lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Sociodemographic and Health Factors Affecting Uptake of Second Dose Covid-19 Vaccine in England: Retrospective Cohort Study Using Data from the National Primary Care Sentinel Surveillance Network (Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub)

21 Pages Posted: 3 May 2022

See all articles by Ruby S. M. Tsang

Ruby S. M. Tsang

University of Oxford - Nuffield Department of Primary Care Health Sciences

Mark Joy

University of Oxford - Nuffield Department of Primary Care Health Sciences

Rachel Byford

University of Oxford - Nuffield Department of Primary Care Health Sciences

Xuejuan Fan

affiliation not provided to SSRN

Gavin Jamie

affiliation not provided to SSRN

Debasish Kar

University of Oxford - Nuffield Department of Primary Care Health Sciences

Sneha Anand

affiliation not provided to SSRN

William Victor

Royal College of General Practitioners

John Williams

University of Oxford - Nuffield Department of Primary Care Health Sciences

Stuart Bedston

Swansea University - Population Data Science

Declan Bradley

Queen’s University Belfast - Public Health Agency

Rhiannon K. Owen

Swansea University - Population Data Science

Fatemeh Torabi

Swansea University - Population Data Science

Emily Lowthian

Swansea University - Department of Education and Childhood Studies

Chris Robertson

University of Strathclyde - Department of Mathematics & Statistics; Government of the United Kingdom - Public Health Scotland

Jillian Beggs

BREATHE – The Health Data Research Hub for Respiratory Health

Gary Howsam

Royal College of General Practitioners - Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)

Aziz Sheikh

University of Edinburgh - Usher Institute

Richard Hobbs

University of Oxford - Nuffield Department of Primary Care Health Sciences

Simon de Lusignan

University of Oxford; Royal College of General Practitioners - Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC); University of Surrey - Department of Clinical & Experimental Medicine

More...

Abstract

Background: Two doses of COVID-19 vaccine offer greater protection than one dose. There are known disparities in COVID-19 outcomes and vaccine uptake. However, it is not known whether non-uptake of the second dose in people who have already received their first dose is predicted by differences in demographic characteristics and disease risk.

Methods: We conducted a retrospective cohort study using computerised medical record data from the nationally representative Oxford-Royal College of General Practitioners primary care sentinel cohort (N=7,952,861). Among adults who received at least one dose of Oxford-AstraZeneca ChAdOx1, mRNA Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccines, we used univariable and multivariable logistic regressions to estimate the odds ratios (ORs) and adjusted ORs (aORs), and their 95% confidence intervals (95% CI), of second dose uptake.

Findings: In adults vaccinated with one dose (n=2,802,314), younger age, ethnic minorities, rurality (aOR=0.93 (95% CI 0.91-0.94)), East of England and the South West, current (0.59 (0.58-0.60)) and ex-smokers (0.93 (0.91-0.94)), severe mental illness (0.58 (0.56-0.60)) among other comorbidities, COVID-19 (0.57 (0.55-0.58)) or adverse events after their first dose, were associated with lower second dose uptake. Male sex (1.02 (1.00-1.03)), increasing socioeconomic status, asthma (1.04 (1.02-1.07)), and first dose mRNA vaccine (1.28 (1.27-1.30)) were associated with higher likelihood of second dose uptake.

Interpretation: Several demographic and risk groups at higher risk of adverse COVID-19 outcomes are less likely to receive second COVID-19 vaccination. Initiatives to increase vaccine uptake targeting people in sociodemographic groups and with comorbidities where interventions might have the greatest impact are needed.

Funding Information: This study was funded by UK Research and Innovation 460 (grant ref MC_PC_20029, MC_PC_20058).

Declaration of Interests: The authors declare that they have no conflict of interests.

Ethics Approval Statement: Ethical permission was obtained from the UK’s Health Research Authority (REC reference: 21/HRA/2786). Participation in DaCVaP was approved by the RCGP Joint Research and Surveillance Centre Committee (JRSCC).

Keywords: sentinel surveillance, medical record systems, computerised, COVID-19, COVID-19 vaccines, primary care, vaccination

Suggested Citation

Tsang, Ruby S. M. and Joy, Mark and Byford, Rachel and Fan, Xuejuan and Jamie, Gavin and Kar, Debasish and Anand, Sneha and Victor, William and Williams, John and Bedston, Stuart and Bradley, Declan and Owen, Rhiannon K. and Torabi, Fatemeh and Lowthian, Emily and Robertson, Chris and Beggs, Jillian and Howsam, Gary and Sheikh, Aziz and Hobbs, F.D. Richard and de Lusignan, Simon, Sociodemographic and Health Factors Affecting Uptake of Second Dose Covid-19 Vaccine in England: Retrospective Cohort Study Using Data from the National Primary Care Sentinel Surveillance Network (Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub). Available at SSRN: https://ssrn.com/abstract=4099405 or http://dx.doi.org/10.2139/ssrn.4099405

Ruby S. M. Tsang

University of Oxford - Nuffield Department of Primary Care Health Sciences

Mansfield Road
Oxford, OX1 4AU
United Kingdom

Mark Joy

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Rachel Byford

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Xuejuan Fan

affiliation not provided to SSRN ( email )

No Address Available

Gavin Jamie

affiliation not provided to SSRN ( email )

No Address Available

Debasish Kar

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Sneha Anand

affiliation not provided to SSRN ( email )

No Address Available

William Victor

Royal College of General Practitioners ( email )

30 Euston Square
London
United Kingdom

John Williams

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Stuart Bedston

Swansea University - Population Data Science

Declan Bradley

Queen’s University Belfast - Public Health Agency ( email )

Ireland

Rhiannon K. Owen

Swansea University - Population Data Science ( email )

Fatemeh Torabi

Swansea University - Population Data Science ( email )

Emily Lowthian

Swansea University - Department of Education and Childhood Studies ( email )

Chris Robertson

University of Strathclyde - Department of Mathematics & Statistics ( email )

26 Richmond Street
Glasgow G1 1XH
United Kingdom

Government of the United Kingdom - Public Health Scotland ( email )

Jillian Beggs

BREATHE – The Health Data Research Hub for Respiratory Health ( email )

Gary Howsam

Royal College of General Practitioners - Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) ( email )

30 Euston Square
London
United Kingdom

Aziz Sheikh

University of Edinburgh - Usher Institute ( email )

F.D. Richard Hobbs

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Simon De Lusignan (Contact Author)

University of Oxford ( email )

Eagle House,
Walton Well Road,
Oxford, OX2 6ED
United Kingdom

HOME PAGE: http://https://orchid.phc.ox.ac.uk

Royal College of General Practitioners - Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) ( email )

30 Euston Square
London
United Kingdom

University of Surrey - Department of Clinical & Experimental Medicine ( email )

Guildford
United Kingdom

Click here to go to TheLancet.com

Paper statistics

Downloads
87
Abstract Views
466
PlumX Metrics