Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis

Jones, Gethin, Perry, Malorie, Bailey, Rowena, Arumugam, Sudha, Edwards, Adrian ORCID: https://orcid.org/0000-0002-6228-4446, Lench, Alex, Cooper, Alison ORCID: https://orcid.org/0000-0001-8660-6721, Akbari, Ashley, Collins, Brendan, Harris, Caroline, Richardson, Gill, Barry, Mai, Harris, Phillippa, Fry, Richard, Lyons, Ronan A. and Cottrell, Simon 2023. Dimensions of equality in uptake of COVID-19 vaccination in Wales, UK: A multivariable linked data population analysis. Vaccine 41 (49) , pp. 7333-7341. 10.1016/j.vaccine.2023.10.066

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	0264-410X
Date of First Compliant Deposit:	4 March 2024
Date of Acceptance:	26 October 2023
Last Modified:	13 Mar 2024 12:27
URI:	https://orca.cardiff.ac.uk/id/eprint/166805

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