Did school characteristics affect the uptake of meningococcal quadrivalent vaccine in Greater Manchester, United Kingdom?

R. Fletcher*, E. Wilkinson, Paul Cleary, S. Blagden, S. Farmer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Objectives: The objective of this study was to assess if school characteristics were associated with the uptake of the meningococcal ACWY (MenACWY)vaccine in Greater Manchester in 2017/18. Study design: This is an ecological cross-sectional study. Methods: We analysed data on all 129 schools in seven local authorities in Greater Manchester from the Department for Education and from local child health information systems to determine whether school characteristics, including school type and Ofsted effectiveness score, were associated with vaccine uptake. Schools with no eligible pupils were excluded. We undertook single-variable and multivariable analysis and considered key interactions. Results: The overall uptake rate was 80.7%, with a median uptake per school of 80.6% (interquartile range, 69.0%–87.4%). Lower vaccination rates were associated with lower overall effectiveness scores (odds ratio [OR]: 3.54, 95% confidence interval [CI]: 3.00–4.19)and lower numbers of pupils eligible for vaccination (OR: 1.39, 95% CI: 1.28–1.51). Schools with a lower percentage of pupils for whom English is a second language and high deprivation were associated with lower uptake (OR: 1.58, 95% CI: 1.41–1.78). In addition, community schools (the schools with the most local authority oversight)had lower vaccination rates than other categories of schools. Conclusions: In this study, uptake rates of the MenACWY vaccine were associated with all five school characteristics considered. Effectiveness scores for schools had the largest association with vaccine uptake, with poorer schools having lower uptake. These characteristics should be used by vaccination providers to prioritise their interventions to increase immunisation rates.

Original languageEnglish
Pages (from-to)24-30
Number of pages7
JournalPublic Health
Publication statusPublished - Jun 2019

Bibliographical note

Funding Information:
This research was conducted through the Structured Operational Research and Training Initiative (SORT IT), a global partnership led by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization (WHO/TDR). The training model is based on a course developed jointly by the International Union Against Tuberculosis and Lung Disease (The Union) and Medécins sans Frontières (MSF). The specific SORT IT program which resulted in this publication was implemented by Public Health England North West and was undertaken as part of routine work. Mentorship and the coordination/facilitation of these SORT IT workshops were provided through the PHE North West, Centre for Operational Research, The Union, Paris, France; The Institute of Medicine, University of Chester, UK; and College of Life and Environmental Science, University of Exeter. Data collection was supported by David Holderness, NHS England (Greater Manchester).

Funding Information:
The SORT IT course that facilitated this research was funded by Public Health England North West . However, the research itself did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Publisher Copyright:
© 2019 The Royal Society for Public Health

Copyright 2019 Elsevier B.V., All rights reserved.


  • MenACWY
  • School health services
  • School-based vaccinations
  • Vaccination programmes


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