COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales: A national prospective cohort study

Bedston, Stuart; Lowthian, Emily; Jarvis, Christopher; Akbari, Ashley; Beggs, Jillian; Bradley, Declan; Lusignan, Simon de; Griffiths, Rowena; Herbert, Laura; Kerr, Steven; Lyons, Jane; Midgley, William; Owen, Rhiannon K; Quint, Jennifer; Tsang, Ruby S M; Torabi, Fatemeh; Sheikh, Aziz; Lyons, Ronan A

doi:10.1016/j.vaccine.2023.01.023

Cited by 5 publications

(7 citation statements)

References 36 publications

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“…22 Additionally, among a specific population of healthcare workers in Wales, booster dose vaccine uptake was consistently lower among black healthcare workers, as well as those from deprived areas. 23 These studies are in line with our results, with lower probability of booster vaccine among individuals with the lowest level of education, lowest disposable household income and those born outside of Sweden as well as in the areas with a low socioeconomic standing. Differences to consider between the studies are that in Massachusetts, in March 2022, a vaccine equity plan was put in place in attempt to encourage and inform the public particularly younger people about booster doses.…”

Section: Results In Relation To Previous Studiessupporting

confidence: 92%

COVID-19 vaccine uptake in Skåne county, Sweden, in relation to individual-level and area-level sociodemographic factors: a register-based cross-sectional analysis

Mitchell,

Inghammar,

Bennet

et al. 2024

bmjph

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ObjectivesBetter understanding of societal factors associated with COVID-19 vaccination can have important implications for public health policy to increase uptake.MethodsThis study investigated sociodemographic determinants of COVID-19 vaccine uptake with ≥2 doses vs 0 doses, and ≥3 doses vs 2 doses, among adults (≥18 years) in a general population from Sweden followed from 27 December 2020 (n=1 064 548 at the present cross-section—12 June 12 2022). Associations between individual-level and area-level sociodemographic factors and vaccine uptake were modelled with logistic regression, with average marginal effects and estimated proportion vaccinated subsequently estimated.ResultsBeing vaccinated with ≥2 doses vs 0 doses was positively associated with education (tertiary vs primary, OR 1.5, 95% CI 1.3 to 1.7), household disposable income (Q5 vs Q1, OR 2.3; 95% CI 1.9 to 2.7), comorbidities (≥2 doses vs none, OR 1.9, 95% CI 1.8 to 1.9) and residential area type (affluent socioeconomic conditions vs poor, OR 2.0, 95% CI 1.6 to 2.4). Whereas, being born outside Sweden was associated with a lower uptake (low and middle-income countries vs Swedish born, OR 0.6, 95% CI 0.5 to 0.7). The associations were generally similar when comparing booster vs remaining on only two doses. From these ORs, there were consistent differences in the estimated proportion vaccinated both for ≥2 doses and booster vaccination. Absolute changes in percentage vaccinated between affluent and poor areas were largely similar across individual country of birth, income and education, both for at least two doses and for the booster doses.ConclusionsCOVID-19 vaccine uptake was associated with higher sociodemographic classifications both at the individual level and area level. The predicted proportion vaccinated increased with more affluent socioeconomic conditions and concurrent increases in individual household income were the strongest indicators. This sociodemographic selection showed consistency with respect to entering (obtaining ≥2 doses) and remaining (obtaining at least one booster dose) in the vaccination programme.

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Section: Results In Relation To Previous Studiessupporting

confidence: 92%

COVID-19 vaccine uptake in Skåne county, Sweden, in relation to individual-level and area-level sociodemographic factors: a register-based cross-sectional analysis

Mitchell,

Inghammar,

Bennet

et al. 2024

bmjph

View full text Add to dashboard Cite

show abstract

“…Moreover, uptake for the booster dose was slightly reduced in this sample (around 7% fewer participants received booster doses in comparison to first and second doses). A recent survey of booster vaccinations in Welsh HCWs found a drop off in vaccine uptake for the third dose, suggesting that the findings in the small sample used in the present study reflect behaviours in the wider population [ 20 ]. There are several potential explanations for this finding—the third ‘booster’ dose of the COVID-19 vaccine was released for HCWs in September of 2021, six months after this group were invited to receive their second dose [ 5 , 28 ].…”

Section: Discussionmentioning

confidence: 97%

“…Over time, hesitancy may have increased, especially if the third dose was perceived as less necessary than the original course, as was suggested by HCWs in previous research [ 19 ]. Research has also shown that uptake of the booster dose was reduced in those who experienced negative side effects following receipt of the initial doses, which may have resulted in a dip in uptake in this sample [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Initial research in a sample of Canadian health professionals suggested that booster doses were less trusted and seen as less necessary in those studied [ 19 ]. In addition to this, vaccine uptake data in Wales, UK show that fewer HCWs are receiving boosters in comparison to those who received the first two doses, suggesting that the perceptions of necessity that encouraged initial vaccination are less influential when considering the booster doses [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

