OpenSAFELY Collaborative; Parker, Edward Pk; Tazare, John; Hulme, William J; Bates, Christopher; Carr, Edward J; Cockburn, Jonathan; Curtis, Helen J; Fisher, Louis; Green, Amelia Ca; +19 more... Harper, Sam; Hester, Frank; Horne, Elsie Mf; Loud, Fiona; Lyon, Susan; Mahalingasivam, Viyaasan; Mehrkar, Amir; Nab, Linda; Parry, John; Santhakumaran, Shalini; Steenkamp, Retha; Sterne, Jonathan Ac; Walker, Alex J; Williamson, Elizabeth J; Willicombe, Michelle; Zheng, Bang; Goldacre, Ben; Nitsch, Dorothea; Tomlinson, Laurie A; (2023) Factors associated with COVID-19 vaccine uptake in people with kidney disease: an OpenSAFELY cohort study. BMJ Open, 13 (1). e066164-. ISSN 2044-6055 DOI: https://doi.org/10.1136/bmjopen-2022-066164
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Abstract
OBJECTIVE: To characterise factors associated with COVID-19 vaccine uptake among people with kidney disease in England. DESIGN: Retrospective cohort study using the OpenSAFELY-TPP platform, performed with the approval of NHS England. SETTING: Individual-level routine clinical data from 24 million people across GPs in England using TPP software. Primary care data were linked directly with COVID-19 vaccine records up to 31 August 2022 and with renal replacement therapy (RRT) status via the UK Renal Registry (UKRR). PARTICIPANTS: A cohort of adults with stage 3-5 chronic kidney disease (CKD) or receiving RRT at the start of the COVID-19 vaccine roll-out was identified based on evidence of reduced estimated glomerular filtration rate (eGFR) or inclusion in the UKRR. MAIN OUTCOME MEASURES: Dose-specific vaccine coverage over time was determined from 1 December 2020 to 31 August 2022. Individual-level factors associated with receipt of a 3-dose or 4-dose vaccine series were explored via Cox proportional hazards models. RESULTS: 992 205 people with stage 3-5 CKD or receiving RRT were included. Cumulative vaccine coverage as of 31 August 2022 was 97.5%, 97.0% and 93.9% for doses 1, 2 and 3, respectively, and 81.9% for dose 4 among individuals with one or more indications for eligibility. Delayed 3-dose vaccine uptake was associated with younger age, minority ethnicity, social deprivation and severe mental illness-associations that were consistent across CKD severity subgroups, dialysis patients and kidney transplant recipients. Similar associations were observed for 4-dose uptake. CONCLUSION: Although high primary vaccine and booster dose coverage has been achieved among people with kidney disease in England, key disparities in vaccine uptake remain across clinical and demographic groups and 4-dose coverage is suboptimal. Targeted interventions are needed to identify barriers to vaccine uptake among under-vaccinated subgroups identified in the present study.
Item Type | Article |
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Faculty and Department |
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology |
Research Centre | Covid-19 Research |
PubMed ID | 36720568 |
Elements ID | 198264 |
Official URL | http://dx.doi.org/10.1136/bmjopen-2022-066164 |
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Filename: OpenSAFELY_Collaborative_2023_Factors-associated-with-covid-19.pdf
Licence: Creative Commons: Attribution 4.0
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