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Journal article

Factors associated with COVID-19 vaccine uptake in people with kidney disease: an OpenSAFELY cohort study

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
Publication status:
Published
Peer review status:
Peer reviewed

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Role:
Author
ORCID:
0000-0001-5847-109X
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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-7194-2615
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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-9162-4999
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Role:
Author
ORCID:
0000-0003-0113-2593


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Funder identifier:
10.13039/100010269
Grant:
222097/Z/20/Z
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Funder identifier:
10.13039/501100000265
Grant:
MC_PC-20059
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Funder identifier:
10.13039/501100000272
Grant:
COV-LT2-0073


Publisher:
BMJ Publishing Group
Journal:
BMJ Open More from this journal
Volume:
13
Issue:
1
Pages:
e066164-e066164
Publication date:
2023-01-31
Acceptance date:
2023-01-06
DOI:
EISSN:
2044-6055
ISSN:
2044-6055


Language:
English
Keywords:
Pubs id:
1326730
Local pid:
pubs:1326730
Source identifiers:
W4318712265
Deposit date:
2026-05-01
ARK identifier:
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