Among older people in Sweden, vaccination against COVID-19 has shifted from a high and uniform level when the first vaccinations were provided to more uneven levels today. A national study shows both regional and socioeconomic differences.
The spring COVID-19 vaccination program in Sweden is in its final stages in several parts of the country. The program has encompassed free booster doses for those at increased risk of serious illness, including the very oldest members of society.
Parallel to this, research is being presented on the factors that have influenced COVID-19 vaccination uptake among older people both during and after the pandemic, up to the beginning of 2024. The study, published in the journal Public Health, encompasses more than two million individuals aged 65 and over.
Geography and socioeconomics
The results confirm the emergence of certain regional differences in vaccination uptake among older people in Sweden. When the vaccines were introduced in December 2020, 95 percent of older people were vaccinated, with no significant differences in uptake between regions in Sweden. This has, however, gradually changed.
The study periods for booster and seasonal doses exhibit a decreasing proportion of older people continuing to get vaccinated, especially in the counties of Skåne, Stockholm, and Västra Götaland and among those aged 65-80 years. The lowest figures in the study, less than 60 percent vaccinated, were for 65-80-year-olds in the three metropolitan counties, for complete vaccination with a sixth dose.
In addition to regional differences, factors other than geographical were also seen, and these had greater impact. Among men, people born outside Sweden, and people with low income and a low level of education, the proportion of vaccinated individuals was considerably lower. This is in line with previous studies, indicating that the differences remain despite the measures taken.
The differences need to be reduced
One possible explanation for the regional differences is considered to be shortcomings in national coordination and priorities. The researchers from the University of Gothenburg, Karolinska Institutet, and the Public Health Agency of Sweden believe that the results underline the importance of using targeted interventions to minimize regional variations.
Both regional and socioeconomic inequalities are described as threats to vaccination programs. The first author of the study is Yiyi Xu, Associate Professor of Occupational and Environmental Medicine at Sahlgrenska Academy, University of Gothenburg:
"Lower vaccination uptake increases vulnerability to severe COVID-19 and post-COVID, especially among older people. National coordination remains key to ensuring uniform vaccination coverage, and the focus should be on socioeconomically disadvantaged groups that consistently show lower uptake rates," she says.
"Linking COVID-19 vaccinations to routine health interventions, such as influenza vaccinations, could increase the COVID-19 vaccination uptake rate, reduce the barriers that seem to exist, and lower public health costs," Yiyi Xu concludes.
Study: Regional differences in COVID-19 vaccine uptake and their determinants among Swedish older adults
