Publication date: Jul 09, 2023

There is limited information about sociodemographic disparities in COVID-19 vaccine uptake among non-elderly adults with increased risk of severe COVID-19. We investigated the COVID-19 vaccine uptake in individuals aged 18 to 64 years with increased risk of severe COVID-19 (non-elderly risk group) in Stockholm County, Sweden. We used population-based health and sociodemographic registries with high coverage to perform a cohort study of COVID-19 vaccine uptake of one to four doses up until 21 November 2022. The vaccine uptake in the non-elderly risk group was compared with non-risk groups aged 18 to 64 years (non-elderly non-risk group) and individuals aged ≥65 years (elderly). The uptake of ≥3 vaccine doses was 55%, 64%, and 87% in the non-elderly non-risk group (n = 1,005,182), non-elderly risk group (n = 308,904), and elderly (n = 422,604), respectively. Among non-elderly risk group conditions, Down syndrome showed the strongest positive association with receiving three doses (adjusted risk ratio [aRR] 1. 62, 95% confidence interval [CI] 1. 54-1. 71), whereas chronic liver disease showed the strongest negative association (aRR 0. 90, 95% CI 0. 88-0. 92). Higher vaccine uptake among the non-elderly risk group was associated with increasing age, being born in Sweden, higher education, higher income, and living in a household where other adults had been vaccinated. Similar trends were observed for the first, second, third, and fourth dose. These results call for measures to tackle sociodemographic disparities in vaccination programmes during and beyond the COVID-19 pandemic. This article is protected by copyright. All rights reserved.

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