

Back in July of this year, we discussed with members of the ‘One Wales’ group the collaborative approach aiding understanding of vaccine uptake and safety in wales in the over 80s. The group has now examined vaccination inequities in the over 50s amongst ethnic minorities and in areas of deprivation.
The One Wales team is comprised of multidisciplinary groups of experts from Swansea University’s Population Data Science, Public Health Wales, NHS Wales, Digital Health and Care Wales, Welsh Government, HDR UK, ADR Wales and others.
In the group’s latest open-access publication, published in the journal Vaccine, lead author and epidemiologist, Malorie Perry, evaluated vaccination coverage across Wales to investigate for potential inequalities. They discovered that vaccination coverage is lower in more deprived areas and among ethnic minority groups.

All analyses were completed using SAIL Databank; a Trusted Research Environment (TRE) hosted by Swansea University, and performed as part of the UKRI funded Con-COV project; Controlling COVID-19 through enhanced population surveillance and intervention.
To overcome the problem of missing ethnicity data within Electronic Health Records (EHRs) the team used multiple data sources including Office for National Statistics (ONS) census data, available within the SAIL Databank, to perform data linkage and enable a population-scale analysis of vaccination inequalities.
The group’s findings are of particular importance given that more severe outcomes from COVID-19 disease have been seen in Black, Asian and Ethnic Minority (BAME) groups as well as in those living in deprived areas.
It’s hoped that these findings will lead to enhanced routine surveillance and targeted interventions that could include direct letters and telephone calls, and wider community engagement to mitigate inequalities. The authors advocate further research to ascertain whether the root-causes may be inequities in service provision or other factors.
Senior Epidemiologist at Public Health Wales and PhD student at Swansea University, Malorie Perry, who led the research, said,
“Prior to undertaking this work we were aware of potential inequalities in vaccination uptake in Wales but were not able to measure the extent of these differences. The opportunity to produce accurate coverage figures, particularly by ethnic group, and feed this information directly back to the service providers puts Wales in a unique position.”
“Exploring some of the multiple and complex factors associated with low coverage is particularly beneficial now uptake has started to level off and cases have been on the rise. Ensuring equitable access to vaccination and therefore protection against COVID-19 should be prioritised.”
Swansea University’s Senior Researcher and Data Scientist, Ashley Akbari, who developed the method to create a population ethnicity spine, said,
“Utilising the anonymised individual-level population-scale data sources from a range of health, administrative and other data sources allows researchers to evaluate and derive new knowledge that would not have been possible without the scale and linkage of data available in a trusted research environment such as the SAIL Databank.”
“The Wales ethnicity spine is an example of this type of new opportunity, which we have used in this novel output to investigate the links between vaccine uptake and inequalities. Our hope is to further develop the population ethnicity spine in the future, which is being used across multiple ongoing and planned research activities around vaccine uptake, and wider COVID-19 research questions. Working towards this, our adopted team science approach to research and intelligence is vital to ensure that questions are answered in a timely fashion and the available ranged of expertise is available.”
The full research publication is available here:
https://www.sciencedirect.com/science/article/pii/S0264410X21011981?via%3Dihub#b0090