1. Is there an association between the coverage of immunisation boosters by the age of 5 and deprivation?: an ecological study
- Author
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Laila J. Tata, Catherine Pritchard, Ivan Browne, and Helena Sandford
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Population ,Ecological study ,Immunization, Secondary ,Diphtheria-Tetanus-acellular Pertussis Vaccines ,Rubella ,Measles ,complex mixtures ,Index of multiple deprivation ,medicine ,Humans ,education ,Children ,education.field_of_study ,Booster (rocketry) ,General Veterinary ,General Immunology and Microbiology ,Tetanus ,business.industry ,Diphtheria ,Public Health, Environmental and Occupational Health ,medicine.disease ,Drug Utilization ,Poliomyelitis ,Vaccination ,Infectious Diseases ,Immunisation ,Socioeconomic Factors ,England ,Child, Preschool ,Molecular Medicine ,Female ,business ,Measles-Mumps-Rubella Vaccine - Abstract
Objective To determine whether there was an association between the coverage of booster immunisation of Diphtheria, Tetanus, acellular Pertussis and Polio (DTaP/IPV) and second Measles, Mumps and Rubella (MMR) dose by age 5 in accordance with the English national immunisation schedule by area-level socioeconomic deprivation and whether this changed between 2007/08 and 2010/11. Design Ecological study. Data Routinely collected national Cover of Vaccination Evaluated Rapidly data on immunisation coverage for DTaP/IPV booster and second MMR dose by age 5 and the Index of Multiple Deprivation (IMD). Setting Primary Care Trust (PCT) areas in England between 2007/08 and 2010/11. Outcome Measures Population coverage (%) of DTaP/IPV booster and second MMR immunisation by age 5. Results Over the 4 years among the 9,457,600 children there was an increase in the mean proportion of children being immunised for DTaP/IPV booster and second MMR across England, increasing from 79% (standard deviation (SD12%)) to 86% (SD8%) for DTaP/IPV and 75% (SD10%) to 84% (SD6%) for second MMR between 2007/08 and 2010/11. In 2007/08 the area with lowest DTaP/IPV booster coverage was 31% compared to 54.4% in 2010/11 and for the second MMR in 2007/08 was 39% compared to 64.8% in 2010/11. A weak negative correlation was observed between average IMD score and immunisation coverage for the DTaP/IPV booster which reduced but remained statistically significant over the study period ( r = −0.298, p r = −0.179, p = 0.028 in 2010/11). This was similar for the second MMR in 2007/08 ( r = −0.225, p = 0.008) and 2008/09 ( r = −0.216, p = 0.008) but there was no statistically significant correlation in 2009/10 ( r = −0.108, p = 0.186) or 2010/11 ( r = −0.078, p = 0.343). Conclusion Lower immunisation coverage of DTaP/IPV booster and second MMR dose was associated with higher area-level socioeconomic deprivation, although this inequality reduced between 2007/08 and 2010/11 as proportions of children being immunised increased at PCT level, particularly for the most deprived areas. However, coverage is still below the World Health Organisation recommended 95% threshold for Europe.
- Published
- 2015