Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012–2018

Joanne Lacy; Elise Tessier; Nick Andrews; Joanne White; Mary Ramsay; Michael Edelstein

doi:10.1016/j.vaccine.2021.12.011

Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012–2018

Joanne Lacy^*
, Elise Tessier
, Nick Andrews
, Joanne White
, Mary Ramsay
, Michael Edelstein

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Background: Vaccination coverage of dose two of MMR (MMR2) at 5th birthday has been consistently low in London and measured 76.3% in 2018/19. Since the early 2000s seven boroughs in London started offering dose two earlier, from 15 to 18 months onwards instead of the recommended 3 years 4 months. In this study we investigate whether the accelerated schedule of MMR2 leads to a change in coverage of MMR2 and other childhood vaccines with an ecological study using childhood immunisation data from 2009 to 2018 in London.

Methods: We modelled coverage used generalized estimating equations (GEE) adjusted for year and DTaP/IPV/Hib3 coverage measured at 2nd birthday as a proxy for baseline local vaccination programme performance to determine the percentage point difference in coverage of MMR2 and other childhood vaccines.

Results: Average MMR2 coverage was higher among early implementing boroughs from 2012/13 onwards. Coverage difference was highest in 2017/18 (9.2 percentage points, 95% CI 4.8, 13.5, p < 0.001). On average over the 6 years, compared to London boroughs on the routine schedule, MMR2 coverage among early implementing boroughs was 3.3 percentage points higher (95% CI 1.3, 5.3, p = 0.01) after adjusting for DTaP/IPV/Hib3 coverage, IMD score and year.

Conclusion: Earlier vaccination of MMR2 is associated with significantly higher coverage at five years for this vaccine in London. Further research is needed to assess the association at a more granular level, but our findings underline a potential opportunity to increase MMR coverage.

Original language	English
Pages (from-to)	444-449
Number of pages	6
Journal	Vaccine
Volume	40
Issue number	3
Early online date	8 Jan 2022
DOIs	https://doi.org/10.1016/j.vaccine.2021.12.011
Publication status	Published - 24 Jan 2022

Bibliographical note

Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. As this study uses open, publicly available data, no ethical approval was required.

Open Access: No Open Access licence.

Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd. All rights reserved.

Citation: Lacy, Joanne, et al. "Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012–2018." Vaccine (2021).

DOI: https://doi.org/10.1016/j.vaccine.2021.12.011

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Immunisation
Immunisation schedule
Measles-Mumps-Rubella Vaccine
Vaccination coverage

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10.1016/j.vaccine.2021.12.011

Cite this

@article{388dd24f12814ab4abd3c6f7fa328cb0,

title = "Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012{\textendash}2018",

abstract = "Background: Vaccination coverage of dose two of MMR (MMR2) at 5th birthday has been consistently low in London and measured 76.3\% in 2018/19. Since the early 2000s seven boroughs in London started offering dose two earlier, from 15 to 18 months onwards instead of the recommended 3 years 4 months. In this study we investigate whether the accelerated schedule of MMR2 leads to a change in coverage of MMR2 and other childhood vaccines with an ecological study using childhood immunisation data from 2009 to 2018 in London. Methods: We modelled coverage used generalized estimating equations (GEE) adjusted for year and DTaP/IPV/Hib3 coverage measured at 2nd birthday as a proxy for baseline local vaccination programme performance to determine the percentage point difference in coverage of MMR2 and other childhood vaccines. Results: Average MMR2 coverage was higher among early implementing boroughs from 2012/13 onwards. Coverage difference was highest in 2017/18 (9.2 percentage points, 95\% CI 4.8, 13.5, p < 0.001). On average over the 6 years, compared to London boroughs on the routine schedule, MMR2 coverage among early implementing boroughs was 3.3 percentage points higher (95\% CI 1.3, 5.3, p = 0.01) after adjusting for DTaP/IPV/Hib3 coverage, IMD score and year. Conclusion: Earlier vaccination of MMR2 is associated with significantly higher coverage at five years for this vaccine in London. Further research is needed to assess the association at a more granular level, but our findings underline a potential opportunity to increase MMR coverage.",

keywords = "Immunisation, Immunisation schedule, Measles-Mumps-Rubella Vaccine, Vaccination coverage",

author = "Joanne Lacy and Elise Tessier and Nick Andrews and Joanne White and Mary Ramsay and Michael Edelstein",

note = "Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. As this study uses open, publicly available data, no ethical approval was required. Open Access: No Open Access licence. Publisher Copyright: Crown Copyright {\textcopyright} 2021 Published by Elsevier Ltd. All rights reserved. Citation: Lacy, Joanne, et al. {"}Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012{\textendash}2018.{"} Vaccine (2021). DOI: https://doi.org/10.1016/j.vaccine.2021.12.011",

year = "2022",

month = jan,

day = "24",

doi = "10.1016/j.vaccine.2021.12.011",

language = "English",

volume = "40",

pages = "444--449",

journal = "Vaccine",

issn = "0264-410X",

publisher = "Elsevier Ltd.",

number = "3",

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T1 - Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage

