Childhood vaccination coverage by ethnicity within London between 2006/2007 and 2010/2011
Karen S Wagner1, Johan C J van Wijgerden, Nick Andrews
1Travel and Migrant Health Section, Public Health England, , London, UK.
Insights
Childhood vaccination coverage in London remains high for primary courses, but the preschool booster shows lower uptake. Specific ethnic groups and unregistered children require targeted interventions to improve immunization rates.
Area of Science:
- Public Health
- Pediatrics
- Immunization
Background:
- Childhood vaccination is crucial for preventing infectious diseases.
- Monitoring vaccine coverage by ethnicity is essential for identifying health disparities.
- Understanding factors influencing vaccine uptake is key to improving public health strategies.
Purpose of the Study:
- To evaluate childhood vaccination coverage at ages one, two, and five by ethnicity in London.
- To identify factors associated with lower vaccination rates in children.
- To inform targeted interventions for improving immunization equity.
Main Methods:
- Analysis of diphtheria-containing vaccine records from Child Health Information Systems (CHIS) for over 315,000 children.
- Assessment of vaccination coverage at first, second, and fifth birthdays.
- Examination of coverage across different ethnic groups and in relation to deprivation and GP registration.
Main Results:
- High coverage (>88%) for primary diphtheria-containing vaccine courses at first and second birthdays across major ethnic groups.
- Preschool booster coverage at age five exceeded 65% for the largest ethnic groups.
- Lower coverage observed in smaller ethnic groups and significantly lower in children not registered with a GP practice; deprivation was not a strong predictor.
Conclusions:
- Targeted strategies are needed for smaller ethnic groups to ensure full immunization.
- Unregistered children are at risk of being missed by current vaccination scheduling and require focused attention.
- Improved data collection, including country of birth alongside ethnicity, is necessary to monitor healthcare access and inequalities post-NHS reorganization.
Objectives:
To assess childhood vaccination coverage at first, second and fifth birthdays by ethnicity in London between 2006/2007 and 2010/2011 and identify factors relating to lower coverage.
Design:
Data concerning receipt of diphtheria-containing vaccines were extracted from child health information systems (CHISs) and sent to the Health Protection Agency.
Setting:
Nine London Primary Care Trusts (PCTs).
Participants:
Records for 315 381 children born April 2001-March 2010.
Main Outcome Measures:
Receipt of a full primary course of diphtheria-containing vaccines at first and second birthdays, and a primary course and preschool booster at fifth birthday.
Results:
Consistently good vaccine coverage of the primary course (>88% at first birthday, >89% at second birthday) was achieved across the five largest ethnic groups. Coverage of the preschool booster at fifth birthday was >65% across the five largest ethnic groups. Lowest coverage was observed in smaller ethnic groups. Deprivation was not a strong indicator of coverage overall, and for most ethnic groups there was no relationship between deprivation and coverage. Coverage was significantly lower in children not assigned to a general practitioner practice in the CHIS.
Conclusions:
Smaller, less well-established ethnic groups within a PCT may require specific targeting to ensure children are fully immunised and to improve record keeping. Unregistered children need particular attention and may be missed by current scheduling processes in London. In order to monitor the impact of the current National Health Service (NHS) reorganisation on inequalities in access to healthcare data on country of birth, in addition to ethnicity, should be available for analysis.
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