PONE-D-22-05078

Variation in English Covid booster uptake: Generalized Additive Model

PLOS ONE

Dear Dr. Dropkin,

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Harapan Harapan, MD, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: in the abstract results, what do you mean by 90% significance? Note - I think you use Bayesian techniques and therefore refer to 90% credibility intervals throughout. But I would stay away from making inference about "significance" within a Bayesian framework.

some sort of figure or flowchart might be useful to explain or diagram what middle super output areas versus upper tier local authorities are. An explanation within the text of what these mean (in terms of average population and area) also could be useful.

The other uses publicly available data about area-level variables on area-level vaccination. But some of the inferences are for an individual level. Distinguishing whether the author thinks of these as a proxxy for an individual level or if he is just studying area-level associations as an ecological association.

On that note, I personally would appreciate some connection to the existing literature on multilevel or neighborhood effects (examples similar but not limited to:

Diez-Roux A. Multilevel analysis in public health research. Annu Rev Public Health. 2000;21: 171–192.

Hegde ST, Wagner AL, Clarke PJ, Potter RC, Swanson RG, Boulton ML. Neighborhood Influence on Diphtheria-Tetanus-Pertussis Booster Vaccination. Public Health. 2019;167: 41–49. https://doi.org/10.1016/j.puhe.2018.11.009

I think the GAM is not the important part that I would emphasize in the title - maybe something like: COVID booster uptake in England: an ecological study

When did booster / 3rd dose vaccination start in England? Would be useful to include this in Intro or Methods.

I do appreciate the attention to detail in the methods. I think as is would be fine, but my recommendation would be to put much of what you have in the appendix along with your guide, and instead explain it in more vague terms which are not specific to the coding in R. Again - this coding is incredibly useful for people to replicate the results, but to me that would be more appropriate for the supplementary appendix.

I would stay away from using causal language like "effects" and instead use terms like association, or maybe even impact, since you have an observational study.

Subheadings in the discussion could be useful. It seems like you have one section related to relating the results to previous literature, one section related to explaining geographic variation with less comments - that could be helpful as an initial structure. As is it is hard to follow your thought process across paragraphs.

Reviewer #2: The author performed Generalized Additive Model analyses on the Covid vaccination data from the UK Government Coronavirus Dashboard. In general, the writing requires heavy improvement, where many technical errors (such as logical flows of the paragraph, captions of charts and tables, data presentation) could be found here and there. I have some recommendations to guide author in revising their manuscript.

SUPPLEMENTARY FILE

1. I could not find/access the supplementary or supporting files author stated in the manuscript. Probably making a special section about Data Availability at the end of the manuscript would help.

ABSTRACT

2. “Are there other relevant predictors?” So, what are other predictors? Please state in the last part of the abstract.

3. What is MSOA? All abbreviation should be defined first.

4. The “discussion” part fits better with “conclusions”

INTRODUCTION

5. “Vaccination uptake is highly dependent on age, gender, ethnicity, and deprivation, as is widely recognised 3 4 5 6 7 8 9” Are all the studies cited from UK? Or, are they from different countries? Readers may assume they are all from UK, I suggest author to breakdown each of the cited literatures.

6. “…in contrast with 41.1% in Liverpool and 67.4% in

Gloucestershire.” Where does this information come from? Please cite the literature.

7. Please define abbreviations: MSOA, UTLA, etc.

8. In the last paragraph, author is encouraged to elaborate as to why this approach is appropriate. Is it more robust in comparison with other approaches?

METHODS

9. “Data sources” and “Statistical method and models” should be under one section “Methods”

RESULTS

10. Table 1 has no border, and should be revised. Not sure what this value mean -15317.25 (0.953), I understand that author put it in the caption, but that is not enough. Furthermore, why author does not make it uniform, e.g. Dose 1, Dose 2, Dose 3 or 1st injection, 2nd injection, 3rd injection?

11. Before Table 1, the paragraph only consists of 1 sentence. I encourage the author to move more sentences into the paragraph. And this applies for every data presented (including the following charts or tables).

12. “….except for distance to pharmacy (p<0.01).” Where can I see the data? Supplementary file? Author should cite it in the text.

DISCUSSION

13. “…COVID-19 vaccine hesitant followed by the Pakistani/Bangladeshi group.” Provide citation please.

14. In the second paragraph of Discussion, consider to include these following studies.

# In a study performing willingness-to-pay analysis, flu vaccination is also among the positive predictors for COVID-19 vaccine acceptance. Citing: Sallam et al. Narra J 2022; 2(1): e74 – doi: 10.52225/narra.v2i1.74

# Side effects of COVID-19 vaccine become the major barrier for vaccination program in population from different countries. Citing: Rosiello et al. Narra J 2021; 1(3): e55- doi: 10.52225/narra.v1i3.55.

#Disinformation and certain religious narrative could discourage individuals to take COVID-19 vaccine. Citing: Hassan et al. Narra J 2021; 1(3): e 57 - doi: 10.52225/narra.v1i3.57

15. I don’t understand what is the author trying to convey in the fourth paragph of the Discussion.

16. This paragraph, “An ONS technical article…” Does author try to compare the method with previous study? I think this paragraph better fit in the introduction, rather than in discussion. Also, clarify the intention of putting this paragraph, because it seems author just arbitrarily put random paragraph in the Discussion.

17. Discussion needs a lot of re-arrangements to make it more readable and acceptable for publication. Other than re-arranging the paragraphs to optimize the logical flow, author is encourage to distinct the findings from previous studies and that of from present study, and followed by a clear comparison. At the present version, it’s very hard to get the comparative pictures of the studies.

18. Please provide limitation of the study at the end of discussion.

19. Please provide a section of “Conclusions”

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Reviewer #1: No

Reviewer #2: No

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Variation in COVID-19 booster uptake in England: an ecological study

PONE-D-22-05078R1

Dear Dr. Dropkin,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Harapan Harapan, MD, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The author adequately responded to my previous comments.

Reviewer #2: The author has responded to all my concerns. The revised version is satisfactory and can be accepted for publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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