(298) The Social Patterning of COVID-19 Vaccine Uptake in Older Adults: A Register-Based Study in Sweden Within The SCIFI-PEARL Project

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1343

Presenting Author(s)

Fredrik Nyberg, MD, PhD, FISPE
– Prof. of Register Epidemiology, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, M�lndal, V�stra G�talands l�n, Sweden

Co-Author(s)

Malin Spetz
– School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Lisa Lundberg
– Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Chioma Nwaru
– School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Huiqi Li
– School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Ailiana Santosa
– School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Susannah Leach
– Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Magnus Gisslén
– Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden
Niklas Hammar
– Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden, Sweden
Maria Rosvall
– School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden

Background: A broad vaccination coverage is crucial for preventing the spread of Covid-19 and reduce serious illness or death.

Objectives: The aim of this study was to examine social inequalities in Covid-19 vaccination uptake as of 17th May 2021 among Swedish adults aged ≥ 60 years.

Methods: The study population comprised a general population cohort aged 60 years or older (n= 350,805), representative of the Swedish population. Data were collected through the nationwide linked multi-register observational study SCIFI-PEARL, and associations between sociodemographic determinants and Covid-19 vaccination uptake were analysed using logistic regression. Intersectional analyses of sociodemographic heterogeneity were performed by taking several overlapping social dimensions into account. Data availability extended to 17 May 2021.

Results: The overall vaccination coverage in the Swedish population aged 60 years or older was 87.2% by 17th May 2021. Individuals in the non-vaccinated group were significantly (p < 0.05) more often younger (78.5% vs. 57.8%), males (49.6% vs. 47.2%), had a lower income (47.5% vs. 30.1%), were born outside Sweden (34.9% vs. 12.2%), lived alone (58.4% vs. 43.1%), lived in a region with a major city (60.9% vs. 46.7%), and/or had a history of Covid-19 (11.3% vs. 5.1%), compared to the vaccinated group. The lowest Covid-19 vaccination uptake was seen in individuals born in low-or middle-income countries, of whom only 60% had received vaccination, with an odds ratio (OR) of not being vaccinated of 6.05 (95% CI: 5.85-6.26) compared to individuals born in Sweden. These associations persisted after adjustments for possible confounding factors. The intersectional analyses showed even larger variations in vaccination in cross-classified sociodemographic subgroups (ranging from 44% to 97%), with marked differences in uptake of vaccination within sociodemographic groups.

Conclusions: The uptake of Covid-19 vaccine during the spring of 2021 in Sweden varied substantially both between and within sociodemographic groups. The use of an intersectional approach, taking several overlapping social dimensions into account at the same time rather than only using unidimensional measures, contributes to a better understanding of the complexity in the uptake of vaccination.