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Factors associated with influenza vaccine uptake during a universal vaccination programme of preschool children in England and Wales: a cohort study
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  1. Pia Hardelid1,2,
  2. Greta Rait3,
  3. Ruth Gilbert1,
  4. Irene Petersen2,4
  1. 1Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
  2. 2Research Department of Primary Care and Population Health, University College London, London, UK
  3. 3PRIMENT Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London, London, UK
  4. 4Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
  1. Correspondence to Dr Pia Hardelid, Population, Policy and Practice Programme, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; p.hardelid{at}ucl.ac.uk

Abstract

Introduction Influenza vaccination through primary care has been recommended for all preschool children in the UK since 2013 as part of a universal immunisation programme. Vaccination is required annually and effectiveness varies by season. Factors associated with influenza vaccine receipt and those for other childhood vaccines may therefore differ.

Methods We used The Health Improvement Network, a large primary care database, to create a cohort of children in England and Wales aged 2–4 years eligible for vaccination in the 2014/2015 season. Mixed-effects Poisson regression models were used to determine sociodemographic and clinical factors associated with influenza vaccine receipt, allowing for practice-level variation.

Results Overall, 38.7% (95% CI 38.3% to 39.1%) of 57 545 children were vaccinated against influenza. Children in the poorest deprivation quintile were 19% less likely to receive influenza vaccine than those in the wealthiest quintile (adjusted risk ratio (ARR) 0.81, 95% CI 0.77 to 0.86). Children who received a timely first dose of measles-mumps-rubella vaccine were twice as likely to receive influenza vaccine (ARR 2.00 95% CI 1.87 to 2.13). Being 4 years old, not in a clinical risk group, or living with 2 or more other children were also significantly associated with a lower probability of vaccination.

Discussion Children living in areas of higher deprivation and in larger families are less likely to receive influenza vaccine. Further research is required into whether interventions, such as offering vaccinations in other settings, could increase uptake in children, particularly in deprived areas.

  • VACCINATION
  • INFLUENZA
  • CHILD HEALTH
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Footnotes

  • Contributors PH and IP conceived the study with GR. PH extracted and analysed the data and drafted the manuscript. All authors critically reviewed the manuscript.

  • Funding PH is funded by a National Institute for Health Research Post Doctoral Fellowship (PDF-2013-06-004). This article represents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not those of the NHS, the NIHR or the Department of Health. RG and PH are members of the Farr Institute of Health Informatics Research London.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement THIN data were purchased from IMS Health (previously CSD Medical Research, see: http://www.epic-uk.org/) by UCL for use in public health research. The data are under license which prevents UCL from distributing the data to third parties. The data can be obtained by contacting IMS Health by phone at +44(0) 20 7388 8215 or email on hbhullar@uk.imshealth.com.

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