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)
Tsang R., Joy M., Byford R., Fan X., Jamie G., Kar D., Anand S., Victor W., Williams J., Bedston S., Bradley D., Owen R., Torabi F., Lowthian E., Robertson C., Beggs J., Howsam G., Sheikh A., Hobbs R., Lusignan SD.
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).