Ethnic differences in COVID-19 mortality in the second and third waves of the pandemic in England during the vaccine rollout: a retrospective, population-based cohort study

BMC Medicine

Research Article

Kamlesh Khunti¹  Raghib Ali²  Nazrul Islam³  Tamanna Ahmed⁴  Matthew L. Bosworth⁴  Tim Larsen⁴  Myer Glickman⁴  Luke Lorenzi⁴  Neil Bannister⁴  Jasper Morgan⁴  Daniel Ayoubkhani⁴  Vahé Nafilyan⁵  Veena Raleigh⁶  Peter Goldblatt⁷ 

[1] Diabetes Research Centre, University of Leicester, LE5 4PW, Leicester, UK;MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, CB2 0QQ, Cambridge, UK;Nuffield Department of Population Health, University of Oxford, OX3 7LF, Oxford, UK;School of Primary Care, Population Sciences and Medical Education, University of Southampton, SO17 1BJ, Southampton, UK;Office for National Statistics, Health Analysis and Life Events, NP10 8XG, Newport, UK;Office for National Statistics, Health Analysis and Life Events, NP10 8XG, Newport, UK;Department of Medical Statistics, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK;The King’s Fund, 11-13 Cavendish Square, W1G 0AN, London, UK;UCL Institute of Health Equity, Department of Epidemiology & Public Health, University College London, WC1E 7HB, London, UK;

关键词: COVID-19;    Coronavirus;    SARS-CoV-2;    Ethnicity;    Ethnic group;    Mortality;    Vaccination;   

DOI  :  10.1186/s12916-022-02704-7

 received in 2022-06-28, accepted in 2022-12-12,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundEthnic minority groups in England have been disproportionately affected by the COVID-19 pandemic and have lower vaccination rates than the White British population. We examined whether ethnic differences in COVID-19 mortality in England have continued since the vaccine rollout and to what extent differences in vaccination rates contributed to excess COVID-19 mortality after accounting for other risk factors.MethodsWe conducted a retrospective, population-based cohort study of 28.8 million adults aged 30–100 years in England. Self-reported ethnicity was obtained from the 2011 Census. The outcome was death involving COVID-19 during the second (8 December 2020 to 12 June 2021) and third wave (13 June 2021 to 1 December 2021). We calculated hazard ratios (HRs) for death involving COVID-19, sequentially adjusting for age, residence type, geographical factors, sociodemographic characteristics, pre-pandemic health, and vaccination status.ResultsAge-adjusted HRs of death involving COVID-19 were elevated for most ethnic minority groups during both waves, particularly for groups with lowest vaccination rates (Bangladeshi, Pakistani, Black African, and Black Caribbean). HRs were attenuated after adjusting for geographical factors, sociodemographic characteristics, and pre-pandemic health. Further adjusting for vaccination status substantially reduced residual HRs for Black African, Black Caribbean, and Pakistani groups in the third wave. Fully adjusted HRs only remained elevated for the Bangladeshi group (men: 2.19 [95% CI 1.72–2.78]; women: 2.12 [1.58–2.86]) and Pakistani men (1.24 [1.06–1.46]).ConclusionsLower COVID-19 vaccination uptake in several ethnic minority groups may drive some of the differences in COVID-19 mortality compared to White British. Public health strategies to increase vaccination uptake in ethnic minority groups would help reduce inequalities in COVID-19 mortality, which have remained substantial since the start of the vaccination campaign.

【 授权许可】

CC BY   
© Crown 2023

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