Journal Article

Timeliness and equity of infant pertussis vaccination in wales: Analysis of the three dose primary course

Perry, Malorie, McGowan, Anne, Roberts, Richard, Cottrell, Simon

2020

Overview

•Small differences in vaccine uptake in the most and least deprived areas.•Significant inequalities in timeliness, widening for doses two and three.•Consideration is needed on interventions that will help improve timeliness.•Need for routine monitoring of timeliness and what influences delayed vaccination. Infants aged under one year are at the highest risk of severe complications or death from pertussis infection. Prompt vaccination with a three dose course at two, three and four months of age decreases the amount of time they are vulnerable following waning of maternal antibodies. In Wales, uptake of all three doses of the primary course of pertussis containing vaccine is high. However, timeliness and equity at a population level have not been previously reported. This analysis included 163,733 children born from 1st January 2013 to 31st December 2017. In this cohort 87.9% received the first dose of a pertussis containing vaccine by 12 weeks of age, 87.1% had received all three doses by 24 weeks of age, and 96.3% received three doses by 52 weeks of age. Differences in uptake between those living in the most deprived and least deprived quintiles of Lower Super Output Area (LSOA) were smaller than differences in timeliness, but statistically significant. In 2017 the difference in timely uptake between those living in the most and least deprived quintiles was 4%, 5% and 7% for doses one, two and three respectively. There was a difference of 10% in the proportion of infants receiving all three primary vaccinations on time between the most and least deprived quintile of LSOAs. Consideration is needed on interventions that will help improve timeliness such as enhanced follow up of defaulters, electronic communication between primary care data systems, enhanced health visitor intervention and opportunistic vaccination in those who fail to attend scheduled vaccination appointments. There is also the need for routine monitoring of timeliness and further research into what influences delayed vaccination.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Age / Allergy and Immunology / Antibodies / Child / children / Childrens health / Cohort Studies / Data systems / death / Health care / Health Equity / Humans / Immunisation / Immunization Schedule / Infant / Infants / maternal immunity / monitoring / Pertussis / Pertussis vaccine / Pertussis Vaccine - administration & dosage / Population / risk / Schedules / Socioeconomic factors / Statistical analysis / Vaccination / Vaccines / Wales / Whooping cough / Whooping Cough - prevention & control