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Trust and experiences of National Health Service healthcare do not fully explain demographic disparities in coronavirus vaccination uptake in the UK: a cross-sectional study

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article numbere053827
Pages (from-to)e053827
JournalBMJ Open
Issue number3
Accepted/In press2 Feb 2022
Published18 Mar 2022

Bibliographical note

Funding Information: Contributors DA, SM, BD and VM-H were jointly responsible for the design of the data collection instrument. DA planned, preregistered and executed the analysis presented here, and wrote this article together with SM, who has overall leadership of the project within which this research took place. Revisions of the article following peer review were implemented by DA, who is also responsible for the overall content as the guarantor. Funding This research was supported by the Economic and Social Research Council (ES/V 015494/1). Competing interests None declared. Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not required. Publisher Copyright: © 2022 Authors


King's Authors


OBJECTIVE: To test whether demographic variation in vaccine hesitancy can be explained by trust and healthcare experiences. DESIGN: Cross-sectional study. SETTING: Data collected online in April 2021. PARTICIPANTS: Data were collected from 4885 UK resident adults, of whom 3223 had received the invitation to be vaccinated against the novel coronavirus and could therefore be included in the study. 1629 included participants identified as female and 1594 as male. 234 identified as belonging to other than white ethnic groups, while 2967 identified as belonging to white ethnic groups. PRIMARY AND SECONDARY OUTCOME MEASURES: Uptake of coronavirus vaccination. RESULTS: Membership of an other than white ethnic group (adjusted OR (AOR)=0.53, 95% CI 0.35 to 0.84, p=0.005) and age (AOR=1.61, 95% CI 1.39 to 1.87, p<0.001 for a 1 SD change from the mean) were the only statistically significant demographic predictors of vaccine uptake. After controls for National Health Service (NHS) healthcare experiences and trust in government, scientists and medical professionals, the effect associated with membership of an other than white ethnic group appears more marginal (AOR=0.61, 95% CI 0.38 to 1.01, p=0.046), while the effect associated with age remains virtually unchanged. Exploratory analysis suggests that NHS healthcare experiences mediate 24% (95% CI 8% to 100%, p=0.024) of the association between ethnicity and uptake, while trust mediates 94% (95% CI 56% to 100%, p=0.001) of the association between NHS healthcare experiences and uptake. CONCLUSIONS: Members of other than white ethnic groups report inferior NHS healthcare experiences, potentially explaining their lower reported trust in government, scientists and medical professionals. However, this does not fully explain the ethnic gap in coronavirus vaccination uptake.

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