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Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination

Suzanne Walton, Mario Cortina-Borja, Carol Dezateux, Lucy Griffiths Orcid Logo, Karen Tingay, Ashley Akbari Orcid Logo, Amrita Bandyopadhyay, Ronan Lyons Orcid Logo, Richard Roberts, Helen Bedford

Vaccine, Volume: 40, Issue: 34, Pages: 5016 - 5022

Swansea University Authors: Lucy Griffiths Orcid Logo, Ashley Akbari Orcid Logo, Amrita Bandyopadhyay, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1016/j.vaccine.2022.06.080

Abstract

BackgroundDelayed primary vaccination is one of the strongest predictors of subsequent incomplete immunisation. Identifying children at risk of such delay may enable targeting of interventions, thus decreasing vaccine-preventable illness.ObjectivesTo explore socio-demographic factors associated with...

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Published in: Vaccine
ISSN: 0264-410X
Published: Elsevier BV 2022
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Identifying children at risk of such delay may enable targeting of interventions, thus decreasing vaccine-preventable illness.ObjectivesTo explore socio-demographic factors associated with delayed receipt of the Diphtheria, Tetanus and Pertussis (DTP) vaccine.MethodsWe included 1,782 children, born between 2000 and 2001, participating in the Millennium Cohort Study (MCS) and resident in Wales, whose parents gave consent for linkage to National Community Child Health Database records at the age seven years contact. We examined child, maternal, family and area characteristics associated with delayed receipt of the first dose of the DTP vaccine.Results98.6% received the first dose of DTP. The majority, 79.6% (n = 1,429) received it on time (between 8 and 12 weeks of age), 14.2% (n = 251) received it early (prior to 8 weeks of age) and 4.8% (n = 79) were delayed (after 12 weeks of age); 1.4% (n = 23) never received it. Delayed primary vaccination was more likely among children with older natural siblings (risk ratio 3.82, 95% confidence interval (1.97, 7.38)), children admitted to special/intensive care (3.15, (1.65, 5.99)), those whose birth weight was &gt; 4Kg (2.02, (1.09, 3.73)) and boys (1.53, (1.01, 2.31)). There was a reduced risk of delayed vaccination with increasing maternal age (0.73, (0.53, 1.00) per 5 year increase) and for babies born to graduate mothers (0.27, (0.08, 0.90)).ConclusionsAlthough the majority of infants were vaccinated in a timely manner, identification of infants at increased risk of early or delayed vaccination will enable targeting of interventions to facilitate timely immunisation. This is to our knowledge the first study exploring individual level socio-demographic factors associated with delayed primary vaccination in the UK and demonstrates the benefits of linking cohort data to routinely-collected child health data.</abstract><type>Journal Article</type><journal>Vaccine</journal><volume>40</volume><journalNumber>34</journalNumber><paginationStart>5016</paginationStart><paginationEnd>5022</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0264-410X</issnPrint><issnElectronic/><keywords>Vaccination; Timeliness; DTP vaccine; Child; Millennium Cohort Study (MCS); Child health systems</keywords><publishedDay>12</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-08-12</publishedDate><doi>10.1016/j.vaccine.2022.06.080</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was supported by the Wellcome Trust (grant number 087389/B/08/Z). LG, CD, RAL and AA are supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, National Institute for Health Research (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome. RAL is also funded by the Asthma UK Centre for Applied Research (AUKAC- 2012-01). KT was supported by an ESRC award establishing the Administrative Data Research Centre Wales (ES/L007444/1). AA, AB, LG and RAL are supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government&#x2019;s national strategy: Prosperity for All.</funders><projectreference/><lastEdited>2022-08-22T11:36:59.0306344</lastEdited><Created>2022-07-13T14:38:56.9887844</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Suzanne</firstname><surname>Walton</surname><order>1</order></author><author><firstname>Mario</firstname><surname>Cortina-Borja</surname><order>2</order></author><author><firstname>Carol</firstname><surname>Dezateux</surname><order>3</order></author><author><firstname>Lucy</firstname><surname>Griffiths</surname><orcid>0000-0001-9230-624X</orcid><order>4</order></author><author><firstname>Karen</firstname><surname>Tingay</surname><order>5</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>6</order></author><author><firstname>Amrita</firstname><surname>Bandyopadhyay</surname><orcid/><order>7</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>8</order></author><author><firstname>Richard</firstname><surname>Roberts</surname><order>9</order></author><author><firstname>Helen</firstname><surname>Bedford</surname><order>10</order></author></authors><documents><document><filename>60484__24984__9d0e804d1ea8436f87779ebf7d363b6a.pdf</filename><originalFilename>60484_VoR.pdf</originalFilename><uploaded>2022-08-22T11:35:08.0956070</uploaded><type>Output</type><contentLength>312865</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: 2022 The Authors. 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spelling 2022-08-22T11:36:59.0306344 v2 60484 2022-07-13 Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination e35ea6ea4b429e812ef204b048131d93 0000-0001-9230-624X Lucy Griffiths Lucy Griffiths true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 9f1e77f76a83746112ef45709bf83630 Amrita Bandyopadhyay Amrita Bandyopadhyay true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2022-07-13 HDAT BackgroundDelayed primary vaccination is one of the strongest predictors of subsequent incomplete immunisation. Identifying children at risk of such delay may enable targeting of interventions, thus decreasing vaccine-preventable illness.ObjectivesTo explore socio-demographic factors associated with delayed receipt of the Diphtheria, Tetanus and Pertussis (DTP) vaccine.MethodsWe included 1,782 children, born between 2000 and 2001, participating in the Millennium Cohort Study (MCS) and resident in Wales, whose parents gave