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A new study by researchers at NDPCHS has shown disparities in vaccine uptake in immunocompromised individuals across ethnic and socioeconomic groups, despite evidence that vaccines are safe and effective for patients with weakened immune systems.

A woman wearing a red headscarf receives a vaccine injection from a healthcare professional wearing a face covering.

The study, published in BMC Medicine, analysed the anonymised real-world data of more than 12 million people in England, using the QResearch database. The researchers compared the effects of COVID-19 vaccination in immunocompromised individuals and the general population. This included more than 580,000 immunocompromised people who had conditions like cancer, had received organ transplants, or were taking immunosuppressive drugs. The authors analysed records from December 2020, when the UK began its vaccine programme, to April 2022, making this one of the largest studies to date evaluating COVID-19 vaccine uptake, effectiveness and safety specifically in immunocompromised groups.

The researchers found that more than 93% of immunocompromised individuals in England had received at least one COVID-19 vaccine dose by April 2022 and more than 80% received three or more doses. However, the most socioeconomically deprived patients were less likely to have received a vaccine compared to those in the more affluent groups and COVID-19 vaccine uptake for immunocompromised patients was significantly lower in Pakistani, Bangladeshi, other Asian, Black Caribbean and Black African ethnicities, compared to patients of white ethnicity.

By analysing the records of immunocompromised people, the authors found strong evidence that COVID vaccines are safe and effective for immunocompromised people.

They found:

  • Vaccination reached 91% effectiveness against severe COVID-19 outcomes in immunocompromised people 2-6 weeks after receiving a third dose, slightly higher than the protection found in the general population.
  • Vaccines were 90% and 95% effective against COVID-19 deaths and ICU admissions respectively in the immunocompromised group after the second and third doses, comparable to the effects in the general population.
  • There was no increased risk of 52 different adverse events after COVID-19 vaccination in immunocompromised individuals when compared to periods before they were vaccinated.

'Our findings underscore the safety of vaccines and the importance of ongoing COVID-19 vaccination for immunocompromised individuals to maximize protection against severe outcomes,' said lead author Dr Daniel Chen, Research Fellow at NDPCHS. 'However, it is crucial to understand and address specific barriers to vaccine uptake within different ethnic and social groups of the wider immunocompromised population. Clinically vulnerable groups face greater risks from COVID-19, so vaccination efforts must remain adaptive and responsive to protect those at highest risk.'

The study reinforces the importance of vaccination for patients at increased risk of serious outcomes from COVID-19 infection and offers reassuring evidence that COVID-19 vaccines are comparably safe and effective in immunocompromised groups compared to the general population. However, it outlines concerning disparities in vaccine uptake, highlighting the need to address barriers to vaccine uptake which could leave certain ethic and social groups of the immunocompromised population vulnerable.

Read the full paper 'Uptake, effectiveness and safety of COVID-19 vaccines in individuals at clinical risk due to immunosuppressive drug therapy or transplantation procedures: a population-based cohort study in England' in BMC Medicine


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