Usher Institute

All-UK study reveals impact of missed Covid vaccines

The first research study of the entire UK population of 67 million people has highlighted gaps in Covid-19 vaccine coverage.

A young black woman wearing a protective face mask sits in a clinic as her male doctor of Asian descent prepares her vaccine

Between a third and a half of the populations of the four UK nations did not have the recommended number of Covid vaccinations and boosters by summer 2022.

Findings suggest that more than 7,000 hospitalisations and deaths might have been averted in summer 2022 if the UK had had better vaccine coverage.

With Covid-19 cases on the rise and a new variant strain recently identified, the research provides a timely insight into vaccine uptake and hesitancy and could inform policy-makers, experts say.

Large-scale data

The findings – led by the University of Edinburgh and Health Data Research UK (HDR UK) – relied on secure access to anonymised health data for everyone in all four nations of the UK, an advance which has only become possible during the pandemic. 

The researchers say that this approach could be extended to many other areas of medicine with great potential for new discoveries in the understanding and treatment of disease.

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.

Professor Sir Aziz SheikhDirector of the Usher Institute at the University of Edinburgh, HDR UK Research Director and study co-lead

Vaccination rates

Early Covid-19 vaccine rollout began strongly in the UK, with more than 90 per cent of the population over the age of 12 vaccinated with at least one dose by January 2022. However, rates of subsequent booster doses across the UK were not fully understood until now.

Scientists from England, Scotland, Northern Ireland and Wales studied securely-held, routinely collected NHS data from everyone over 5 years of age during 1 June to 30 September 2022. All data was de-identified and available only to approved researchers.

Thanks to advances in data collection, for the first time data from the four countries was then pooled and harmonised – made more uniform. People were grouped by vaccine status, with under-vaccination defined as not having had all doses of a vaccine for which that person was eligible.

The findings reveal that the proportion of people who were under-vaccinated on 1 June 2022 ranged between one third and one half of the population – 45.7% for England, 49.8% for Northern Ireland, 34.2% for Scotland and 32.8% Wales.

Severe outcomes

Mathematical modelling indicated that 7,180 hospitalisations and deaths out of around 40,400 severe Covid-19 outcomes during four months in summer 2022 might have been averted if the UK population was fully vaccinated.

Under-vaccination was related to significantly more hospitalisations and deaths across all age groups studied, with under-vaccinated people over 75 more than twice as likely to have a severe Covid-19 outcome than those who were fully protected.

The highest rates of under-vaccination were found in younger people, men, people in areas of higher deprivation, and people of non-white ethnicity.

New era

Researchers say the study – the largest ever study carried out in the UK – also ushers in a new era for UK science by overcoming challenges in uniting NHS data that is gathered and stored in different ways between devolved nations.

The 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.

Professor Cathie SudlowChief Scientist at Health Data Research UK and Director of the British Heart Foundation (BHF) Data Science Centre

The study – named COALESCE – was set up to provide UK and devolved governments with data-driven insights into Covid-19 vaccination coverage and establish data pooling methods and infrastructure to pave the way for future UK-wide studies.

It is led by HDR UK and the University of Edinburgh, in collaboration with research teams from across the four nations.

Related links

Read the paper in The Lancet

Read the plain English summary of the findings


Image credit: Fly View Productions via Getty Images