COVID-19 Vaccination Uptake in Belgium : Sociodemographic and Socioeconomic Disparities

Summary

In January 2021, the vaccination campaign against coronavirus disease 2019 (COVID-19) started in Belgium. The vaccination campaign was conducted in several phases, with the first phase targeting priority groups starting in January 2021. The second phase began in June 2021 with the invitation of everyone aged 18 years and older before extending access to 12 years and older from summer 2021. Children aged 5-11 were also invited for vaccination from December 2021 onwards.

The presence of a social gradient in COVID-19 infections and subsequent outcomes has been clearly demonstrated. Individuals from lower socioeconomic groups, for example with lower income, lower education level or unemployed are more likely to be infected by the SARS-CoV-2 and to develop severe complications after the infection such as hospitalization, ICU admission or death. Certain sociodemographic characteristics such as male gender, older age, living in crowded households, or belonging to ethnic/racial minorities are also associated with a higher risk of COVID-19 infection and severe outcomes. In addition to disparities in infection, hospitalization and mortality, some studies have also documented a lower COVID-19 vaccination coverage among people from disadvantaged socioeconomic groups during COVID-19 pandemic.

Despite widespread vaccine promotion efforts and the fact that Belgium has the 7th highest full vaccine coverage in the European Union (89% of people over 18 years old had completed their primary course of vaccination on 08 April 2022), concerns regarding vaccine equity remain. Vaccine uptake depends on a range of factors, including the socio-cultural environment, pre-existing health needs and individual choice. Identifying differences in vaccination between population groups is crucial to assess the effectiveness of the vaccination strategy in Belgium and its relationship to the further spread of COVID-19.

The objective is to identify whether vaccination coverage has been equitable across Belgium and, if not, which groups of individuals are less likely to be covered by the COVID-19 vaccine, with respect to their sociodemographic (SD) and socioeconomic (SE) characteristics.

This study therefore aims to highlight SD and SE disparities in the uptake of the first dose of COVID-19 vaccine in Belgium among people of 18 years and over.

Conditions

• COVID-19

Interventions

OTHER

Education level

Educational level was classified using the International Standard Classification of Education (ISCED) : ISCED0 (less than primary education), ISCED1 (primary education), ISCED2 (lower secondary school), ISCED3 (upper secondary school), ISCED4 (post-secondary non tertiary education), ISCED5 (short-cycle tertiary education), ISCED6 (bachelor's or equivalent level), ISCED7 (master's or equivalent level), ISCED8 (doctoral or equivalent level). We merged these different categories into three main education level : low (ISCED0 to ISCED2), middle (ISCED3 to ISCED4) and high (ISCED5 to ISCED 8). This information is provided by STATBEL.

OTHER

Household net income

Income information is available as deciles of the net income of the whole household. This indicator is further categorized into low income (deciles 1 to 4), middle income (deciles 5 to 7), and high income (deciles 8 to 10). This information is provided by STATBEL.

OTHER

Gender

Male or female. This variable is obtained from the Belgian national registry.

OTHER

Migration background

Migration background is based on the first nationality and the parents' country of origin. This variable distinguishes between native-born individuals, second-generation migrants, first-generation European migrants, and first-generation non-European migrants. This information is provided by STATBEL.

OTHER

Household type

Household type provides a partial picture of the social environment and is distinguished between one person, couples, couples with children, single parents, other, collectivity (prison, nursing homes, religious community, etc.). This information is provided by STATBEL.

OTHER

Health literacy

Having a health care degree is used as a proxy for health literacy and is provided by CoBRHA. The scientific and medical background can lead to more preventive and responsible behaviors towards infectious diseases. Moreover, being a health professional can lead to the need to protect patients and themselves against infections, without necessarily having very advanced knowledge of infectious diseases and vaccines.

Sponsors & Collaborators

• Sciensano

  lead OTHER_GOV

Principal Investigators

• Lucy LC Catteau, PhD · Sciensano

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-12-28

Primary Completion

2021-08-31

Completion

2021-08-31

Countries

• Belgium

Study Locations