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

Malorie Perry, Ashley Akbari Orcid Logo, Simon Cottrell, Michael Gravenor Orcid Logo, Richard Roberts, Ronan Lyons Orcid Logo, Stuart Bedston, Fatemeh Torabi Orcid Logo, Lucy Griffiths Orcid Logo

Vaccine, Volume: 39, Issue: 42, Pages: 6256 - 6261

Swansea University Authors: Ashley Akbari Orcid Logo, Michael Gravenor Orcid Logo, Ronan Lyons Orcid Logo, Stuart Bedston, Fatemeh Torabi Orcid Logo, Lucy Griffiths Orcid Logo

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DOI (Published version): 10.1016/j.vaccine.2021.09.019

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...

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Published in: Vaccine
ISSN: 0264-410X
Published: Elsevier BV 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa57823
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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 25th 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 8th 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&#x2013;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.</abstract><type>Journal Article</type><journal>Vaccine</journal><volume>39</volume><journalNumber>42</journalNumber><paginationStart>6256</paginationStart><paginationEnd>6261</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0264-410X</issnPrint><issnElectronic/><keywords>COVID-19 Vaccines; Vaccination; Immunisation; Socioeconomic factors; Ethnic groups</keywords><publishedDay>8</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-10-08</publishedDate><doi>10.1016/j.vaccine.2021.09.019</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was supported by Health Data Research (HDR) UK [HDR-9006] which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; Administrative Data Research (ADR) UK which is funded by the Economic and Social Research Council [grant ES/S007393/1].</funders><projectreference/><lastEdited>2022-10-27T16:00:24.2289225</lastEdited><Created>2021-09-09T07:45:12.9009439</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Malorie</firstname><surname>Perry</surname><order>1</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>2</order></author><author><firstname>Simon</firstname><surname>Cottrell</surname><order>3</order></author><author><firstname>Michael</firstname><surname>Gravenor</surname><orcid>0000-0003-0710-0947</orcid><order>4</order></author><author><firstname>Richard</firstname><surname>Roberts</surname><order>5</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>6</order></author><author><firstname>Stuart</firstname><surname>Bedston</surname><order>7</order></author><author><firstname>Fatemeh</firstname><surname>Torabi</surname><orcid>0000-0002-5853-4625</orcid><order>8</order></author><author><firstname>Lucy</firstname><surname>Griffiths</surname><orcid>0000-0001-9230-624X</orcid><order>9</order></author></authors><documents><document><filename>57823__21085__524d40019af34006905bbb495a5f4a77.pdf</filename><originalFilename>57823.pdf</originalFilename><uploaded>2021-10-04T15:35:31.9832303</uploaded><type>Output</type><contentLength>509308</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9;2021 The Authors. 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spelling 2022-10-27T16:00:24.2289225 v2 57823 2021-09-09 Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 70a544476ce62ba78502ce463c2500d6 0000-0003-0710-0947 Michael Gravenor Michael Gravenor true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false c79d07eaba5c9515c0df82b372b76a41 Stuart Bedston Stuart Bedston true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false e35ea6ea4b429e812ef204b048131d93 0000-0001-9230-624X Lucy Griffiths Lucy Griffiths true false 2021-09-09 MEDS 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 25th 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 8th 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. Journal Article Vaccine 39 42 6256 6261 Elsevier BV 0264-410X COVID-19 Vaccines; Vaccination; Immunisation; Socioeconomic factors; Ethnic groups 8 10 2021 2021-10-08 10.1016/j.vaccine.2021.09.019 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University This work was supported by Health Data Research (HDR) UK [HDR-9006] which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; Administrative Data Research (ADR) UK which is funded by the Economic and Social Research Council [grant ES/S007393/1]. 2022-10-27T16:00:24.2289225 2021-09-09T07:45:12.9009439 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Malorie Perry 1 Ashley Akbari 0000-0003-0814-0801 2 Simon Cottrell 3 Michael Gravenor 0000-0003-0710-0947 4 Richard Roberts 5 Ronan Lyons 0000-0001-5225-000X 6 Stuart Bedston 7 Fatemeh Torabi 0000-0002-5853-4625 8 Lucy Griffiths 0000-0001-9230-624X 9 57823__21085__524d40019af34006905bbb495a5f4a77.pdf 57823.pdf 2021-10-04T15:35:31.9832303 Output 509308 application/pdf Version of Record true ©2021 The Authors. This is an open access article under the CC BY-NC-ND license true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
spellingShingle Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
Ashley Akbari
Michael Gravenor
Ronan Lyons
Stuart Bedston
Fatemeh Torabi
Lucy Griffiths
title_short Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
title_full Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
title_fullStr Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
title_full_unstemmed Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
title_sort Inequalities in coverage of COVID-19 vaccination: A population register based cross-sectional study in Wales, UK
author_id_str_mv aa1b025ec0243f708bb5eb0a93d6fb52
70a544476ce62ba78502ce463c2500d6
83efcf2a9dfcf8b55586999d3d152ac6
c79d07eaba5c9515c0df82b372b76a41
f569591e1bfb0e405b8091f99fec45d3
e35ea6ea4b429e812ef204b048131d93
author_id_fullname_str_mv aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
70a544476ce62ba78502ce463c2500d6_***_Michael Gravenor
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
c79d07eaba5c9515c0df82b372b76a41_***_Stuart Bedston
f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi
e35ea6ea4b429e812ef204b048131d93_***_Lucy Griffiths
author Ashley Akbari
Michael Gravenor
Ronan Lyons
Stuart Bedston
Fatemeh Torabi
Lucy Griffiths
author2 Malorie Perry
Ashley Akbari
Simon Cottrell
Michael Gravenor
Richard Roberts
Ronan Lyons
Stuart Bedston
Fatemeh Torabi
Lucy Griffiths
format Journal article
container_title Vaccine
container_volume 39
container_issue 42
container_start_page 6256
publishDate 2021
institution Swansea University
issn 0264-410X
doi_str_mv 10.1016/j.vaccine.2021.09.019
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 - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description 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 25th 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 8th 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.
published_date 2021-10-08T14:08:09Z
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