Background The programme to vaccinate adults in England has been rapidly implemented
since it began in December 2020. The community prevalence of SARS-CoV-2 anti-spike
protein antibodies provides an estimate of total cumulative response to natural infection and
vaccination. We describe the distribution of SARS-CoV-2 IgG antibodies in adults in
England in May 2021 at a time when approximately 7 in 10 adults had received at least one
dose of vaccine.
Methods Sixth round of REACT-2 (REal-time Assessment of Community Transmission-2),
a cross-sectional random community survey of adults in England, from 12 to 25 May 2021;
207,337 participants completed questionnaires and self-administered a lateral flow
immunoassay test producing a positive or negative result.
Results Vaccine coverage with one or more doses, weighted to the adult population in
England, was 72.9% (95% confidence interval 72.7-73.0), varying by age from 25.1% (24.5-
25.6) of those aged 18 to 24 years, to 99.2% (99.1-99.3) of those 75 years and older. In
adjusted models, odds of vaccination were lower in men (odds ratio [OR] 0.89 [0.85-0.94])
than women, and in people of Black (0.41 [0.34-0.49]) compared to white ethnicity. There
was higher vaccine coverage in the least deprived and highest income households. People
who reported a history of COVID-19 were less likely to be vaccinated (OR 0.61 [0.55-0.67]).
There was high coverage among health workers (OR 9.84 [8.79-11.02] and care workers (OR
4.17 [3.20-5.43]) compared to non-key workers, but lower in hospitality and retail workers
(OR 0.73 [0.64-0.82] and 0.77 [0.70-0.85] respectively) after adjusting for age and key
covariates
