Child poverty and declining measles, mumps and rubella (MMR) vaccination in England, 2015 to 2024. A longitudinal ecological study at local area level

To assess the contribution of changing child poverty rates to trends in measles, mumps and rubella (MMR) vaccination.

Longitudinal area-level analysis using within-between models to assess the association of increases in child poverty within-areas on MMR vaccination.

148 upper-tier local authorities in England from 2015 and 2024.

Children aged 5 years or younger eligible for MMR vaccination in England between 2015 and 2024. 6,468,620 children aged 24 months were included in the study and 6,907,640 aged 5 years.

Child poverty rates for each upper-tier local authority, measured as the percentage of children aged 0 to 15 living in households below 60% of Organisation for Economic Co-operation and Development (OECD) median, before housing costs.

MMR 1^st and 2^nd dose uptake rates by 24 months 5 years of age respectively, at upper-tier local authority.

Over the study period, MMR 1^st dose fell by 4.0 percentage-points (%) (range: -20.8 to 7.7) and MMR 2^nd dose by 4.9% (range: -23.4 to 10.1) while child poverty rose by 5.6% (range: 0.2 to 13.9) on average. A 1 percentage-point (%) increase in child poverty was associated with a 0.17% [95%CI: -0.29; -0.06] fall in MMR 1^st dose rates and a 0.26% [95%CI: -0.42; -0.10] fall in MMR 2^nd dose rates.

Rising child poverty rates have contributed to a decrease in MMR vaccination in children in England. Action to reduce child poverty is needed to improve childhood vaccination uptake alongside policies and interventions specific to vaccination and infectious disease prevention.