study included 1,256,412 individuals aged 50 years and over. Vaccine coverage increased steadily from 8 th December 2020 until mid-April 2021. Overall uptake of first dose of COVID-19 vaccine in this group was 92.1%. After adjustment the odds of being vaccinated were lower for individuals who were male, resident in the most deprived areas, resident in an urban area and an ethnic group other than White. The largest inequality was seen between ethnic groups, with the odds of being vaccinated 0.22 (95%CI 0.21-0.24) if in any Black ethnic group compared to any White ethnic group. Ongoing monitoring of inequity in uptake of vaccinations is required, with better targeted interventions and engagement with deprived and ethnic communities to improve vaccination uptake.

Characteristics of the Third COVID-19 Pandemic Wave with Special Focus on Socioeconomic Inequalities in Morbidity, Mortality and the Uptake of COVID-19 Vaccination in Hungary

“…Less deprived, mainly urban areas achieved higher coverage so, by the end of the third wave, protection was strongly socially patterned. This is consistent with experience elsewhere, in the UK and the United States [ 12 , 13 , 44 , 45 ]. As expected, coverage was especially low in areas with the highest proportion of Roma population, even more so than in the other most deprived areas.…”

“…Those taking this perspective argue that relying on vaccines is less likely to exacerbate inequalities. However, inequities in the uptake of COVID-19 vaccination, which are reported from several countries, may jeopardize this goal [ 12 , 13 ].…”

Educational Inequalities in COVID-19 Vaccination: A Cross-Sectional Study of the Adult Population in the Lazio Region, Italy

“…Elliott and colleagues found a lower intent to get vaccinated in black than white and Asians, in essential workers, and the most vulnerable groups of the population [ 18 ]. A study conducted in Wales, UK, using administrative data, with a methodology similar to this study, found that in April 2021, subjects living in a more deprived area or belonging to an ethnic group other than white were less likely to be vaccinated [ 26 ].…”

Immunogenicity and reactogenicity after booster dose with AZD1222 via intradermal route among adult who had received CoronaVac

“…Median (IQR) of RBD-specific memory B cell spots at day 0 was 2 (0-10), increased to 18 (14-36) at day 28, and declined to 6 (4-20) SFU/10 6 PBMCs at day 90. Compared with IM study of 4 (0-16) at day 0, 26 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) at day 28, and 8 (4-16) SFU/10 6 PBMCs at day 90.…”

“…As current situation of COVID-19 pandemic, more vaccine supply is still needed for many countries as vaccine coverage is not enough to prevent mortality [31][32][33]. Almost half of the world population has received at least one dose of COVID-19 vaccine but only 2.2% of people in low-income countries have received vaccine [34].…”