SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: A cross-sectional study

BackgroundHealthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce. Methods and findingsWe conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26-0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62-0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction. ConclusionsEthnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening. Author summary Why was this study done? Healthcare workers, particularly those from ethnic minority groups, are at high risk of COVID-19.There are concerns that uptake of vaccination against COVID-19 in healthcare workers may vary by ethnicity as well as other demographic, occupational, and health factors, but there is limited real-world evidence on this topic.Determining factors that are associated with a lack of vaccine uptake in healthcare workers is important as it allows for targeted interventions to improve vaccine uptake, which will protect healthcare workers and the patients under their care. What did the researchers do and find? We used routinely collected data from a hospital vaccination programme to establish which staff at a large, ethnically diverse hospital trust in the UK had accepted the offer of vaccination against COVID-19.We combined these data with data on the demographic and occupational characteristics of staff members and also with data on previous test results and work absences for COVID-19.Using this dataset, we were able to determine that 65% of staff had accepted vaccination and that vaccine uptake was significantly lower in ethnic minority groups, younger age groups, females, pregnant healthcare workers, those living in more deprived areas, and those with a history of COVID-19. What do these findings mean? Our findings indicate that there are many healthcare workers who have not accepted a vaccine against COVID-19, which has important implications for the risk of infection for the individual healthcare workers and for patients under their care.We have identified particular demographic and occupational groups that should be targeted for interventions aimed at improving vaccine uptake.To make these interventions effective, more research should be undertaken to understand what the barriers are to COVID-19 vaccination in these groups and to evaluate methods of overcoming these barriers.