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The Role of Medication Beliefs in COVID-19 Vaccine and Booster Uptake in Healthcare Workers: An Exploratory Study

et al. 2023

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Illness and medication beliefs have shown to predict COVID-19 vaccination behaviour in the general population, but this relationship has yet to be demonstrated in healthcare staff. This research aimed to explore the potential explanatory value of illness and medication beliefs on the COVID-19 vaccination uptake of a sample of patient-facing healthcare workers (HCWs). A web-based questionnaire—measuring beliefs about vaccinations (the BMQ), perceptions of COVID-19 (the BIPQ), vaccine hesitancy, and vaccine uptake—was targeted to HCWs via social media platforms between May–July 2022. Open text responses allowed participants to provide explanations for any delay in vaccine uptake. A total of 91 participants completed the questionnaire. Most respondents (77.1%, n = 64) had received three doses of the COVID-19 vaccination, and vaccination uptake (number of doses received) was predicted by Vaccine Concerns, Vaccine Hesitancy, and their Necessity–Concerns Differential score. Vaccine Hesitancy was predicted by Necessity, Concerns, and Overuse scores, as well as Necessity–Concerns Differential scores. Delay in Vaccine Uptake could only be predicted for Dose 3 (Booster). Qualitative data revealed that hesitant respondents were “unable to take time off work” for vaccination and that some had concerns over vaccine safety. In conclusion, illness and medication beliefs have potential value in predicting vaccine hesitancy and uptake in healthcare workers. Interventions to improve vaccination uptake in this population should address concerns about vaccine safety and releasing staff for vaccination booster appointments should be prioritised. Future research should further investigate the relationship between illness and medication beliefs and COVID-19 vaccine uptake in a larger sample of healthcare workers.

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“…Age was a significant factor in the analysis of breakthrough infections, with participants aged 45 and older exhibiting a notably lower incidence of breakthrough infections in comparison to those under 45 years old. Similarly, Bedston et al reported an inverse relationship between advancing age and susceptibility to breakthrough infection after both the second and third vaccine doses [ 13 ]. This phenomenon could potentially be attributed to varying levels of adherence and protective measures among different age groups, with adherence increasing with age [ 14 ], leading to potentially reduced breakthrough infections among older healthcare workers.…”

Section: Discussionmentioning

confidence: 99%

Characteristics Associated with COVID-19 Breakthrough Infections after Booster Vaccinations in Healthcare Workers: Insights from the TüSeRe:exact Study

Uzun,

Bareiß,

Becker

et al. 2024

JCM

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Background: The prevalence of COVID-19 breakthrough infections in healthcare workers (HCWs) remains an issue of concern. This study examines the different characteristics associated with breakthrough infections in HCWs. Methods: From the total participants in the TüSeRe:exact study (n = 1046), we specifically included study participants who had received three vaccinations and were not infected prior to the third vaccination. Participants were invited to complete an online questionnaire, which included inquiries about any breakthrough infections they might have experienced. Univariate Cox regression analysis was used to investigate the association between participant characteristics and breakthrough infections. Results: Among 629 HCWs (497 female and 132 male), 241 (38%) experienced breakthrough infections during the follow-up period. The frequency of breakthrough infections was 39.2% (195/497) among female participants and 34.8% (46/132) among male participants (p = 0.357). The Cox regression model adjusted for age and sex showed that participants with cardiovascular disease (hazard ratio (95%CI) = 0.621 (0.392–0.985); p = 0.043) and those taking antihypertensives (hazard ratio (95%CI) = 0.551 (0.331–0.915); p = 0.021) had a significantly lower hazard ratio for breakthrough infections. The use of analgesics after the first vaccine (hazard ratio (95%CI) = 1.343 (1.025–1.759); p = 0.032) was associated with an increased risk of breakthrough infections. Conclusions: These findings can inform targeted preventive measures and risk management strategies to protect frontline workers and maintain a resilient healthcare system during the ongoing pandemic.

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COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales: A national prospective cohort study

Cited by 5 publications

References 36 publications

COVID-19 vaccine uptake in Skåne county, Sweden, in relation to individual-level and area-level sociodemographic factors: a register-based cross-sectional analysis

COVID-19 vaccine uptake in Skåne county, Sweden, in relation to individual-level and area-level sociodemographic factors: a register-based cross-sectional analysis

The Role of Medication Beliefs in COVID-19 Vaccine and Booster Uptake in Healthcare Workers: An Exploratory Study

Characteristics Associated with COVID-19 Breakthrough Infections after Booster Vaccinations in Healthcare Workers: Insights from the TüSeRe:exact Study

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