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在多民族的英国医疗保健工作者中,对 SARS-CoV-2 疫苗的接种情况:一项横断面研究。

SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: A cross-sectional study.

机构信息

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom.

Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.

出版信息

PLoS Med. 2021 Nov 5;18(11):e1003823. doi: 10.1371/journal.pmed.1003823. eCollection 2021 Nov.

Abstract

BACKGROUND

Healthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce.

METHODS AND FINDINGS

We conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26-0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62-0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction.

CONCLUSIONS

Ethnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening.

摘要

背景

医疗工作者(HCWs)和少数族裔群体感染 COVID-19 和出现不良结果的风险增加。目前,英国的一线 HCWs 可以接种严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)疫苗;然而,在这一人群中,疫苗接种率与人口统计学/职业因素的关系尚不清楚。我们试图在英国一家大型医院的劳动力中确定这些关联。

方法和发现

我们进行了横断面监测,检查了莱斯特大学医院 NHS 信托基金所有员工的疫苗接种情况。我们按人口统计学因素、职业以及之前的 COVID-19 检测结果(血清学/PCR)对疫苗接种人员的比例进行了分层,并使用逻辑回归来确定调整混杂因素后的疫苗接种状况预测因素。我们纳入了 19044 名 HCWs;其中 12278 人(64.5%)接种了 SARS-CoV-2 疫苗。与白人 HCWs(70.9%接种疫苗)相比,少数族裔 HCWs 的接种比例明显较小(南亚裔,58.5%;黑人,36.8%;两者均<0.001)。在调整年龄、性别、族裔、贫困程度、职业、SARS-CoV-2 血清学/PCR 结果以及与 COVID-19 相关的缺勤情况后,发现与疫苗接种率呈负相关的因素是年龄较小、女性、贫困程度增加、怀孕以及属于任何非白人群体(黑人:调整后的优势比[aOR]0.30,95%置信区间[CI]0.26-0.34,p<0.001;南亚裔:aOR 0.67,95% CI 0.62-0.72,p<0.001)。那些之前通过 PCR 确诊 COVID-19 的人比那些检测结果为阴性的人接种疫苗的可能性更小。局限性包括数据来自单个中心,缺乏在医院系统外接种疫苗的工作人员数据,并且工作人员可能在数据提取后接受了疫苗接种。

结论

少数族裔 HCWs 和来自贫困地区的人员以及年轻员工和女性员工接种 SARS-CoV-2 疫苗的可能性较低。这些发现对 HCWs 和更广泛人群中 SARS-CoV-2 疫苗接种计划的实施具有重大影响,应告知国家疫苗接种计划,以防止大流行造成的差异进一步扩大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c45/8570522/596798dc9c20/pmed.1003823.g001.jpg

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