COVID-19 vaccination uptake for half a million non-EU migrants and refugees in England: a linked retrospective population-based cohort study

Rachel Burns; Ines Campos-Matos; Katie Harron; Robert W Aldridge

doi:10.1016/S0140-6736(22)02215-2

COVID-19 vaccination uptake for half a million non-EU migrants and refugees in England: a linked retrospective population-based cohort study

Lancet. 2022 Nov:400 Suppl 1:S5. doi: 10.1016/S0140-6736(22)02215-2. Epub 2022 Nov 24.

Authors

Rachel Burns¹, Ines Campos-Matos², Katie Harron³, Robert W Aldridge⁴

Affiliations

¹ Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK. Electronic address: r.burns@ucl.ac.uk.
² Office for Health Improvement and Disparities, UK Department of Health and Social Care, London, UK.
³ Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; Institute of Child Health, University College London, London, UK.
⁴ Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK.

Abstract

Background: COVID-19 has highlighted severe health inequities experienced by certain migrants. Despite evidence suggesting that migrants are at risk of under-immunisation, data are limited for migrants' COVID-19 vaccine uptake in England.

Methods: We did a retrospective population-based cohort study on COVID-19 vaccination uptake in England. We linked the Million Migrant cohort (which includes non-EU migrants and resettled refugees) to the national COVID-19 vaccination dataset, using a stepwise deterministic matching procedure adapted from NHS Digital, and compared migrants with the general population. For migrants who linked to at least one vaccination record, we estimate temporal trends in first dose uptake and differences in second and third dose uptake and consequent delays between Dec 8, 2020, and April 20, 2022, by age, visa type, and ethnicity.

Findings: Of the 465 470 migrants who linked to one or more vaccination record, 427 073 (91·8%) received a second dose and 238 721 (51·3%) received a third. Migrants (>30 years) reached 75% first-dose coverage between 1 and 2 weeks after the general population in England, with the gap widening to 6 weeks for younger migrants (16-29 years). Refugees specifically had a higher risk of a delayed second dose (odds ratio 1·75 [95 CI% 1·62-1·88]) and third dose (1·41 [1·31-1·53]). Older migrants (>65 years) were at least four times more likely to have not received their second or third dose compared with those of the same age in England.

Interpretation: Uptake of the first dose was slower across all age groups for migrants compared with the general population. Refugees and older migrants were more likely to have delayed uptake of COVID-19 vaccines and to not have received their second or third dose. Policymakers, researchers, and practitioners should consider how to best drive uptake of COVID-19 and other routine vaccine doses and understand and address personal and structural barriers to vaccination systems for diverse migrant populations.

Funding: Wellcome Trust and UK Research and Innovation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines
COVID-19* / epidemiology
COVID-19* / prevention & control
Cohort Studies
England / epidemiology
Humans
Refugees*
Retrospective Studies
Transients and Migrants*
Vaccination / methods

Substances

COVID-19 Vaccines

Grants and funding

WT_/Wellcome Trust/United Kingdom