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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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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
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa64916
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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 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.
Keywords: Immunisation equity, COVID-19 vaccines, Vaccination, Immunisation, Socioeconomic factors, Under-served groups, Ethnic groups
College: Faculty of Medicine, Health and Life Sciences
Funders: 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).
Issue: 49
Start Page: 7333
End Page: 7341