Characteristics associated with COVID-19 vaccine uptake among adults aged 50 years and above in England (8 December 2020–17 May 2021): a population-level observational study

  1. Elise Tessier
  2. Yuma Rai
  3. Eleanor Clarke
  4. Anissa Lakhani
  5. Camille Tsang
  6. Ashley Makwana
  7. Heather Heard
  8. Tim Rickeard
  9. Shreya Lakhani
  10. Partho Roy
  11. Michael Edelstein
  12. Mary Ramsay
  13. Jamie Lopez-Bernal
  14. Joanne White
  15. Nick Andrews
  16. Colin N J Campbell
  17. Julia Stowe

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Abstract

To determine characteristics associated with COVID-19 vaccine coverage among individuals aged 50 years and above in England since the beginning of the programme.

Design

Observational cross-sectional study assessed by logistic regression and mean prevalence margins.

Setting

COVID-19 vaccinations delivered in England from 8 December 2020 to 17 May 2021.

Participants

30 624 257/61 967 781 (49.4%) and 17 360 045/61 967 781 (28.1%) individuals in England were recorded as vaccinated in the National Immunisation Management System with a first dose and a second dose of a COVID-19 vaccine, respectively.

Interventions

Vaccination status with COVID-19 vaccinations.

Main outcome measures

Proportion, adjusted ORs and mean prevalence margins for individuals not vaccinated with dose 1 among those aged 50–69 years and dose 1 and 2 among those aged 70 years and above.

Results

Of individuals aged 50 years and above, black/African/Caribbean ethnic group was the least likely of all ethnic groups to be vaccinated with dose 1 of the COVID-19 vaccine. However, of those aged 70 years and above, the odds of not having dose 2 was 5.53 (95% CI 5.42 to 5.63) and 5.36 (95% CI 5.29 to 5.43) greater among Pakistani and black/African/Caribbean compared with white British ethnicity, respectively. The odds of not receiving dose 2 was 1.18 (95% CI 1.16 to 1.20) higher among individuals who lived in a care home compared with those who did not. This was the opposite to that observed for dose 1, where the odds of being unvaccinated was significantly higher among those not living in a care home (0.89 (95% CI 0.87 to 0.91)).

Conclusions

We found that there are characteristics associated with low COVID-19 vaccine coverage. Inequalities, such as ethnicity are a major contributor to suboptimal coverage and tailored interventions are required to improve coverage and protect the population from SARS-CoV-2.

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  1. Version published to 10.1136/bmjopen-2021-055278
  2. ScreenIT

    SciScore for 10.1101/2021.08.27.21262422: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    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:
    Strengths and Limitations of this study: Our study has several strengths; this is the is the first study assessing characteristics associated with COVID-19 vaccine coverage for all individuals aged 50 years and above in England and one of the first studies globally assessing COVID-19 vaccine coverage. Our study also uses data from the NIMS which is based on all individuals in England with a registered NHS number which is likely to be more complete than other datasets used to estimate COVID-19 vaccine coverage. Furthermore, immunisation registers have been proven to be fundamental when assessing and protecting the population, can be used for linkage to health-outcome databases and can play a key role in the delivery of a national immunisation programme 23-25. This is the first time England has developed a centralised national system capturing individual level data for both vaccination status and demographic characteristics. Previous studies assessing factors influencing vaccine coverage in England have been based on aggregate general practice-level data where estimates such as deprivation were based on the general practice post code. Having individual level data such as for frontline healthcare workers and care home residents allowed us to link individual NHS numbers to properly account for these individuals which is not available in similar studies or in general practice records. We are unable to capture details on the total number of individuals without an NHS number and, of...

    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.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.08.27.21262422v1 on medRxiv