Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records
Objectives To quantify the effect of the COVID-19 pandemic on the timeliness of, and geographical and sociodemographic inequalities in, receipt of first measles, mumps and rubella (MMR) vaccination.Design Longitudinal study using primary care electronic health records.Setting 285 general practices i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/12/e066288.full |
| _version_ | 1797777719872716800 |
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| author | Carol Dezateux Kate Homer Nicola Firman John Robson Gill Harper Zaheer Ahmed Isabel Dostal Crystal Williams Ana Gutiérrez Milena Marszalek |
| author_facet | Carol Dezateux Kate Homer Nicola Firman John Robson Gill Harper Zaheer Ahmed Isabel Dostal Crystal Williams Ana Gutiérrez Milena Marszalek |
| author_sort | Carol Dezateux |
| collection | DOAJ |
| description | Objectives To quantify the effect of the COVID-19 pandemic on the timeliness of, and geographical and sociodemographic inequalities in, receipt of first measles, mumps and rubella (MMR) vaccination.Design Longitudinal study using primary care electronic health records.Setting 285 general practices in North East London.Participants Children born between 23 August 2017 and 22 September 2018 (pre-pandemic cohort) or between 23 March 2019 and 1 May 2020 (pandemic cohort).Main outcome measure Receipt of timely MMR vaccination between 12 and 18 months of age.Methods We used logistic regression to estimate the ORs (95% CIs) of receipt of a timely vaccination adjusting for sex, deprivation, ethnic background and Clinical Commissioning Group. We plotted choropleth maps of the proportion receiving timely vaccinations.Results Timely MMR receipt fell by 4.0% (95% CI: 3.4% to 4.6%) from 79.2% (78.8% to 79.6%) to 75.2% (74.7% to 75.7%) in the pre-pandemic (n=33 226; 51.3% boys) and pandemic (n=32 446; 51.4%) cohorts, respectively. After adjustment, timely vaccination was less likely in the pandemic cohort (0.79; 0.76 to 0.82), children from black (0.70; 0.65 to 0.76), mixed/other (0.77; 0.72 to 0.82) or with missing (0.77; 0.74 to 0.81) ethnic background, and more likely in girls (1.07; 1.03 to 1.11) and those from South Asian backgrounds (1.39; 1.30 to 1.48). Children living in the least deprived areas were more likely to receive a timely MMR (2.09; 1.78 to 2.46) but there was no interaction between cohorts and deprivation (Wald statistic: 3.44; p=0.49). The proportion of neighbourhoods where less than 60% of children received timely vaccination increased from 7.5% to 12.7% during the pandemic.Conclusions The COVID-19 pandemic was associated with a significant fall in timely MMR receipt and increased geographical clustering of measles susceptibility in an area of historically low and inequitable MMR coverage. Immediate action is needed to avert measles outbreaks and support primary care to deliver timely and equitable vaccinations. |
| first_indexed | 2024-03-12T23:08:44Z |
| format | Article |
| id | doaj.art-8994cfe8eaad45cd831d5e8961b21659 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T23:08:44Z |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-8994cfe8eaad45cd831d5e8961b216592023-07-18T10:00:06ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-066288Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health recordsCarol Dezateux0Kate Homer1Nicola Firman2John Robson3Gill Harper4Zaheer Ahmed5Isabel Dostal6Crystal Williams7Ana Gutiérrez8Milena Marszalek9Wolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKObjectives To quantify the effect of the COVID-19 pandemic on the timeliness of, and geographical and sociodemographic inequalities in, receipt of first measles, mumps and rubella (MMR) vaccination.Design Longitudinal study using primary care electronic health records.Setting 285 general practices in North East London.Participants Children born between 23 August 2017 and 22 September 2018 (pre-pandemic cohort) or between 23 March 2019 and 1 May 2020 (pandemic cohort).Main outcome measure Receipt of timely MMR vaccination between 12 and 18 months of age.Methods We used logistic regression to estimate the ORs (95% CIs) of receipt of a timely vaccination adjusting for sex, deprivation, ethnic background and Clinical Commissioning Group. We plotted choropleth maps of the proportion receiving timely vaccinations.Results Timely MMR receipt fell by 4.0% (95% CI: 3.4% to 4.6%) from 79.2% (78.8% to 79.6%) to 75.2% (74.7% to 75.7%) in the pre-pandemic (n=33 226; 51.3% boys) and pandemic (n=32 446; 51.4%) cohorts, respectively. After adjustment, timely vaccination was less likely in the pandemic cohort (0.79; 0.76 to 0.82), children from black (0.70; 0.65 to 0.76), mixed/other (0.77; 0.72 to 0.82) or with missing (0.77; 0.74 to 0.81) ethnic background, and more likely in girls (1.07; 1.03 to 1.11) and those from South Asian backgrounds (1.39; 1.30 to 1.48). Children living in the least deprived areas were more likely to receive a timely MMR (2.09; 1.78 to 2.46) but there was no interaction between cohorts and deprivation (Wald statistic: 3.44; p=0.49). The proportion of neighbourhoods where less than 60% of children received timely vaccination increased from 7.5% to 12.7% during the pandemic.Conclusions The COVID-19 pandemic was associated with a significant fall in timely MMR receipt and increased geographical clustering of measles susceptibility in an area of historically low and inequitable MMR coverage. Immediate action is needed to avert measles outbreaks and support primary care to deliver timely and equitable vaccinations.https://bmjopen.bmj.com/content/12/12/e066288.full |
| spellingShingle | Carol Dezateux Kate Homer Nicola Firman John Robson Gill Harper Zaheer Ahmed Isabel Dostal Crystal Williams Ana Gutiérrez Milena Marszalek Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records BMJ Open |
| title | Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records |
| title_full | Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records |
| title_fullStr | Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records |
| title_full_unstemmed | Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records |
| title_short | Impact of the COVID-19 pandemic on timeliness and equity of measles, mumps and rubella vaccinations in North East London: a longitudinal study using electronic health records |
| title_sort | impact of the covid 19 pandemic on timeliness and equity of measles mumps and rubella vaccinations in north east london a longitudinal study using electronic health records |
| url | https://bmjopen.bmj.com/content/12/12/e066288.full |
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