COVID-19 vaccination rates among adolescents (12-17 years) by immigrant background and sociodemographic factors: A nationwide registry study in Norway

Sociodemographic determinants of COVID-19 vaccination in adolescents in Stockholm, Sweden

INTRODUCTION

Limited data exists on sociodemographic differences in vaccination coverage against COVID-19 among adolescents. This study investigated the association of sociodemographic factors and vaccination coverage of adolescents aged 12 to 17 years over the period of the general vaccination recommendation in Stockholm County, Sweden.

METHOD

We conducted a population-based retrospective cross-sectional study of vaccine uptake of at least one dose of a COVID-19 vaccine up until 31 October 2022. We analysed vaccination coverage by sex, age group, underlying medical conditions, household socioeconomic factors, and vaccination status among adults in the household, using stratified analyses and multivariable modified Poisson regression models.

RESULTS

The study cohort consisted of 166,634 adolescents out of which 70.3 % (n = 117,185) received at least one dose of a COVID-19 vaccine. In the fully adjusted model, the strongest predictor for not being vaccinated was if all adults in the household were unvaccinated (adjusted relative risk, aRR, 0.11, 95 % CI 0.10-0.12). Lower household education level and having both parents born outside Sweden were similarly negatively associated with vaccination coverage among adolescents. No association was observed between vaccination coverage and being an adolescent with an underlying medical condition (aRR 1.00, 95 % CI 0.99-1.02).

CONCLUSION

Our results emphasise the necessity to address sociodemographic disparities and to engage adolescents at risk through targeted measures with particular emphasis in low-vaccination households in addition to households with lower education and non-Swedish origins in future vaccination program strategies.

COVID-19 vaccine uptake among children and adolescents in Norway: A comprehensive registry-based cohort study of over 800,000 individuals

Factors related with COVID-19 vaccine uptake in children and adolescents in Norway remain unclear, despite this being useful knowledge for future pandemic preparedness. This study aimed to comprehensively examine individual and familial factors associated with vaccine uptake in children and adolescents in Norway. We utilized nationwide registry-data from various health registries and Statistics Norway, encompassing all children and adolescents living in Norway during the pandemic, until 31-Dec-2022. Vaccine uptake is defined as receiving at least one dose of COVID-19 vaccine. We employed a forward stepwise logistic regression model and a random forest machine-learning algorithm to explore the relationship between vaccine uptake and socio-cultural, demographic, and health-related factors. We included 423,548 5-11-year-olds, 269,830 12-15-year-olds, and 120,854 16-17-year-olds. Vaccine uptake in these three groups was respectively 2.6 %, 73.3 %, and 87.3 %. Factors associated with vaccine uptake varied by age group. In youngest children, immigrant background (Odds-ratio (OR) = 1.58, 95 % confidence interval (CI) (1.14-2.19)), born extremely preterm (OR = 2.38, 95 % CI (1.60-3.54)), having risk of severe COVID-19 (OR = 5.40, 95 % CI (4.69-6.23) and maternal COVID-19 vaccination (OR = 6.34, 95 % CI (5.35-7.53)) were positively associated with vaccine uptake. The latter two factors were also strongly, positively associated with vaccine uptake in 12-15-year-olds, while previous SARS-CoV-2 infection was negatively associated (OR = 0.12, 95 % CI (0.11-0.14). Similar findings were observed in 16-17-year-olds. COVID-19 vaccine uptake differed markedly by age group, and major associated factors included socio-demographics and parental COVID-19 vaccination status, prior SARS-CoV-2 infection, but also being born premature and having moderate or high risk of severe COVID-19.