Self-reported COVID-19 vaccine hesitancy and uptake among participants from different racial and ethnic groups in the United States and United Kingdom

Claire J. Steves,Cristina Menni,Sébastien Ourselin ,Jonathan Wolf,David A. Drew,Wenjie Ma,Andrew T. Chan,Long H. Nguyen,Null Author_Id ,Carole H. Sudre,Adjoa Anyane‐Yeboa ,Paul W. Franks,Christina M Astley ,Richard Davies,Sohee Kwon,Mark S. Graham,Denis Nash,Amit D. Joshi,Tim D. Spector,Erica T. Warner,Somesh Selvachandran,Christina Hu ,Lorenzo Polidori,Jordi Merino,Chun‐Han Lo ,Kai Wang

doi:10.1038/s41467-022-28200-3

Abstract

Worldwide, racial and ethnic minorities have been disproportionately impacted by COVID-19 with increased risk of infection, its related complications, and death. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy may result in differences in uptake. We performed a cohort study among U.S. and U.K. participants who volunteered to take part in the smartphone-based COVID Symptom Study (March 2020-February 2021) and used logistic regression to estimate odds ratios of vaccine hesitancy and uptake. In the U.S. (n = 87,388), compared to white participants, vaccine hesitancy was greater for Black and Hispanic participants and those reporting more than one or other race. In the U.K. (n = 1,254,294), racial and ethnic minority participants showed similar levels of vaccine hesitancy to the U.S. However, associations between participant race and ethnicity and levels of vaccine uptake were observed to be different in the U.S. and the U.K. studies. Among U.S. participants, vaccine uptake was significantly lower among Black participants, which persisted among participants that self-reported being vaccine-willing. In contrast, statistically significant racial and ethnic disparities in vaccine uptake were not observed in the U.K sample. In this study of self-reported vaccine hesitancy and uptake, lower levels of vaccine uptake in Black participants in the U.S. during the initial vaccine rollout may be attributable to both hesitancy and disparities in access.

Highlights

Worldwide, racial and ethnic minorities have been disproportionately impacted by COVID-19 with increased risk of infection, its related complications, and death
In addition to concerns over fairness and availability, a substantial barrier to uptake in racial and ethnic minority communities is vaccine hesitancy, which may be rooted in ongoing discrimination and prior injustices that have resulted in deeply seated mistrust of the medical system[11,12]
From 24 March 2020 to 1 February 2021, we enrolled a total of 4,797,306 individuals (n = 370,282 U.S participants and n = 4,427,024 U.K participants), of whom 1,605,019 individuals were active and logged at least one entry in December 2020 (i.e., 2 weeks prior to the initial vaccine questionnaire)

Summary

Introduction

Racial and ethnic minorities have been disproportionately impacted by COVID-19 with increased risk of infection, its related complications, and death. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy may result in differences in uptake. Initial U.S efforts were led by fragmented state and local health authorities that had not routinely collected information on race, ethnicity, or vaccine hesitancy[13] and have not adhered to uniform eligibility criteria[14]. In both countries, there have been reports of racial and ethnic disparities in vaccine uptake, but specific data across a broad community-based sample, in the U.S, are lacking[15,16,17,18]

Methods

Results

Conclusion