Differences in COVID-19 vaccination coverage by occupation in England: a national linked data study (preprint)

Background: Monitoring differences in COVID-19 vaccination uptake in different groups is crucial to help inform the policy response to the pandemic. A key gap is the absence of data on uptake by occupation. Methods: Using nationwide population-level data, we calculated the proportion of people who had received two doses of a COVID-19 vaccine (assessed on 31 August 2021) by detailed occupational categories in adults aged 40-64 and estimated adjusted odds ratios to examine whether these differences were driven by occupation or other factors, such as education. We also examined whether vaccination rates differed by ability to work from home. Results: Our study population included 14,298,147 adults 40-64. Vaccination rates differed markedly by occupation, being higher in administrative and secretarial occupations (90.8%); professional occupations (90.7%); and managers, directors and senior officials (90.6%); and lowest (83.1%) in people working in elementary occupations. We found substantial differences in vaccination rates looking at finer occupational groups even after adjusting for confounding factors, such as education. Vaccination rates were higher in occupations which can be done from home and lower in those which cannot. Many occupations with low vaccination rates also involved contact with the public or with vulnerable people. Conclusions: Increasing vaccination coverage in occupations with low vaccination rates is crucial to help protecting the public and control infection, especially in occupations that cannot be done from home and involve contacts with the public. Policies such as 'work from home if you can' may only have limited future impact on hospitalisations and deaths

Monitoring sociodemographic inequality in COVID-19 vaccination coverage in England: a national linked data study (preprint)

Background: The UK began an ambitious COVID-19 vaccination programme on 8th December 2020. This study describes variation in vaccination coverage by sociodemographic characteristics between December 2020 and August 2021. Methods: Using population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics amongst adults aged 18 years or over in England. We also present a tool to display the results interactively. Findings: Our study population included 35,223,466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18-59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged [≥]80 years) and Black Caribbeans (18-79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socio-economic group, and had fewer qualifications. Interpretation: We found inequalities in COVID-19 vaccination rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socio-economic position, and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.