Effect of socioeconomic deprivation on uptake of measles mumps and rubella vaccination in Liverpool UK over 16 years: a longitudinal ecological study.

Thursday, 24th of November 2016 Print

Epidemiol Infect. 2016 Apr;144(6):1201-11. doi: 10.1017/S0950268815002599. Epub 2015 Nov 6.

Effect of socioeconomic deprivation on uptake of measles mumps and rubella vaccination in Liverpool UK over 16 years: a longitudinal ecological study.

Hungerford D1 Macpherson P2 Farmer S3 Ghebrehewet S4 Seddon D5 Vivancos R6 Keenan A4.

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Suboptimal uptake of the measles mumps and rubella (MMR) vaccine by certain socioeconomic groups may have contributed to recent large measles outbreaks in the UK. We investigated whether socioeconomic deprivation was associated with MMR vaccine uptake over 16 years. Using immunization data for 72351 children born between 1995 and 2012 in Liverpool UK we examined trends in vaccination uptake. Generalized linear models were constructed to examine the relative effect of socioeconomic deprivation and year of birth on MMR uptake. Uptake of MMR1 by age 24 months ranged between 82·5% in 2003 [95% confidence interval (CI) 81·2-83·7] and 93·4% in 2012 (95% CI 92·7-94·2). Uptake of MMR2 by age 60 months ranged between 65·3% (95% CI 64·4-67·4) in 2006 and 90·3% (95% CI 89·4-91·2) in 2012. In analysis adjusted for year of birth and sex children in the most deprived communities were at significantly greater risk of not receiving MMR1 [risk ratio (RR) 1·70 95% CI 1·45-1·99] and MMR2 (RR 1·36 95% CI 1·22-1·52). Higher unemployment and lower household income were significantly associated with low uptake. Contrary to concerns about lower MMR uptake in affluent families over 16 years children from the most socioeconomically deprived communities have consistently had the lowest MMR uptake. Targeted catch-up campaigns and strategies to improve routine immunization uptake in deprived areas are needed to minimize the risk of future measles outbreaks.


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