SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: A cross-sectional study

  1. Christopher A. Martin
  2. Colette Marshall
  3. Prashanth Patel
  4. Charles Goss
  5. David R. Jenkins
  6. Claire Ellwood
  7. Linda Barton
  8. Arthur Price
  9. Nigel J. Brunskill
  10. Kamlesh Khunti
  11. Manish Pareek

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Abstract

Healthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce.

Methods and findings

We conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26–0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62–0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction.

Conclusions

Ethnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening.

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  1. Version published to 10.1371/journal.pmed.1003823
  2. ScreenIT

    SciScore for 10.1101/2021.02.11.21251548: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    24 All analyses were conducted using Stata (StataCorp. 2017. Stata Statistical Software: Release 16.1 College Station, TX: StataCorp LLC).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)
    Figures were prepared in Excel (Microsoft 2021).
    Excel
    suggested: None

    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:
    This study has limitations. Although the population is large, data are from a single centre affecting their generalisability. We only have vaccination data on those who were vaccinated through UHL. HCWs who obtained vaccination through primary care will be coded as unvaccinated in our analysis, although we expect these numbers to be small given that few other vaccination centres were in operation prior to establishing vaccination hubs at UHL. We cannot predict if HCWs who are currently unvaccinated will take up vaccination in the future, however the numbers of staff taking up the vaccine over time are falling, implying that most who will accept vaccination have already done so. SARS-CoV-2 PCR testing has been available at other non-UHL centres and PCR results from HCWs accessing testing via these centres were not available within UHL records, however given the convenience and availability of PCR testing within UHL it is likely that the vast majority of staff would have accessed testing via this route. There are other factors which may influence vaccine uptake, (e.g. past medical history, educational level) on which we do not have data as we felt this was beyond the scope of an audit, and therefore cannot adjust for these in our analysis. Despite these limitations, our work has many novel findings which will be of direct relevance to policy makers involved in designing SARS-CoV-2 vaccination programmes. In summary, we have found that in a population of UK HCWs, those from ethn...

    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.

    About SciScore

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  3. Version published to 10.1101/2021.02.11.21251548v3 on medRxiv
  4. Version published to 10.1101/2021.02.11.21251548v2 on medRxiv
  5. Version published to 10.1101/2021.02.11.21251548v1 on medRxiv