{
  "abstract": "Objectives: To examine differences between foreign-born and Swedish-born individuals regarding four interrelated research questions, 2021–2022: (1) risk factors for hospital-registered COVID-19, (2) vaccination rates for COVID-19, (3) the association between vaccination and COVID-19 and (4) 30-day mortality following COVID-19.\n\nDesign: A total-population, register-based cohort study of adults in Sweden.\n\nParticipants: All foreign-born (n=1 676 516) and Swedish-born (n=6 037 151) individuals aged 20–87 years, residing in Sweden on 31 December 2019.\n\nOutcomes: Hospital-registered cases of COVID-19, vaccine rates of COVID-19 and the influence of vaccination on hospital-registered and 30-day mortality of COVID-19.\n\nMethods: HRs with 95% CIs for estimating differences between foreign-born and Swedish-born individuals regarding hospital-registered COVID-19 and mortality with or without COVID-19 vaccinations were estimated. Effect estimates were adjusted for age, sex, educational level, household size and occupation.\n\nResults: In working age (20–64 years), women had a higher risk of COVID-19 than men, both among foreign-born (adjusted HR: 1.13; 95% CI 1.10 to 1.16) and Swedish-born individuals (adjusted HR: 1.17; 95% CI 1.15 to 1.20). In crude models, increasing age was strongly associated with COVID-19 (HRs: 1.27–2.91); however, it diminished after adjustment (HRs: 1.07–1.48). Furthermore, elementary school only (adjusted HRs: 1.24–1.66), contact-intensive occupations (adjusted HRs: 1.11–1.97) and larger household size among foreign-born individuals (adjusted HR: 1.60; 95% CI 1.53 to 1.68) were associated with a higher risk of COVID-19 before taking vaccination into account. As of 31 December 2021, foreign-born individuals had substantially lower vaccination coverage (64.1%) than Swedish-born individuals (86.9%). After adjustment, vaccinated foreign-born individuals had a similar risk of hospital-registered COVID-19 as that of Swedish-born individuals. The 30-day mortality rate was generally low, with similar rates between foreign-born and Swedish-born individuals.\n\nConclusions: The difference in severe COVID-19 between foreign-born and Swedish-born individuals diminished after the vaccine rollout. Remaining risks were associated with low educational level, large household size and certain occupations, while 30-day mortality was similar between foreign-born and Swedish-born individuals.",
  "abstract_shown": true,
  "affiliations": [
    "Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden",
    "Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala Universitet, Uppsala, Sweden",
    "Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden",
    "Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Magnus Helgesson",
      "orcid": "0000-0002-7868-9712"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Martin Tondel",
      "orcid": "0000-0003-4469-2451"
    },
    {
      "affs": [
        3
      ],
      "name": "Tobias Nordquist"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Magnus Svartengren",
      "orcid": "0000-0002-8165-7236"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3dfbmv3v47sr9.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjopen-2026-118005",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723806/",
  "id": "3dfbmv3v47sr9",
  "issns": [
    "2044-6055",
    "2044-6055"
  ],
  "landing_url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-118005",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "1724"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "heading",
      "Public Health"
    ],
    [
      "openalex",
      "3306|Vaccine Coverage and Hesitancy"
    ]
  ],
  "openalex": "W7223850103",
  "pdf_url": null,
  "pmcid": "PMC13723806",
  "pmid": "42946353",
  "published": "2026-10-27",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/3dfbmv3v47sr9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:44Z",
      "native_id": "10.1136/bmjopen-2026-118005",
      "source": "crossref",
      "url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-118005"
    },
    {
      "first_seen": "2026-11-04T12:22:22Z",
      "native_id": "PMC13723806",
      "source": "pmc",
      "url": "https://doi.org/10.1136/bmjopen-2026-118005"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Public Health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Did the vaccination campaign in Sweden narrow the gap in hospital-registered COVID-19 cases between foreign-born and Swedish-born individuals? A register-based cohort study of adults",
  "title_text": "Did the vaccination campaign in Sweden narrow the gap in hospital-registered COVID-19 cases between foreign-born and Swedish-born individuals? A register-based cohort study of adults",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:33Z",
  "url": "https://research.draconitic.com/paper/3dfbmv3v47sr9",
  "venue": "BMJ Open",
  "versions": []
}