GM Care Record study published on ethnic inequalities in vaccine uptake

A study using data from the Greater Manchester Care Record to explore vaccine uptake among ethnic minority groups has been published.

The study, entitled ‘Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study‘ was published on 3 March 2022.

The study used de-identified electronic health record data, utilising the GMCR, from approximately 2.8 million patients registered with GP surgeries in the region. The researchers extracted data from individuals aged 18+ for use in the study, comparing inequalities between COVID-19 and influenza vaccine uptake by age group and clinical risk.

The study notes that “previous research has found wide disparities in early COVID-19 vaccine uptake between ethnic groups in many countries”, but “previous research has tended to use broad ethnic groupings, and ethnic inequalities in COVID-19 vaccine uptake had not been contextualised by comparison with inequalities in uptake of previous vaccination programmes.”

The researchers used the GMCR electronic health records to estimate inequalities in COVID-19 and seasonal influenza vaccine uptake between white British and 16 minority ethnic groups. They found that ethnic inequalities in this area are wider than the inequalities seen previously for seasonal influenza vaccine uptake, and concentrated among the most vulnerable. Individuals who are older, extremely clinically vulnerable, and/ living in the most deprived neighbourhoods experienced the highest levels of inequality.

The study notes: “Inequalities were particularly wide for all Black or Black British groups and the Arab group. Vaccine uptake inequalities were substantially wider for COVID-19 vaccination than for influenza vaccination. We also found wide ethnic inequalities amongst individuals who previously took up influenza vaccination.

“Our findings show that COVID-19 vaccine uptake was lower among almost all minority ethnic groups, and particularly low amongst people belonging to Black or Black British ethnic groups, is broadly consistent with existing reports… however, previous studies have not analysed uptake inequalities for Arab individuals, so these inequalities were not previously recognised.”

The study highlights that there were many differences in how people were able to access COVID-19 vaccination compared to influenza vaccination, “which may have introduced additional barriers that disproportionately affected minority groups. For example, there was a strict requirement for booked COVID-19 vaccination appointments, and much delivery was through mass vaccination centres or hospital hubs… in contrast, influenza vaccines are available through GPs and community pharmacies, often via drop-in services. Community pharmacies have been shown to be more accessible in areas of high deprivation than in less deprived areas. Participants in PCIE discussion groups also raised concerns that vaccine information was rarely presented in languages other than English, and that public health messaging sometimes failed to address the concerns of target populations.”

The comparison with the influenza vaccine uptake “brings crucial context to observed inequalities, and demonstrates that COVID-19 vaccine uptake reproduces previous health inequalities, but also harbours new inequalities that are particularly concentrated in income-deprived neighbourhoods.”

Authors and researchers include Ruth Elizabeth Watkinson, Richard Williams, Stephanie Gillibrand, Caroline Sanders and Matt Sutton.

Click here to read the full report.