T2 - An ecological study among London children, 2012–2018

AU - Lacy, Joanne

AU - Tessier, Elise

AU - Andrews, Nick

AU - White, Joanne

AU - Ramsay, Mary

AU - Edelstein, Michael

N1 - Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. As this study uses open, publicly available data, no ethical approval was required. Open Access: No Open Access licence. Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd. All rights reserved. Citation: Lacy, Joanne, et al. "Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012–2018." Vaccine (2021). DOI: https://doi.org/10.1016/j.vaccine.2021.12.011

PY - 2022/1/24

Y1 - 2022/1/24

N2 - Background: Vaccination coverage of dose two of MMR (MMR2) at 5th birthday has been consistently low in London and measured 76.3% in 2018/19. Since the early 2000s seven boroughs in London started offering dose two earlier, from 15 to 18 months onwards instead of the recommended 3 years 4 months. In this study we investigate whether the accelerated schedule of MMR2 leads to a change in coverage of MMR2 and other childhood vaccines with an ecological study using childhood immunisation data from 2009 to 2018 in London. Methods: We modelled coverage used generalized estimating equations (GEE) adjusted for year and DTaP/IPV/Hib3 coverage measured at 2nd birthday as a proxy for baseline local vaccination programme performance to determine the percentage point difference in coverage of MMR2 and other childhood vaccines. Results: Average MMR2 coverage was higher among early implementing boroughs from 2012/13 onwards. Coverage difference was highest in 2017/18 (9.2 percentage points, 95% CI 4.8, 13.5, p < 0.001). On average over the 6 years, compared to London boroughs on the routine schedule, MMR2 coverage among early implementing boroughs was 3.3 percentage points higher (95% CI 1.3, 5.3, p = 0.01) after adjusting for DTaP/IPV/Hib3 coverage, IMD score and year. Conclusion: Earlier vaccination of MMR2 is associated with significantly higher coverage at five years for this vaccine in London. Further research is needed to assess the association at a more granular level, but our findings underline a potential opportunity to increase MMR coverage.

AB - Background: Vaccination coverage of dose two of MMR (MMR2) at 5th birthday has been consistently low in London and measured 76.3% in 2018/19. Since the early 2000s seven boroughs in London started offering dose two earlier, from 15 to 18 months onwards instead of the recommended 3 years 4 months. In this study we investigate whether the accelerated schedule of MMR2 leads to a change in coverage of MMR2 and other childhood vaccines with an ecological study using childhood immunisation data from 2009 to 2018 in London. Methods: We modelled coverage used generalized estimating equations (GEE) adjusted for year and DTaP/IPV/Hib3 coverage measured at 2nd birthday as a proxy for baseline local vaccination programme performance to determine the percentage point difference in coverage of MMR2 and other childhood vaccines. Results: Average MMR2 coverage was higher among early implementing boroughs from 2012/13 onwards. Coverage difference was highest in 2017/18 (9.2 percentage points, 95% CI 4.8, 13.5, p < 0.001). On average over the 6 years, compared to London boroughs on the routine schedule, MMR2 coverage among early implementing boroughs was 3.3 percentage points higher (95% CI 1.3, 5.3, p = 0.01) after adjusting for DTaP/IPV/Hib3 coverage, IMD score and year. Conclusion: Earlier vaccination of MMR2 is associated with significantly higher coverage at five years for this vaccine in London. Further research is needed to assess the association at a more granular level, but our findings underline a potential opportunity to increase MMR coverage.

KW - Immunisation

KW - Immunisation schedule

KW - Measles-Mumps-Rubella Vaccine

KW - Vaccination coverage

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U2 - 10.1016/j.vaccine.2021.12.011

DO - 10.1016/j.vaccine.2021.12.011

M3 - Article

AN - SCOPUS:85121747274

SN - 0264-410X

VL - 40

SP - 444

EP - 449

JO - Vaccine

JF - Vaccine

IS - 3

ER -

Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012–2018

Abstract

Bibliographical note

UN SDGs

Keywords

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