Morrison, K. et al. (2023) Predictors of incomplete COVID-19 vaccine schedule among adults in Scotland: two retrospective cohort analyses of the primary schedule and third dose. Vaccine, 41(40), pp. 5863-5876. (doi: 10.1016/j.vaccine.2023.07.070) (PMID:37598025)
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Abstract
Background: Vaccination continues to be the key public health measure for preventing severe COVID-19 outcomes. Certain groups may be at higher risk of incomplete vaccine schedule, which may leave them vulnerable to COVID-19 hospitalisation and death. Aim: To identify the sociodemographic and clinical predictors for not receiving a scheduled COVID-19 vaccine after previously receiving one. Methods: We conducted two retrospective cohort studies with ≥3.7 million adults aged ≥18 years in Scotland. Multivariable logistic regression was used to estimate adjusted odds ratios (aOR) of not receiving a second, and separately a third dose between December 2020 and May 2022. Independent variables included sociodemographic and clinical factors. Results: Of 3,826,797 people in the study population who received one dose, 3,732,596 (97.5%) received two doses, and 3,263,153 (86.5%) received all doses available during the study period. The most strongly associated predictors for not receiving the second dose were: being aged 18–29 (reference: 50–59 years; aOR:4.26; 95% confidence interval (CI):4.14–4.37); hospitalisation due to a potential vaccine related adverse event of special interest (AESI) (reference: not having a potential AESI, aOR:3.78; 95%CI: 3.29–4.35); and living in the most deprived quintile (reference: least deprived quintile, aOR:3.24; 95%CI: 3.16–3.32). The most strongly associated predictors for not receiving the third dose were: being 18–29 (reference: 50–59 years aOR:4.44; 95%CI: 4.38–4.49), living in the most deprived quintile (reference: least deprived quintile aOR:2.56; 95%CI: 2.53–2.59), and Black, Caribbean, or African ethnicity (reference: White ethnicity aOR:2.38; 95%CI: 2.30–2.46). Pregnancy, previous vaccination with mRNA-1273, smoking history, individual and household severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, and having an unvaccinated adult in the household were also associated with incomplete vaccine schedule. Conclusion: We observed several risk factors that predict incomplete COVID-19 vaccination schedule. Vaccination programmes must take immediate action to ensure maximum uptake, particularly for populations vulnerable to severe COVID-19 outcomes.
| Item Type: | Articles |
|---|---|
| Additional Information: | Funding: UK Research and Innovation (Medical Research Council); Research and Innovation Industrial Strategy Challenge Fund; Chief Scientist's Office of the Scottish Government; Health Data Research UK; National Core Studies – Data and Connectivity. SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Scottish Government Chief Scientist Office (SPHSU17) and the Medical Research Council (MC_UU_00022/2). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal |
| Authors: | Morrison, K., Cullen, L., James, A. B., Chua, V., Sullivan, C., Robertson, C., Carruthers, J., Wood, R., Jeffrey, K., MacDonald, C., Shah, S. A., Rudan, I., Simpson, C. R., McCowan, C., Vittal Katikireddi, S., Grange, Z., Ritchie, L., and Sheikh, A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Vaccine |
| Publisher: | Elsevier |
| ISSN: | 0264-410X |
| ISSN (Online): | 1873-2518 |
| Published Online: | 17 August 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Vaccine 41(40): 5863-5876 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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