Occupation, Worker Vulnerability, and COVID-19 Vaccination Uptake: Analysis of the Virus Watch prospective cohort study

• Published in: Vaccine 2022-12, Vol.40 (52), p.7646-7652
• Main Authors: Beale, Sarah, Burns, Rachel, Braithwaite, Isobel, Byrne, Thomas, Lam Erica Fong, Wing, Fragaszy, Ellen, Geismar, Cyril, Hoskins, Susan, Kovar, Jana, Navaratnam, Annalan M.D., Nguyen, Vincent, Patel, Parth, Yavlinsky, Alexei, Van Tongeren, Martie, Aldridge, Robert W, Hayward, Andrew
• Format: Article
• Language: English
• Subjects: Adult; Adults; Cohort analysis; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; Education; Exposure; Humans; Immunization; Investigations; Occupation; Occupational exposure; Occupational health; Occupations; Pandemics; Prospective Studies; Public transportation; Registration; Risk; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Trends; Vaccination; Vaccination uptake; Vaccines; Viral diseases; Viruses; Workers
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2022.10.080

Occupational disparities in COVID-19 vaccine uptake can impact the effectiveness of vaccination programmes and introduce particular risk for vulnerable workers and those with high workplace exposure. This study aimed to investigate COVID-19 vaccine uptake by occupation, including for vulnerable groups and by occupational exposure status. We used data from employed or self-employed adults who provided occupational information as part of the Virus Watch prospective cohort study (n = 19,595) and linked this to study-obtained information about vulnerability-relevant characteristics (age, medical conditions, obesity status) and work-related COVID-19 exposure based on the Job Exposure Matrix. Participant vaccination status for the first, second, and third dose of any COVID-19 vaccine was obtained based on linkage to national records and study records. We calculated proportions and Sison-Glaz multinomial 95% confidence intervals for vaccine uptake by occupation overall, by vulnerability-relevant characteristics, and by job exposure. Vaccination uptake across occupations ranged from 89-96% for the first dose, 87–94% for the second dose, and 75–86% for the third dose, with transport, trade, service and sales workers persistently demonstrating the lowest uptake. Vulnerable workers tended to demonstrate fewer between-occupational differences in uptake than non-vulnerable workers, although clinically vulnerable transport workers (76%-89% across doses) had lower uptake than several other occupational groups (maximum across doses 86%–96%). Workers with low SARS-CoV-2 exposure risk had higher vaccine uptake (86%-96% across doses) than those with elevated or high risk (81–94% across doses). Differential vaccination uptake by occupation, particularly amongst vulnerable and highly-exposed workers, is likely to worsen occupational and related socioeconomic inequalities in infection outcomes. Further investigation into occupational and non-occupational factors influencing differential uptake is required to inform relevant interventions for future COVID-19 booster rollouts and similar vaccination programmes.