Self-reported COVID-19 vaccine hesitancy and uptake among participants from different racial and ethnic groups in the United States and United Kingdom
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Abstract
Worldwide, racial and ethnic minorities have been disproportionately impacted by COVID-19 with increased risk of infection, its related complications, and death. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy may result in differences in uptake. We performed a cohort study among U.S. and U.K. participants who volunteered to take part in the smartphone-based COVID Symptom Study (March 2020-February 2021) and used logistic regression to estimate odds ratios of vaccine hesitancy and uptake. In the U.S. ( n = 87,388), compared to white participants, vaccine hesitancy was greater for Black and Hispanic participants and those reporting more than one or other race. In the U.K. ( n = 1,254,294), racial and ethnic minority participants showed similar levels of vaccine hesitancy to the U.S. However, associations between participant race and ethnicity and levels of vaccine uptake were observed to be different in the U.S. and the U.K. studies. Among U.S. participants, vaccine uptake was significantly lower among Black participants, which persisted among participants that self-reported being vaccine-willing. In contrast, statistically significant racial and ethnic disparities in vaccine uptake were not observed in the U.K sample. In this study of self-reported vaccine hesitancy and uptake, lower levels of vaccine uptake in Black participants in the U.S. during the initial vaccine rollout may be attributable to both hesitancy and disparities in access.
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SciScore for 10.1101/2021.02.25.21252402: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: 17 This research study was approved by the Mass General Brigham Human Research Committee (Institutional Review Board Protocol 2020P000909) and King’s College London Ethics Committee (REMAS ID 18210). Randomization not detected. Blinding Study staff blinded to participant-provided information found excellent agreement between self-report and test reports with 88% sensitivity and 94% specificity. Power Analysis Based on the size of the assembled study population and the empirically observed vaccine hesitancy of 6%, we had 80% power to detect a minimum OR of 1.12 and 1.07, respectively, in the U.S. and the U.K. for risk of (or protection from) reporting vaccine … SciScore for 10.1101/2021.02.25.21252402: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: 17 This research study was approved by the Mass General Brigham Human Research Committee (Institutional Review Board Protocol 2020P000909) and King’s College London Ethics Committee (REMAS ID 18210). Randomization not detected. Blinding Study staff blinded to participant-provided information found excellent agreement between self-report and test reports with 88% sensitivity and 94% specificity. Power Analysis Based on the size of the assembled study population and the empirically observed vaccine hesitancy of 6%, we had 80% power to detect a minimum OR of 1.12 and 1.07, respectively, in the U.S. and the U.K. for risk of (or protection from) reporting vaccine hesitancy among non-White compared to White participants. Sex as a biological variable U.S. zip codes were further categorized into broader regions using U.S. Census Bureau criteria26–28 (American Northeast, Midwest, South, and West) and LSOAs were linked to one of four countries in the U.K. (England, Scotland, Northern Ireland, and Wales).24 Ascertainment of other covariates and exposures: We collected information on age (years), sex at birth (male, female, or other), weight (kg) and height (meters) were used to calculate body mass index (BMI, <18.5, 18.5-24.9, 25-29.9, and ≥30 kg/m2), prior history of diabetes, heart disease, lung disease, kidney disease, or active malignancy (each yes/no), smoking history (current/prior vs. never), and frontline HCW status (yes/no). Table 2: Resources
Software and Algorithms Sentences Resources LHN, ADJ, DAD, and ATC had access to raw data. ATCsuggested: NoneAll statistical analyses were performed using R 4.0.3 (Vienna, Austria) and packages from the Bioconductor 3.12 release. Bioconductorsuggested: (Bioconductor, RRID:SCR_006442)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:We acknowledge several limitations. We relied primarily on volunteered information which may be subject to measurement and reporting bias. However, our validation study (Methods) demonstrates that self-reported information from the general population was accurately and faithfully reported. While our study had comparatively lower proportions of minorities, we enrolled relatively high absolute numbers for most groups. To maximize participation, greater detail on racial/ethnic self-identity could not be obtained, and our current categorizations may oversimplify or incompletely characterize the different lived experiences of minority participants navigating the healthcare system. Despite more than 80% of U.S. adults adopting smartphones,35 we acknowledge that our data collection may have comparatively lower penetrance among certain socioeconomic/age groups, though under-recruitment of more deprived or less technologically literate participants would likely have attenuated observed differences. In fact, the use of a mobile app for data collection allowed us to highlight racial/ethnic disparities in uptake that persisted despite access to technology. Finally, our cohort of study volunteers willing to share information about COVID-19 does not represent a random sampling of the U.S. and U.K. population and are likely enriched for individuals that are generally more accepting of vaccinations. Nonetheless, the significant differences we observed in vaccine hesitancy and uptake between ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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