Characteristics associated with COVID-19 vaccine uptake among adults in England (08 December – 17 May 2021)
Authors: Tessier Elise , Rai Yuma , Clarke Eleanor , Lakhani Anissa , Tsang Camille , Makwana Ashley , Heard Heather , Rickeard Tim , Lakhani Shreya , Roy Partho , Edelstein Michael , Ramsay Mary , Lopez-Bernal Jamie , White Joanne , Andrews Nick , Campbell Colin , Stowe Julia 
Published: September 2021

Objective

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 08 December 2020 – 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 odds ratios and mean prevalence margins for individuals not vaccinated with dose 1 among those aged 50-69 years old and dose 1 and 2 among those aged 70 years old and above.

Results

Among 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, among 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 (90% CI 5.29 to 5.43) greater among Pakistani and Black/African/Caribbean compared to 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 to those who did not. This was the opposite to that observed for dose 1, where the odds of not being vaccinated 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.

Article summary

Strengths and Limitations of this study

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.

This study uses data from the National Immunisation Management System (NIMS) which is based on all individuals in England with a registered NHS number.

This centralised national system captures individual level data for both vaccination status and demographic characteristics and allows for linkage to other datasets such as health care worker and care home resident status.

This study does not include those without an NHS number and, therefore, it is possible we have underestimated the number of vaccines delivered and odds of not being vaccinated for characteristics such as ethnic groups where we have seen the greatest impact.

Residual errors in data entry on the point of care apps at the vaccination sites may have also occurred, though these errors are not likely to be widespread.