Those who are unvaccinated are more likely to be male, live in urban areas with high deprivation or to have more than three pre-existing medical conditions, experts say.

By highlighting factors that predict whether someone is unvaccinated, scientists believe the findings could help create more targeted national vaccination strategies.

Identifying who is unvaccinated is challenging because it is based on GP records that may be out of date due to lags in recording those who, for example, have migrated out of the country or have died. Estimates suggest that the number of people with GP records is eight per cent higher than the current Scottish population.

To produce a more accurate picture a team from the University of Edinburgh and Public Health Scotland performed a detailed analysis of GP records as part of the EAVE II project, which links anonymised patient data to track the pandemic and the vaccine roll out in real time.

To account for people who no longer lived in Scotland, the team excluded those without any Covid-19 vaccination record who had not interacted with the NHS in any way since 1 January 2019.

They also excluded records for people who had died prior to the start of the vaccination programme, those who had recorded as having left Scotland and those under the age of 18.

This left 573,289 people in Scotland with no Covid-19 vaccination record. When adjusted for the number of people listed as not receiving a jab for clinical reasons and deaths since the start of the vaccination programme, the figure of unvaccinated people living in Scotland was 494,288.

The average age of unvaccinated people was 42 years old. Some 29 per cent of all unvaccinated adults lived in the most deprived areas in Scotland.

The majority (60.5 per cent) of unvaccinated people had no pre-existing medical conditions; however, 11.2 per cent had three or more conditions, compared with 12.5 per cent of the vaccinated.

Three of the most common pre-existing conditions in unvaccinated people were chronic respiratory disease, depression and high blood pressure.

The results are published as a research letter in The Lancet. Research letters are externally peer-reviewed, and their findings are usually preliminary or exploratory.

Professor Sir Aziz Sheikh, Director of the University of Edinburgh’s Usher Institute and EAVE II study lead, said: “It is of concern to see that such a large portion of the adult Scottish population is still not vaccinated against Covid-19. Most worrying is that a large percentage of these people are from deprived backgrounds and have pre-existing medical conditions – factors that have been previously shown to be associated with worse outcomes for those with Covid-19.”

Dr Jim McMenamin, Head of Health Protection Infection Services at Public Health Scotland, said: “It’s important to remember that Covid-19 is still circulating within our communities and that there is a risk that individuals may become infected at some point with the virus.

“Vaccination is the most effective way of protecting yourself and others from severe Covid-19. This analysis of health service data provides a clear indication of those who could still benefit from the increased protection it offers.  It’s not too late to come forward for all your recommended Covid-19 vaccinations and we are encouraging those who have not already done so to take the opportunity.”

The study was funded by the Medical Research Council, UK Research and Innovation Industrial Strategy Challenge Fund, the National Institute for Health Research and Health Data Research UK (HDR UK), and was supported by the Scottish Government.

Additional support was provided through the Scottish Government Director-General Health and Social Care, and the UKRI Covid-19 National Core Studies Data and Connectivity programme led by HDR UK.

More information on the coronavirus (Covid-19) vaccine: The coronavirus (Covid-19) vaccine | NHS inform