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Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis

Gethin Jones, Malorie Perry Orcid Logo, Rowena Bailey, Sudha Arumugam, Adrian Edwards Orcid Logo, Alex Lench, Alison Cooper Orcid Logo, Ashley Akbari Orcid Logo, Brendan Collins Orcid Logo, Caroline Harris Orcid Logo, Gill Richardson Orcid Logo, Mai Barry Orcid Logo, Phillippa Harris Orcid Logo, Rich Fry Orcid Logo, Ronan Lyons Orcid Logo, Simon Cottrell

Vaccine, Volume: 41, Issue: 49, Pages: 7333 - 7341

Swansea University Authors: Rowena Bailey, Sudha Arumugam, Ashley Akbari Orcid Logo, Rich Fry Orcid Logo, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1016/j.vaccine.2023.10.066

Abstract

Vaccination has proven to be effective at preventing severe outcomes of COVID-19 infection, and uptake in the population has been high in Wales. However, there is a risk that high-level vaccination coverage statistics may mask hidden inequalities in under-served populations, many of whom may be at i...

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Published in: Vaccine
ISSN: 0264-410X
Published: Elsevier BV 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa64916
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However, there is a risk that high-level vaccination coverage statistics may mask hidden inequalities in under-served populations, many of whom may be at increased risk of severe outcomes of COVID-19 infection. The study population included 1,436,229 individuals aged 18 years and over, alive and residence in Wales as at 31st July 2022, and excluded immunosuppressed or care home residents. We compared people who had received one or more vaccinations to those with no vaccination using linked data from nine datasets within the Secure Anonymised Information Linkage (SAIL) databank. Multivariable analysis was undertaken to determine the impact of a range of sociodemographic characteristics on vaccination uptake, including ethnicity, country of birth, severe mental illness, homelessness and substance use. We found that overall uptake of first dose of COVID-19 vaccination was high in Wales (92.1 %), with the highest among those aged 80 years and over and females. Those aged under 40 years, household composition (aOR 0.38 95 %CI 0.35–0.41 for 10+ size household compared to two adult household) and being born outside the UK (aOR 0.44 95 %CI 0.43–0.46) had the strongest negative associations with vaccination uptake. This was followed by a history of substance misuse (aOR 0.45 95 %CI 0.44–0.46). Despite high-level population coverage in Wales, significant inequalities remain across several underserved groups. Factors associated with vaccination uptake should not be considered in isolation, to avoid drawing incorrect conclusions. 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spelling v2 64916 2023-11-05 Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis 455e2c1e6193448f6269b9e72acaf865 Rowena Bailey Rowena Bailey true false 6679f11a2f5dac900f1139aa791de2dd Sudha Arumugam Sudha Arumugam true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2023-11-05 HDAT Vaccination has proven to be effective at preventing severe outcomes of COVID-19 infection, and uptake in the population has been high in Wales. However, there is a risk that high-level vaccination coverage statistics may mask hidden inequalities in under-served populations, many of whom may be at increased risk of severe outcomes of COVID-19 infection. The study population included 1,436,229 individuals aged 18 years and over, alive and residence in Wales as at 31st July 2022, and excluded immunosuppressed or care home residents. We compared people who had received one or more vaccinations to those with no vaccination using linked data from nine datasets within the Secure Anonymised Information Linkage (SAIL) databank. Multivariable analysis was undertaken to determine the impact of a range of sociodemographic characteristics on vaccination uptake, including ethnicity, country of birth, severe mental illness, homelessness and substance use. We found that overall uptake of first dose of COVID-19 vaccination was high in Wales (92.1 %), with the highest among those aged 80 years and over and females. Those aged under 40 years, household composition (aOR 0.38 95 %CI 0.35–0.41 for 10+ size household compared to two adult household) and being born outside the UK (aOR 0.44 95 %CI 0.43–0.46) had the strongest negative associations with vaccination uptake. This was followed by a history of substance misuse (aOR 0.45 95 %CI 0.44–0.46). Despite high-level population coverage in Wales, significant inequalities remain across several underserved groups. Factors associated with vaccination uptake should not be considered in isolation, to avoid drawing incorrect conclusions. Ensuring equitable access to vaccination is essential to protecting under-served groups from COVID-19 and further work needs to be done to address these gaps in coverage, with focus on tailored vaccination pathways and advocacy, using trusted partners and communities. Journal Article Vaccine 41 49 7333 7341 Elsevier BV 0264-410X Immunisation equity, COVID-19 vaccines, Vaccination, Immunisation, Socioeconomic factors, Under-served groups, Ethnic groups 1 11 2023 2023-11-01 10.1016/j.vaccine.2023.10.066 http://dx.doi.org/10.1016/j.vaccine.2023.10.066 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1. This work was supported by Health Data Research UK. This work was supported by the ADR Wales programme of work. