Predictors of incomplete COVID-19 vaccine schedule among adults in Scotland : two retrospective cohort analyses of the primary schedule and third dose
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.
Citation
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 & Sheikh , A 2023 , ' Predictors of incomplete COVID-19 vaccine schedule among adults in Scotland : two retrospective cohort analyses of the primary schedule and third dose ' , Vaccine , vol. 41 , no. 40 . https://doi.org/10.1016/j.vaccine.2023.07.070
Publication
Vaccine
Status
Peer reviewed
Type
Journal article
Description
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).Collections
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