Inequality in Vaccine Uptake: Lessons Learned From Denmark Analyzing Real-World Data From National Registries
Author(s)
Rikke F. Hansen, MSc1, Mette Skovdal, MSc2, Katrine Dragsbæk Møller, PhD2, Anne Cathrine Falch-Jørgensen, PhD1.
1Real World Evidence, Signum Life Science, Copenhagen, Denmark, 2Pfizer Denmark Aps, Copenhagen, Denmark.
1Real World Evidence, Signum Life Science, Copenhagen, Denmark, 2Pfizer Denmark Aps, Copenhagen, Denmark.
OBJECTIVES: First, we compared the uptake of NIP vaccines with that of vaccines not included in the NIP (non-NIP) in Denmark from 2016 to 2022. Second, we aimed to assess sociodemographic and health-related determinants predisposing individuals to non-NIP vaccine uptake.
METHODS: This case-control study included 1,987,982 Danish individuals residing in Denmark between 2016 and 2022. Study participants were split into groups of children (aged 0-11), adolescents (aged 12-17), adults (aged 18-64) and older adults (aged 65 and older). Cases were collected at the time of vaccination and matched with controls on year of birth and sex. Data on sociodemographic and health-related factors were obtained from registers available at Statistics Denmark and at The Danish Health Data Authority. Associations were estimated by crude and adjusted multivariable logistic regression models.
RESULTS: Vaccination rates were 10-40 times higher for NIP vaccines compared to non-NIP vaccines. Among children and adolescents, socioeconomic factors including parental educational level (ORhigh,children: 5.02, 95% CI: 4.42-5.71) and parental income (OR4th, adolescents: 2.94, 95% CI: 2.73-3.17) were the main contributors to non-NIP vaccine uptake, whereas among adults, poor health in terms of chronic disease (ORadults: 2.38, 95% CI: 2.36, 2.40; ORolder adults: 2.17, 95% CI: 2.13-2.21) as well as high frequency of hospital visits were observed.
CONCLUSIONS: Non-NIP vaccine uptake is markedly lower than NIP vaccine uptake. Health and social inequality in non-NIP vaccine uptake exist across all age groups. Socioeconomic factors among children and adolescents are seemingly the prevailing contributing factors, whereas it is poor health status among adults.
METHODS: This case-control study included 1,987,982 Danish individuals residing in Denmark between 2016 and 2022. Study participants were split into groups of children (aged 0-11), adolescents (aged 12-17), adults (aged 18-64) and older adults (aged 65 and older). Cases were collected at the time of vaccination and matched with controls on year of birth and sex. Data on sociodemographic and health-related factors were obtained from registers available at Statistics Denmark and at The Danish Health Data Authority. Associations were estimated by crude and adjusted multivariable logistic regression models.
RESULTS: Vaccination rates were 10-40 times higher for NIP vaccines compared to non-NIP vaccines. Among children and adolescents, socioeconomic factors including parental educational level (ORhigh,children: 5.02, 95% CI: 4.42-5.71) and parental income (OR4th, adolescents: 2.94, 95% CI: 2.73-3.17) were the main contributors to non-NIP vaccine uptake, whereas among adults, poor health in terms of chronic disease (ORadults: 2.38, 95% CI: 2.36, 2.40; ORolder adults: 2.17, 95% CI: 2.13-2.21) as well as high frequency of hospital visits were observed.
CONCLUSIONS: Non-NIP vaccine uptake is markedly lower than NIP vaccine uptake. Health and social inequality in non-NIP vaccine uptake exist across all age groups. Socioeconomic factors among children and adolescents are seemingly the prevailing contributing factors, whereas it is poor health status among adults.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH147
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Vaccines