COVID-19 vaccination rates among healthcare workers by immigrant background: A nation-wide registry study from Norway
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Abstract
Studies have suggested that some minority groups tend to have lower vaccination rates than the overall population. This study aims to examine COVID-19 vaccination rates among healthcare workers in Norway, according to immigrant background.
Methods:
We used individual-level, nation-wide registry data from Norway to identify all healthcare workers employed full time at 1 December 2020. We examined the relationship between country of birth and COVID-19 vaccination from December 2020 to August 2021, both crude and adjusted for, for example, age, sex, municipality of residence and detailed occupation codes in logistic regression models.
Results:
Among all healthcare workers in Norway, immigrants had a 9 percentage point lower vaccination rate (85%) than healthcare workers without an immigrant background (94%) at 31 August 2021. The overall vaccination rate varied by country of birth, with immigrants born in Russia (71%), Serbia (72%), Lithuania (72%), Romania (75%), Poland (76%), Eritrea (77%) and Somalia (78%) having the lowest crude vaccination rates. When we adjusted for demographics and detailed occupational codes, immigrant groups that more often worked as healthcare assistants, such as immigrants from Eritrea and Somalia, increased their vaccination rates.
Conclusions:
Substantial differences in vaccination rates among immigrant groups employed in the healthcare sector in Norway indicate that measures to improve vaccine uptake should focus on specific immigrant groups rather than all immigrants together. Lower vaccination rates in some immigrant groups appear to be largely driven by the occupational composition, suggesting that some of the differences in vaccine rates can be attributed to variation in vaccine access.
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SciScore for 10.1101/2021.09.17.21263619: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Institutional board review was conducted, and The Ethics Committee of South-East Norway confirmed (June 4th 2020, #153204) that external ethical board review was not required Study population: The study population included all HCWs in Norway with a contract of equal or more than hours per week and aged between 20 and 65 at 1st of December 2020. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not 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 LimitationReco…SciScore for 10.1101/2021.09.17.21263619: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Institutional board review was conducted, and The Ethics Committee of South-East Norway confirmed (June 4th 2020, #153204) that external ethical board review was not required Study population: The study population included all HCWs in Norway with a contract of equal or more than hours per week and aged between 20 and 65 at 1st of December 2020. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not 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:There are a few limitations that may bring some uncertainty to the study. First, some immigrant HCWs may have been vaccinated in their country of birth but not registered as such in Norway. We do not know the full extent of this, and it may be a reason for a lower rate, especially for the Eastern European countries. Additionally, there are HCW without a permanent identity number, which cannot be included since they are not registered with country of birth. It means that the sample are not capturing all immigrant HCW in Norway, and it may create some systematic differences. However, it is not likely that the magnitude of these limitations may alter the main results. Which of the factors or barriers that have contributed the most to a lower vaccine rate for some groups has not been examined in this study. If vaccine hesitancy is a barrier, we do not know how deeply ingrained it is, or how easily it can change over time with more information about the vaccines. Since the population sample of this study is HCWs, so we could assume that HCWs have better, or at least equal, willingness to take a COVID-19 vaccine than the overall population. To ensure the highest possible vaccination rates in all groups we need more knowledge about this topic - we therefore call for more research to understand barriers to vaccination, including vaccine hesitancy.
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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