UK-wide COVID-19 vaccination coverage study reveals gaps and preventable hospitalizations

A third and a half of the UK’s four-nation population had not had the recommended number of vaccinations and boosters against COVID by summer 2022, according to the first research study to look at overall population-wide COVID-19 vaccine coverage United Kingdom.

The findings, published today in The Lancetsuggest that more than 7,000 hospitalizations and deaths could have been avoided in the summer of 2022 if the UK had better vaccine coverage.

With COVID-19 cases on the rise and a new variant of the strain recently identified, this research provides timely insight into vaccine uptake and reluctance and could inform policymakers.

The research was based on secure access to anonymized health data for everyone in all four nations of the UK, an advance that was only possible during the pandemic.

Co-author Angela Wood, Professor of Health Data Science at the Victor Phillip Dahdaleh Heart & Lung Research Institute, University of Cambridge and Associate Director of the British Heart Foundation Data Science Center said: “This is the first epidemiological study to use individual-level Anonymous health data covering the entire UK population. We’ve created a detailed picture across the UK of who is under-vaccinated against COVID-19 and the associated risks of under-vaccination.

“These results can be used to help create health policy and public health interventions to improve vaccine uptake. This approach could be extended to many other areas of medicine with great potential for new discoveries in the understanding and treatment of disease.”

The early roll-out of the COVID-19 vaccine is off to a strong start in the UK, with over 90% of the population aged over 12 vaccinated with at least one dose by January 2022. However, rates of subsequent booster doses across the United Kingdom were not fully understood until now.

Scientists from England, Scotland, Northern Ireland and Wales – led by Health Data Research UK (HDR UK) and the University of Edinburgh – studied NHS data collected securely from everyone over the age of five from 1 June through September 30, 2022. All data were de-identified and available only to approved researchers.

Data from the four countries were then collated and harmonized, which was not possible until now. Subjects were grouped by vaccine status, with undervaccination defined as not having received all doses of a vaccine for which the subject was eligible.

The findings reveal that the proportion of people who were under-vaccinated on 1 June 2022 ranged between a third and half of the population – 45.7% for England, 49.8% for Northern Ireland, 34.2% for Scotland and 32.8% Wales.

Mathematical modeling showed that 7,180 hospitalizations and deaths from around 40,400 severe COVID-19 outcomes over four months in the summer of 2022 could have been avoided if the UK population had been fully vaccinated.

Undervaccination was associated with significantly more hospitalizations and deaths in all age groups studied, with undervaccinated people over 75 more than twice as likely to have a severe COVID-19 outcome as those who were fully protected.

The highest rates of under-vaccination were found in younger people, men, people in areas of higher deprivation and people of non-white ethnicity.

Researchers say the study – the largest ever undertaken in the UK – also ushers in a new era for UK science by overcoming challenges in integrating NHS data collected and stored in different ways across devolved nations.

The infrastructure is now in place to harness the full potential of the data routinely collected across the NHS across the UK’s four nations. We believe that we could and should extend these approaches to many other areas of medicine, such as cancer, heart disease, and diabetes, to seek better understanding, prevention, and treatment of disease.”

Professor Cathie Sudlow, Chief Scientist at Health Data Research UK and Director of the British Heart Foundation (BHF) Data Science Center

Professor Sir Aziz Sheikh, Director of the Usher Institute at the University of Edinburgh, Director of HDR UK Research and co-leader of the study, said: “Large-scale data studies have been critical to the management of the pandemic, enabling scientists to make policy-relevant findings in Vaccines against COVID-19 save lives. As new variants emerge, this study will help identify groups in our society and areas of the country where public health campaigns should be focused and tailored to those communities.”