Effect of socioeconomic deprivation on uptake of measles, mumps and rubella vaccination in Liverpool, UK over 16 years: a longitudinal ecological study
Effect of socioeconomic deprivation on uptake of measles, mumps and rubella vaccination in Liverpool, UK over 16 years: a longitudinal ecological study
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DOI：
10.1017/s0950268815002599
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发表时间：
2016-04-01
影响因子：
4.2
通讯作者：
Keenan, A.
中科院分区：
文献类型：
--
作者：
Hungerford, D.;Macpherson, P.;Keenan, A.
某些社会经济群体对麻疹、腮腺炎和风疹（MMR）疫苗的次优吸收可能导致了英国最近的大规模麻疹疫情。我们调查了16年来社会经济贫困是否与MMR疫苗接种有关。我们使用1995年至2012年在英国利物浦出生的72351名儿童的免疫接种数据，研究了疫苗接种的趋势。广义线性模型被构建来检验社会经济剥夺和出生年份对MMR摄取的相对影响。2003年，24个月龄的MMR 1摄取率为825%[95%置信区间（CI）812-837]，2012年为934%（95% CI 927-942）。2006年，60个月龄的MMR 2摄取率为653%（95% CI 644-674），2012年为903%（95% CI 894-912）。在调整出生年份和性别的分析中，最贫困社区的儿童未接受MMR 1 [风险比（RR）170，95%CI 145-199]和MMR 2（RR 136，95%CI 122-152）的风险显著更高。高失业率和低家庭收入与低吸收率显著相关。与富裕家庭的产妇死亡率较低的担忧相反，16年来，来自社会经济最贫困社区的儿童的产妇死亡率一直最低。需要开展有针对性的追赶运动和战略，以提高贫困地区的常规免疫接种率，从而最大限度地降低今后麻疹爆发的风险。
Suboptimal uptake of the measles, mumps and rubella (MMR) vaccine by certain socioeconomic groups may have contributed to recent large measles outbreaks in the UK. We investigated whether socioeconomic deprivation was associated with MMR vaccine uptake over 16 years. Using immunization data for 72 351 children born between 1995 and 2012 in Liverpool, UK, we examined trends in vaccination uptake. Generalized linear models were constructed to examine the relative effect of socioeconomic deprivation and year of birth on MMR uptake. Uptake of MMR1 by age 24 months ranged between 825% in 2003 [95% confidence interval (CI) 812-837] and 934% in 2012 (95% CI 927-942). Uptake of MMR2 by age 60 months ranged between 653% (95% CI 644-674) in 2006 and 903% (95% CI 894-912) in 2012. In analysis adjusted for year of birth and sex, children in the most deprived communities were at significantly greater risk of not receiving MMR1 [risk ratio (RR) 170, 95% CI 145-199] and MMR2 (RR 136, 95% CI 122-152). Higher unemployment and lower household income were significantly associated with low uptake. Contrary to concerns about lower MMR uptake in affluent families, over 16 years, children from the most socioeconomically deprived communities have consistently had the lowest MMR uptake. Targeted catch-up campaigns and strategies to improve routine immunization uptake in deprived areas are needed to minimize the risk of future measles outbreaks.