Disparities in COVID-19 vaccine coverage and risk factors among individuals with disabilities

Vaccination is a crucial strategy in responding to infectious diseases. We investigated the COVID-19 vaccination coverage among people with disabilities compared to people without disabilities. We identified risk factors of under-vaccination and vulnerable subgroups.

To assess COVID-19 vaccination coverage in individuals with disabilities compared with individuals without disabilities and identify risk factors for under-vaccination.

This cross-sectional study analysed the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service (K-COV-N) cohort, which registered adults with disabilities in 2020 and age and sex-matched individuals without disabilities were included. Vaccination records from the rollout through March 31, 2022 were analysed. Multivariable ordinal logistic regression models were employed.

This study included 4,811,866 participants after exclusions. Within the same disability type, individuals with severe disabilities had higher non-vaccination rates than those with mild disabilities. Individuals with pulmonary, brain and cardiac disabilities exhibited higher age-standardized non-vaccination rates (16.7 %, 15.1 % and 12.5 %, respectively). individuals with disabilities were more likely to be under-vaccinated than those without disabilities, with an adjusted odds ratio (aOR) of 1.01 (95 % CI 1.01-1.02). Females consistently exhibited a higher likelihood of non-vaccination in all subgroups. The impact of age differed based on the disability subgroups. The likelihood of under-vaccination was low in employee-insured individuals.

Individuals with disabilities were less likely to receive COVID-19 vaccination compared with those without disabilities and variations were observed by disability types. Tailored strategies considering identified risk factors are required to ensure equal vaccination access for individuals with disabilities in future pandemics.