Correction: Measurement of coverage, compliance and determinants of uptake in a publicly funded rotavirus vaccination programme: a retrospective cohort study

AbstractBackgroundOn December 8th 2020, NHS England administered the first COVID-19 vaccination as part of an ambitious vaccination programme during a global health emergency.AimsTo develop a framework for detailed near-real-time monitoring of COVID-19 vaccine roll-out; to describe trends and variation in coverage by geographic area, and between key clinical and demographic patient groups.MethodsWorking on behalf of NHS England we used routine clinical data from 23.4 million patients to conduct a retrospective cohort study of comprehensive electronic health record data in NHS England, using the OpenSAFELY-TPP platform which covers approximately 40% of the general population in England with weekly data updates. We developed algorithms to identify key demographic and clinical sub-groups within this population and generated descriptive statistics on proportion of eligible patients receiving the vaccine among key Joint Committee on Vaccination and Immunisation (JCVI) target groups.ResultsBetween December 8th and January 13th 961,580 people out of 23.4m in our dataset received a COVID-19 vaccine. Of 1,160,062 patients aged 80 or over and not living in a care home (currently targeted by JCVI) 476,375 had been vaccinated in total (41.1%). We observed a substantial divergence in vaccination by ethnicity within this group (White 42.5% vaccinated, Black 20.5%) and across rankings of deprivation (least deprived 44.7%, most deprived 37.9%). Patients with pre-existing medical conditions were equally likely, or more likely, to have received a vaccine across most co-morbidity groups with two exceptions: severe mental illness (30.3% vaccinated) and learning disability (28.1%). We identify substantial variation in vaccination among the over-80s between Sustainability and Transformation Partnerships (STPs; Range 12%-74%); lower vaccination rates among ethnic minority and deprived groups was observed in most but not all STPs. In the 70-79 age cohort 74,108 people (3.6%) had been vaccinated. 378,921 vaccine recipients under 70 and not identifiably resident in a care home were presumed to be health or social care workers; 32,174 recipients were identified as older aged care home residents (33.2% coverage). Of all those vaccinated, 169,472 had received a second dose (17.6%).ConclusionsThe NHS in England has rapidly delivered mass vaccination. We were able to deploy a data monitoring framework across small clinical subgroups using linked patient-level NHS data on 23.4 million people with very short delays from vaccine administration to completed analysis. Targeted activity may be needed to address lower vaccination rates observed among certain key groups: ethnic minorities, people living in areas of higher deprivation, and those with severe mental illness or learning disabilities. However we note that this data is only from the first preliminary weeks of the vaccination programme. Variation in vaccination coverage between groups and regions will have many complex drivers, the figures presented in this manuscript require thoughtful interpretation to support a rapidly evolving NHS vaccination campaign; we are sharing local level data with national and regional NHS teams on request.

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Measurement of coverage, compliance and determinants of uptake in a publicly funded rotavirus vaccination programme: a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2019-031718 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031718 ◽

Cited By ~ 1

Author(s):

Ellen Rafferty ◽

Xiaoyan Guo ◽

Bruce McDonald ◽

Lawrence W Svenson ◽

Shannon Elizabeth MacDonald

Keyword(s):

Vaccination Programme ◽

Retrospective Cohort ◽

Vaccine Coverage ◽

Vaccine Uptake ◽

Socioeconomic Disparities ◽

Rotavirus Vaccine ◽

Publicly Funded ◽

Factors Associated ◽

Rotavirus Vaccination ◽

Vaccine Schedule

ObjectivesIn June 2015, Alberta, Canada instituted a universal publicly funded rotavirus vaccination programme (Rotarix, RV1), with vaccine doses scheduled for 2 and 4 months of age. Vaccination was restricted so that infants were only allowed to receive first dose between 6 and 20 weeks of age, and second dose before eight calendar months of age. We assessed the coverage and schedule non-compliance of rotavirus vaccination for babies born between June 2015 and August 2016, that is, since the inception of the publicly funded rotavirus vaccination programme, and determined factors associated with rotavirus vaccine uptake.DesignRetrospective cohort study using linked administrative health data.SettingAlberta, Canada.ParticipantsCohort of 66 689 children.Primary and secondary outcome measures(1) First and second dose rotavirus vaccination coverage, (2) percent of children non-compliant with recommended vaccine schedule and (3) adjusted ORs for factors associated with vaccination status.ResultsFor the 66 689 children included in the study, coverage levels for one-dose and two-dose rotavirus vaccination were 87% and 83%, respectively. In comparison, two-dose diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine coverage was 92%, despite having the same dosing schedule. Schedule non-compliance during the publicly funded programme was very low. We observed socioeconomic disparities in the uptake of the vaccine, with income, location of residence and number of children in the household all contributing to the odds of a child being vaccinated with rotavirus.ConclusionsCompliance to the recommended rotavirus schedule was very high, suggesting that even with the restrictive rotavirus vaccine schedule, the vaccine can be delivered on-time. However, rotavirus vaccine coverage remained lower than DTaP, a similarly scheduled childhood vaccination. We also observed socioeconomic disparities in vaccine uptake. These findings raise concerns about rotavirus protection in the groups at highest risk for gastrointestinal illness, including low-income and rural populations.

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