Vaccine hesitancy: what were the real-term impacts in the UK?

BioTechniques News
Jade Parker


The results are in for the impact of undervaccination on hospitalizations and deaths during the COVID-19 pandemic.

A recent research effort from Health Data Research UK (HDR UK; London, UK) and the University of Edinburgh (UK) has utilized anonymized UK health data for the entire UK population and mathematical modelling to determine the impact of vaccine refusal and missed vaccine doses. The findings provide key insights into the efficacy of the vaccines and their booster doses, and the methodology provides a template for similar studies to investigate further diseases.

Throughout the COVID-19 pandemic, the exceptional pace of vaccine development, resulting from unprecedented levels of collaboration and innovation in the scientific community and a near-universal unity of purpose, was coupled with an undercurrent of suspicion and resistance towards the vaccines.

Legitimate initial concerns about safety and due process, exacerbated by the rapid pace of development, became intertwined with fake news agendas fed by opportunists with ulterior motives, leading to a significant challenge in communicating the true safety and efficacy of the vaccines to the general population.

As a result, vaccine hesitancy became relatively commonplace and scientific communication efforts were largely aimed at convincing those who had initially refused to take the vaccine to change their mind. Indeed, receiving the first dose of the vaccine yielded the greatest benefit to immunity compared to the following doses. However, while total refusal to be inoculated took most of the headlines in this arena, another issue, perhaps less well targeted with scientific communications was a complacency in the uptake of subsequent booster vaccines.

This is well demonstrated by this University of Edinburgh and HDR UK study of the UK population, which revealed that while 90% had received the first vaccine dose by January 2022, by June of the same year, 45.7% of the English, 49.8% of the Northern Irish, 34.2% of the Scottish and 32.8% of the Welsh populations had not received the recommended number of vaccinations that they were entitled to. The study’s 67 million strong sample size makes it the largest study ever conducted in the UK.

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The team pooled and harmonized data from each of the four countries of the UK, grouping the data set into those who had been fully vaccinated and those who had not received their full vaccine entitlement, termed undervaccinated. Using this data set, they deployed mathematical modeling techniques to determine the impact of undervaccination on the nation’s health.

The study uncovered that undervaccination was associated with a statistically increased risk of severe outcomes (hospitalization or death) across all age ranges. The over 75s were particularly at risk, twice as likely to experience a severe outcome from SARS-CoV-2 infection when compared to fully vaccinated people in the same age range.

Ultimately the team found that, had the gap been closed and the entire population had been vaccinated in full, 7,180 hospitalisations and deaths could have been avoided in the 4 months of summer 2022 alone.

Commenting on the impact of the study, co-senior author Aziz Sheikh (University of Edinburgh and HDR UK) explained that, “large-scale data studies have been critical to pandemic management, allowing scientists to make policy-relevant findings at speed. COVID-19 vaccines save lives. As new variants emerge, this study will help to pinpoint groups of our society and areas of the country where public health campaigns should be focused and tailored for those communities.”

Considering the methodology of the study and its potential utilization in other disease areas, co-author Cathie Sudlow commented that, “infrastructure now exists to make full use of the potential of routinely collected data in the NHS across the four nations of the UK. We believe that we could and should extend these approaches to many other areas of medicine, such as cancer, heart disease and diabetes to search for better understanding, prevention and treatment of disease.”

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