consent for linkage to National Community Child Health Database records at the age seven years contact. We examined child, maternal, family and area characteristics associated with delayed receipt of the first dose of the DTP vaccine.Results98.6% received the first dose of DTP. The majority, 79.6% (n = 1,429) received it on time (between 8 and 12 weeks of age), 14.2% (n = 251) received it early (prior to 8 weeks of age) and 4.8% (n = 79) were delayed (after 12 weeks of age); 1.4% (n = 23) never received it. Delayed primary vaccination was more likely among children with older natural siblings (risk ratio 3.82, 95% confidence interval (1.97, 7.38)), children admitted to special/intensive care (3.15, (1.65, 5.99)), those whose birth weight was > 4Kg (2.02, (1.09, 3.73)) and boys (1.53, (1.01, 2.31)). There was a reduced risk of delayed vaccination with increasing maternal age (0.73, (0.53, 1.00) per 5 year increase) and for babies born to graduate mothers (0.27, (0.08, 0.90)).ConclusionsAlthough the majority of infants were vaccinated in a timely manner, identification of infants at increased risk of early or delayed vaccination will enable targeting of interventions to facilitate timely immunisation. This is to our knowledge the first study exploring individual level socio-demographic factors associated with delayed primary vaccination in the UK and demonstrates the benefits of linking cohort data to routinely-collected child health data. Journal Article Vaccine 40 34 5016 5022 Elsevier BV 0264-410X Vaccination; Timeliness; DTP vaccine; Child; Millennium Cohort Study (MCS); Child health systems 12 8 2022 2022-08-12 10.1016/j.vaccine.2022.06.080 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University This work was supported by the Wellcome Trust (grant number 087389/B/08/Z). LG, CD, RAL and AA are supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, National Institute for Health Research (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome. RAL is also funded by the Asthma UK Centre for Applied Research (AUKAC- 2012-01). KT was supported by an ESRC award establishing the Administrative Data Research Centre Wales (ES/L007444/1). AA, AB, LG and RAL are supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. 2022-08-22T11:36:59.0306344 2022-07-13T14:38:56.9887844 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Suzanne Walton 1 Mario Cortina-Borja 2 Carol Dezateux 3 Lucy Griffiths 0000-0001-9230-624X 4 Karen Tingay 5 Ashley Akbari 0000-0003-0814-0801 6 Amrita Bandyopadhyay 7 Ronan Lyons 0000-0001-5225-000X 8 Richard Roberts 9 Helen Bedford 10 60484__24984__9d0e804d1ea8436f87779ebf7d363b6a.pdf 60484_VoR.pdf 2022-08-22T11:35:08.0956070 Output 312865 application/pdf Version of Record true Copyright: 2022 The Authors. This is an open access article under the CC BY license true eng http://creativecommons.org/licenses/by/4.0/
title Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
spellingShingle Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
Lucy Griffiths
Ashley Akbari
Amrita Bandyopadhyay
Ronan Lyons
title_short Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
title_full Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
title_fullStr Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
title_full_unstemmed Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
title_sort Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination
author_id_str_mv e35ea6ea4b429e812ef204b048131d93
aa1b025ec0243f708bb5eb0a93d6fb52
9f1e77f76a83746112ef45709bf83630
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv e35ea6ea4b429e812ef204b048131d93_***_Lucy Griffiths
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
9f1e77f76a83746112ef45709bf83630_***_Amrita Bandyopadhyay
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Lucy Griffiths
Ashley Akbari
Amrita Bandyopadhyay
Ronan Lyons
author2 Suzanne Walton
Mario Cortina-Borja
Carol Dezateux
Lucy Griffiths
Karen Tingay
Ashley Akbari
Amrita Bandyopadhyay
Ronan Lyons
Richard Roberts
Helen Bedford
format Journal article
container_title Vaccine
container_volume 40
container_issue 34
container_start_page 5016
publishDate 2022
institution Swansea University
issn 0264-410X
doi_str_mv 10.1016/j.vaccine.2022.06.080
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BackgroundDelayed primary vaccination is one of the strongest predictors of subsequent incomplete immunisation. Identifying children at risk of such delay may enable targeting of interventions, thus decreasing vaccine-preventable illness.ObjectivesTo explore socio-demographic factors associated with delayed receipt of the Diphtheria, Tetanus and Pertussis (DTP) vaccine.MethodsWe included 1,782 children, born between 2000 and 2001, participating in the Millennium Cohort Study (MCS) and resident in Wales, whose parents gave consent for linkage to National Community Child Health Database records at the age seven years contact. We examined child, maternal, family and area characteristics associated with delayed receipt of the first dose of the DTP vaccine.Results98.6% received the first dose of DTP. The majority, 79.6% (n = 1,429) received it on time (between 8 and 12 weeks of age), 14.2% (n = 251) received it early (prior to 8 weeks of age) and 4.8% (n = 79) were delayed (after 12 weeks of age); 1.4% (n = 23) never received it. Delayed primary vaccination was more likely among children with older natural siblings (risk ratio 3.82, 95% confidence interval (1.97, 7.38)), children admitted to special/intensive care (3.15, (1.65, 5.99)), those whose birth weight was > 4Kg (2.02, (1.09, 3.73)) and boys (1.53, (1.01, 2.31)). There was a reduced risk of delayed vaccination with increasing maternal age (0.73, (0.53, 1.00) per 5 year increase) and for babies born to graduate mothers (0.27, (0.08, 0.90)).ConclusionsAlthough the majority of infants were vaccinated in a timely manner, identification of infants at increased risk of early or delayed vaccination will enable targeting of interventions to facilitate timely immunisation. This is to our knowledge the first study exploring individual level socio-demographic factors associated with delayed primary vaccination in the UK and demonstrates the benefits of linking cohort data to routinely-collected child health data.
published_date 2022-08-12T04:18:38Z
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