eprintid: 10144866
rev_number: 9
eprint_status: archive
userid: 699
dir: disk0/10/14/48/66
datestamp: 2022-03-10 13:23:02
lastmod: 2022-03-10 13:23:02
status_changed: 2022-03-10 13:23:02
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: McQuaid, Fiona
creators_name: Mulholland, Rachel
creators_name: Sangpang Rai, Yuma
creators_name: Agrawal, Utkarsh
creators_name: Bedford, Helen
creators_name: Cameron, J Claire
creators_name: Gibbons, Cheryl
creators_name: Roy, Partho
creators_name: Sheikh, Aziz
creators_name: Shi, Ting
creators_name: Simpson, Colin R
creators_name: Tait, Judith
creators_name: Tessier, Elise
creators_name: Turner, Steve
creators_name: Villacampa Ortega, Jaime
creators_name: White, Joanne
creators_name: Wood, Rachael
title: Uptake of infant and preschool immunisations in Scotland and England during the COVID-19 pandemic: An observational study of routinely collected data
ispublished: pub
divisions: UCL
divisions: G25
divisions: D13
divisions: B02
keywords: COVID-19, COVID-19 Vaccines, Child, Child, Preschool, Communicable Disease Control, Female, Humans, Immunization Programs, Infant, Male, Routinely Collected Health Data, SARS-CoV-2, Vaccination
note: © 2022 McQuaid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
abstract: BACKGROUND: In 2020, the SARS-CoV-2 (COVID-19) pandemic and lockdown control measures threatened to disrupt routine childhood immunisation programmes with early reports suggesting uptake would fall. In response, public health bodies in Scotland and England collected national data for childhood immunisations on a weekly or monthly basis to allow for rapid analysis of trends. The aim of this study was to use these data to assess the impact of different phases of the pandemic on infant and preschool immunisation uptake rates. METHODS AND FINDINGS: We conducted an observational study using routinely collected data for the year prior to the pandemic (2019) and immediately before (22 January to March 2020), during (23 March to 26 July), and after (27 July to 4 October) the first UK "lockdown". Data were obtained for Scotland from the Public Health Scotland "COVID19 wider impacts on the health care system" dashboard and for England from ImmForm. Five vaccinations delivered at different ages were evaluated; 3 doses of "6-in-1" diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccine (DTaP/IPV/Hib/HepB) and 2 doses of measles, mumps, and rubella (MMR) vaccine. This represented 439,754 invitations to be vaccinated in Scotland and 4.1 million for England. Uptake during the 2020 periods was compared to the previous year (2019) using binary logistic regression analysis. For Scotland, uptake within 4 weeks of a child becoming eligible by age was analysed along with geographical region and indices of deprivation. For Scotland and England, we assessed whether immunisations were up-to-date at approximately 6 months (all doses 6-in-1) and 16 to 18 months (first MMR) of age. We found that uptake within 4 weeks of eligibility in Scotland for all the 5 vaccines was higher during lockdown than in 2019. Differences ranged from 1.3% for first dose 6-in-1 vaccine (95.3 versus 94%, odds ratio [OR] compared to 2019 1.28, 95% confidence intervals [CIs] 1.18 to 1.39) to 14.3% for second MMR dose (66.1 versus 51.8%, OR compared to 2019 1.8, 95% CI 1.74 to 1.87). Significant increases in uptake were seen across all deprivation levels. In England, fewer children due to receive their immunisations during the lockdown period were up to date at 6 months (6-in-1) or 18 months (first dose MMR). The fall in percentage uptake ranged from 0.5% for first 6-in-1 (95.8 versus 96.3%, OR compared to 2019 0.89, 95% CI 0.86- to 0.91) to 2.1% for third 6-in-1 (86.6 versus 88.7%, OR compared to 2019 0.82, 95% CI 0.81 to 0.83). The use of routinely collected data used in this study was a limiting factor as detailed information on potential confounding factors were not available and we were unable to eliminate the possibility of seasonal trends in immunisation uptake. CONCLUSIONS: In this study, we observed that the national lockdown in Scotland was associated with an increase in timely childhood immunisation uptake; however, in England, uptake fell slightly. Reasons for the improved uptake in Scotland may include active measures taken to promote immunisation at local and national levels during this period and should be explored further. Promoting immunisation uptake and addressing potential vaccine hesitancy is particularly important given the ongoing pandemic and COVID-19 vaccination campaigns.
date: 2022
date_type: published
publisher: Public Library of Science (PLoS)
official_url: https://doi.org/10.1371/journal.pmed.1003916
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1943395
doi: 10.1371/journal.pmed.1003916
medium: Electronic-eCollection
pii: PMEDICINE-D-21-03163
lyricists_name: Bedford, Helen
lyricists_id: HEBED28
actors_name: Bedford, Helen
actors_id: HEBED28
actors_role: owner
funding_acknowledgements: MC_PC_19075 [Medical Research Council]
full_text_status: public
publication: PLoS Medicine
volume: 19
number: 2
article_number: e1003916
event_location: United States
citation:        McQuaid, Fiona;    Mulholland, Rachel;    Sangpang Rai, Yuma;    Agrawal, Utkarsh;    Bedford, Helen;    Cameron, J Claire;    Gibbons, Cheryl;                                         ... Wood, Rachael; + view all <#>        McQuaid, Fiona;  Mulholland, Rachel;  Sangpang Rai, Yuma;  Agrawal, Utkarsh;  Bedford, Helen;  Cameron, J Claire;  Gibbons, Cheryl;  Roy, Partho;  Sheikh, Aziz;  Shi, Ting;  Simpson, Colin R;  Tait, Judith;  Tessier, Elise;  Turner, Steve;  Villacampa Ortega, Jaime;  White, Joanne;  Wood, Rachael;   - view fewer <#>    (2022)    Uptake of infant and preschool immunisations in Scotland and England during the COVID-19 pandemic: An observational study of routinely collected data.                   PLoS Medicine , 19  (2)    , Article e1003916.  10.1371/journal.pmed.1003916 <https://doi.org/10.1371/journal.pmed.1003916>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10144866/3/Bedford_Uptake%20of%20infant%20and%20preschool%20immunisations%20in%20Scotland%20and%20England%20during%20the%20COVID-19%20pandemic_VoR.pdf