Improving COVID-19 Vaccine Uptake and Equity in Wales

Background

Evidence from existing vaccination programmes in Wales highlights that the under-vaccinated population is likely to include vulnerable or poorly reached groups and those who face additional challenges in accessing health care.

Those with physical impairments, individuals with mental health conditions and those who live in poorly served areas, may face more difficulties in accessing and accepting vaccinations; as may people who interact with health care less frequently; including those with unstable housing situations or substance misuse challenges, and asylum seekers and refugees.

Wales is in a unique position to develop methods that can estimate equity of vaccination coverage across a number of key characteristics, given the population size, the breadth of national patient-level databases and data collection tools that exist.

Aim

This study aims to look at the predictors of vaccine uptake in vulnerable and poorly reached groups. This will help to better understand inequality surrounding the uptake of the COVID-19 vaccine, and potential areas of intervention, investment and further research.

Approach

The SAIL databank offers the ability to link datasets that may be outside the NHS environment.

Due to the close working partnerships of key stakeholders in Welsh Government, Public Health Wales, Health Boards and NHS Delivery services, and Academia, there is also a valuable opportunity to directly guide NHS service improvements and prospective policy development through robust and innovative surveillance and evidence gathering.

The questions this study aims to answer include: ‘What are the predictors of vaccine uptake (first and second dose)?’ and ‘What are the clinical characteristics, outcomes and health care utilisation patterns of vaccinated and unvaccinated patients admitted to critical care?’.

The above questions will be applied to the following 11 key areas of interest:

1. Chronic risk conditions

2. At risk of homelessness

3. Rurality

4. Physical disability

5. Severe mental health conditions

6. Welsh Index of Multiple Deprivation ranking

7. Known history of substance misuse

8. Asylum seeker and refugee populations

9. Household size and composition

10. Political ward

11. Distance from vaccination centre