How Covid vaccine and booster uptake varied, for people and places in England

What is it about?

Covid vaccines have been freely available in Britain through the NHS. The UK published data on primary vaccinations and the first booster dose in small geographical units called “Middle Super Output Areas”. At the peak of the winter pandemic in early January 2022, cumulative uptake of the first booster across 6789 MSOA within England ranged from around 11% to 83%. Does this simply reflect varying attitudes to vaccination in neighbourhoods whose populations differ by age, gender, ethnicity, or employment? I analysed MSOA-level data on uptake, demography, employment, deprivation, population density, housing, and access to healthcare, using a non-linear model including random effects for 149 Upper Tier Local Authorities and 9 Regions. Booster uptake in the North East and North West, and particularly in Merseyside, was lower than would be expected without the random effects. Local authority effects were partly explained by flu vaccination rates, Covid vaccination sites, and changes in public health budget allocations.

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Photo by Ben Garratt on Unsplash

Photo by Ben Garratt on Unsplash

Why is it important?

Once they were available, vaccines formed the first line of defence against Covid. Yet many local areas had very low uptake, especially for the first booster. Demographic effects are real, with lower uptake in neighbourhoods with higher proportions of young people, or particular ethnicities. If “vaccine hesitancy” were the only issue, it would make sense to focus entirely on engaging with particular groups of people to encourage vaccination. But if uptake also depends on where people live, not just who they are and what job they do, then addressing inequalities in economic policy and development is also vital.