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant (ES/W012227/1). 2023-12-04T14:51:38.9945806 2023-11-05T19:49:10.2879037 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Gethin Jones 1 Malorie Perry 0000-0003-1397-5934 2 Rowena Bailey 3 Sudha Arumugam 4 Adrian Edwards 0000-0002-6228-4446 5 Alex Lench 6 Alison Cooper 0000-0001-8660-6721 7 Ashley Akbari 0000-0003-0814-0801 8 Brendan Collins 0000-0002-3023-8189 9 Caroline Harris 0000-0002-2778-3362 10 Gill Richardson 0000-0001-8554-3271 11 Mai Barry 0009-0003-6877-9823 12 Phillippa Harris 0009-0001-2641-7889 13 Rich Fry 0000-0002-7968-6679 14 Ronan Lyons 0000-0001-5225-000X 15 Simon Cottrell 16 64916__29199__c12f65d7dad7405bbbb14d4b6f1ee5f9.pdf 64916.VOR.pdf 2023-12-04T14:44:12.7093062 Output 491046 application/pdf Version of Record true Crown Copyright © 2023 Published by Elsevier Ltd. Distributed under the terms of a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
spellingShingle Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
Rowena Bailey
Sudha Arumugam
Ashley Akbari
Rich Fry
Ronan Lyons
title_short Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
title_full Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
title_fullStr Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
title_full_unstemmed Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
title_sort Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis
author_id_str_mv 455e2c1e6193448f6269b9e72acaf865
6679f11a2f5dac900f1139aa791de2dd
aa1b025ec0243f708bb5eb0a93d6fb52
d499b898d447b62c81b2c122598870e0
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv 455e2c1e6193448f6269b9e72acaf865_***_Rowena Bailey
6679f11a2f5dac900f1139aa791de2dd_***_Sudha Arumugam
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
d499b898d447b62c81b2c122598870e0_***_Rich Fry
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Rowena Bailey
Sudha Arumugam
Ashley Akbari
Rich Fry
Ronan Lyons
author2 Gethin Jones
Malorie Perry
Rowena Bailey
Sudha Arumugam
Adrian Edwards
Alex Lench
Alison Cooper
Ashley Akbari
Brendan Collins
Caroline Harris
Gill Richardson
Mai Barry
Phillippa Harris
Rich Fry
Ronan Lyons
Simon Cottrell
format Journal article
container_title Vaccine
container_volume 41
container_issue 49
container_start_page 7333
publishDate 2023
institution Swansea University
issn 0264-410X
doi_str_mv 10.1016/j.vaccine.2023.10.066
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1016/j.vaccine.2023.10.066
document_store_str 1
active_str 0
description Vaccination has proven to be effective at preventing severe outcomes of COVID-19 infection, and uptake in the population has been high in Wales. However, there is a risk that high-level vaccination coverage statistics may mask hidden inequalities in under-served populations, many of whom may be at increased risk of severe outcomes of COVID-19 infection. The study population included 1,436,229 individuals aged 18 years and over, alive and residence in Wales as at 31st July 2022, and excluded immunosuppressed or care home residents. We compared people who had received one or more vaccinations to those with no vaccination using linked data from nine datasets within the Secure Anonymised Information Linkage (SAIL) databank. Multivariable analysis was undertaken to determine the impact of a range of sociodemographic characteristics on vaccination uptake, including ethnicity, country of birth, severe mental illness, homelessness and substance use. We found that overall uptake of first dose of COVID-19 vaccination was high in Wales (92.1 %), with the highest among those aged 80 years and over and females. Those aged under 40 years, household composition (aOR 0.38 95 %CI 0.35–0.41 for 10+ size household compared to two adult household) and being born outside the UK (aOR 0.44 95 %CI 0.43–0.46) had the strongest negative associations with vaccination uptake. This was followed by a history of substance misuse (aOR 0.45 95 %CI 0.44–0.46). Despite high-level population coverage in Wales, significant inequalities remain across several underserved groups. Factors associated with vaccination uptake should not be considered in isolation, to avoid drawing incorrect conclusions. Ensuring equitable access to vaccination is essential to protecting under-served groups from COVID-19 and further work needs to be done to address these gaps in coverage, with focus on tailored vaccination pathways and advocacy, using trusted partners and communities.
published_date 2023-11-01T14:51:40Z
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