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.
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.
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伦敦东北部的共同 - 19日大流行对麻疹，腮腺炎和风疹疫苗的及时性的影响：使用电子健康记录的纵向研究。
DOI：
10.1136/bmjopen-2022-066288
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发表时间：
2022-12-01
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
量化新冠肺炎大流行对首次接种麻疹、腮腺炎和风疹疫苗的及时性以及地理和社会人口不平等的影响。利用初级保健电子健康记录进行纵向研究。285在伦敦东北部的一般做法。2017年8月23日至2018年9月22日之间出生的儿童(大流行前队列)或2019年3月23日至2020年5月1日之间出生的儿童(大流行队列)。在12至18个月龄期间及时接种MMR疫苗。我们用Logistic回归估计了及时接受疫苗接种的OR(95%的顺位)，调整了性别、剥夺、种族背景和临床调试组。我们绘制了及时接种疫苗的比例地图。在大流行前(n=33 226；男孩51.3%)和大流行(n=32 446；51.4%)队列中，及时收到的MMR分别从79.2%(78.8%至79.6%)和75.2%(74.7%至75.7%)下降了4.0%(95%可信区间：3.4%至4.6%)。调整后，大流行队列儿童(0.79；0.76至0.82)、黑人儿童(0.70；0.65至0.76)、混血/其他儿童(0.77；0.72至0.82)或失踪儿童(0.77；0.74至0.81)及时接种疫苗的可能性较低，而女孩(1.07；1.03至1.11)和南亚背景儿童(1.39；1.30至1.48)更有可能接种疫苗。生活在最贫困地区的儿童更有可能得到及时的MMR(2.09；1.78至2.46)，但队列与剥夺之间没有交互作用(Wald统计：3.44；p=0.49)。在大流行期间，不到60%的儿童及时接种疫苗的社区比例从7.5%增加到12.7%。新冠肺炎大流行与MMR及时接收量大幅下降以及麻疹易感性的地理聚集性增加有关，该地区的MMR覆盖率历来较低且不公平。需要立即采取行动，以避免麻疹暴发，并支持初级保健提供及时和公平的疫苗接种。
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. Longitudinal study using primary care electronic health records. 285 general practices in North East London. Children born between 23 August 2017 and 22 September 2018 (pre-pandemic cohort) or between 23 March 2019 and 1 May 2020 (pandemic cohort). Receipt of timely MMR vaccination between 12 and 18 months of age. 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. 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. 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.
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影响因子：
5.5
作者：
Jain R;Chopra A;Falézan C;Patel M;Dupas P
通讯作者：
Dupas P
影响因子：
11.8
作者：
Feldman, Amy G.;O'Leary, Sean T.;Danziger-Isakov, Lara
通讯作者：
Danziger-Isakov, Lara
影响因子：
5.5
作者：
Bielecki, K.;Kirolos, A.;Gorman, D. R.
通讯作者：
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影响因子：
5.5
作者：
Aizawa Y;Katsuta T;Sakiyama H;Tanaka-Taya K;Moriuchi H;Saitoh A
通讯作者：
Saitoh A
DOI：
10.1136/bmj-2021-067519
发表时间：
2022-01-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Kadambari S;Goldacre R;Morris E;Goldacre MJ;Pollard AJ
通讯作者：
Pollard AJ