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Immunisation status of children receiving care and support in Wales: a national data linkage study

Grace Bailey Orcid Logo, Alexandra Lee, Helen Bedford, Malorie Perry, Sally Holland, Suzanne Walton, Lucy Griffiths Orcid Logo

Frontiers in Public Health, Volume: 11

Swansea University Authors: Grace Bailey Orcid Logo, Alexandra Lee, Lucy Griffiths Orcid Logo

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DOI (Published version): 10.3389/fpubh.2023.1231264

Abstract

In the UK, a robust childhood immunisation programme ensures children are offered protection against serious infections; identifying inequalities in vaccination coverage is essential. This is one of the first data linkage studies to examine coverage of primary, as well as pre-school booster and seco...

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Published in: Frontiers in Public Health
ISSN: 2296-2565
Published: Frontiers Media SA 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63928
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This is one of the first data linkage studies to examine coverage of primary, as well as pre-school booster and second dose of MMR vaccines, in children receiving support from social care services across Wales.Methods: By accessing records held within the Secure Anonymised Information Linkage (SAIL) Databank, vaccination status of children receiving social care and support between April 2016 and March 2021 (n = 24,540) was ascertained. This was achieved through linkage of the Children Receiving Care and Support (CRCS) Census and National Community Child Health Database which holds vaccination records for all children in Wales registered for NHS care. This sample was split into three groups – those children who had never been recorded on the Child Protection Register (CPR) or as ‘Looked After’ but in CRCS (n = 12,480), children ever on the CPR (n = 6,225) and those ever recorded as ‘Looked After’ but who were never on the CPR (n = 5,840). The comparison group of children and young people (CYP) never receiving welfare support consisted of 624,905 children.Results: Children receiving care or support were more likely to be up-to-date with all six vaccines (no recorded vaccines: 0.6–6.3%) compared to children in the comparison group (no recorded vaccines: 3–10.3%). However, of those who were vaccinated, they were less likely to be vaccinated in a timely manner; both early (5.2% vs. 22.2%; margin of error [ME] = 0.52, 95% CI [confidence interval] = −0.18 – −0.17, p &lt; 0.001) and delayed vaccinations were more common (62.7% vs. 71.3%; ME = 0.58, 95% CI = 0.08–0.09, p &lt; 0.001). Validation of the CRCS immunisation flag showed moderate levels of accuracy. Around 70% of immunisation flags were correct across all three groups.Discussion: Findings suggest a positive association between receiving services under a care and support plan and being up-to-date with immunisations; children receiving support under a care and support plan were more likely to have experienced early or late vaccinations, demonstrating that there is still more inter-disciplinary co-ordination and planning needed to improve these outcomes. 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spelling v2 63928 2023-07-21 Immunisation status of children receiving care and support in Wales: a national data linkage study 1e09a407fca9e8047e7738b18d381130 0000-0003-4646-3134 Grace Bailey Grace Bailey true false 7c6dc217555b0fea264ff0dd7d0aa374 Alexandra Lee Alexandra Lee true false e35ea6ea4b429e812ef204b048131d93 0000-0001-9230-624X Lucy Griffiths Lucy Griffiths true false 2023-07-21 HDAT In the UK, a robust childhood immunisation programme ensures children are offered protection against serious infections; identifying inequalities in vaccination coverage is essential. This is one of the first data linkage studies to examine coverage of primary, as well as pre-school booster and second dose of MMR vaccines, in children receiving support from social care services across Wales.Methods: By accessing records held within the Secure Anonymised Information Linkage (SAIL) Databank, vaccination status of children receiving social care and support between April 2016 and March 2021 (n = 24,540) was ascertained. This was achieved through linkage of the Children Receiving Care and Support (CRCS) Census and National Community Child Health Database which holds vaccination records for all children in Wales registered for NHS care. This sample was split into three groups – those children who had never been recorded on the Child Protection Register (CPR) or as ‘Looked After’ but in CRCS (n = 12,480), children ever on the CPR (n = 6,225) and those ever recorded as ‘Looked After’ but who were never on the CPR (n = 5,840). The comparison group of children and young people (CYP) never receiving welfare support consisted of 624,905 children.Results: Children receiving care or support were more likely to be up-to-date with all six vaccines (no recorded vaccines: 0.6–6.3%) compared to children in the comparison group (no recorded vaccines: 3–10.3%). However, of those who were vaccinated, they were less likely to be vaccinated in a timely manner; both early (5.2% vs. 22.2%; margin of error [ME] = 0.52, 95% CI [confidence interval] = −0.18 – −0.17, p < 0.001) and delayed vaccinations were more common (62.7% vs. 71.3%; ME = 0.58, 95% CI = 0.08–0.09, p < 0.001). Validation of the CRCS immunisation flag showed moderate levels of accuracy. Around 70% of immunisation flags were correct across all three groups.Discussion: Findings suggest a positive association between receiving services under a care and support plan and being up-to-date with immunisations; children receiving support under a care and support plan were more likely to have experienced early or late vaccinations, demonstrating that there is still more inter-disciplinary co-ordination and planning needed to improve these outcomes. Thus, identifying inequalities in vaccination coverage is essential to target interventions and to prioritise geographic areas for catch-up. Journal Article Frontiers in Public Health 11 Frontiers Media SA 2296-2565 Vaccination, vaccine, immunisation, timeliness, children receiving care and support, looked after children, Child Protection Register, data linkage. 31 7 2023 2023-07-31 10.3389/fpubh.2023.1231264 http://dx.doi.org/10.3389/fpubh.2023.1231264 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU College/Department paid the OA fee The CASCADE partnership receives infrastructure funding from Health and Care Research Wales (517199). Swansea University paid the Open Access fee. 2024-02-01T15:52:12.7951833 2023-07-21T13:49:08.0981507 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Grace Bailey 0000-0003-4646-3134 1 Alexandra Lee 2 Helen Bedford 3 Malorie Perry 4 Sally Holland 5 Suzanne Walton 6 Lucy Griffiths 0000-0001-9230-624X 7 63928__28300__f95ae0be4533467d8c95d0a0a02ae2f0.pdf 63928.VOR.pdf 2023-08-16T12:42:54.8528645 Output 636938 application/pdf Version of Record true © 2023 Bailey, Lee, Bedford, Perry, Holland, Walton and Griffiths. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). true eng http://creativecommons.org/licenses/by/4.0/ 199
title Immunisation status of children receiving care and support in Wales: a national data linkage study
spellingShingle Immunisation status of children receiving care and support in Wales: a national data linkage study
Grace Bailey
Alexandra Lee
Lucy Griffiths
title_short Immunisation status of children receiving care and support in Wales: a national data linkage study
title_full Immunisation status of children receiving care and support in Wales: a national data linkage study
title_fullStr Immunisation status of children receiving care and support in Wales: a national data linkage study
title_full_unstemmed Immunisation status of children receiving care and support in Wales: a national data linkage study
title_sort Immunisation status of children receiving care and support in Wales: a national data linkage study
author_id_str_mv 1e09a407fca9e8047e7738b18d381130
7c6dc217555b0fea264ff0dd7d0aa374
e35ea6ea4b429e812ef204b048131d93
author_id_fullname_str_mv 1e09a407fca9e8047e7738b18d381130_***_Grace Bailey
7c6dc217555b0fea264ff0dd7d0aa374_***_Alexandra Lee
e35ea6ea4b429e812ef204b048131d93_***_Lucy Griffiths
author Grace Bailey
Alexandra Lee
Lucy Griffiths
author2 Grace Bailey
Alexandra Lee
Helen Bedford
Malorie Perry
Sally Holland
Suzanne Walton
Lucy Griffiths
format Journal article
container_title Frontiers in Public Health
container_volume 11
publishDate 2023
institution Swansea University
issn 2296-2565
doi_str_mv 10.3389/fpubh.2023.1231264
publisher Frontiers Media SA
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 - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.3389/fpubh.2023.1231264
document_store_str 1
active_str 0
description In the UK, a robust childhood immunisation programme ensures children are offered protection against serious infections; identifying inequalities in vaccination coverage is essential. This is one of the first data linkage studies to examine coverage of primary, as well as pre-school booster and second dose of MMR vaccines, in children receiving support from social care services across Wales.Methods: By accessing records held within the Secure Anonymised Information Linkage (SAIL) Databank, vaccination status of children receiving social care and support between April 2016 and March 2021 (n = 24,540) was ascertained. This was achieved through linkage of the Children Receiving Care and Support (CRCS) Census and National Community Child Health Database which holds vaccination records for all children in Wales registered for NHS care. This sample was split into three groups – those children who had never been recorded on the Child Protection Register (CPR) or as ‘Looked After’ but in CRCS (n = 12,480), children ever on the CPR (n = 6,225) and those ever recorded as ‘Looked After’ but who were never on the CPR (n = 5,840). The comparison group of children and young people (CYP) never receiving welfare support consisted of 624,905 children.Results: Children receiving care or support were more likely to be up-to-date with all six vaccines (no recorded vaccines: 0.6–6.3%) compared to children in the comparison group (no recorded vaccines: 3–10.3%). However, of those who were vaccinated, they were less likely to be vaccinated in a timely manner; both early (5.2% vs. 22.2%; margin of error [ME] = 0.52, 95% CI [confidence interval] = −0.18 – −0.17, p < 0.001) and delayed vaccinations were more common (62.7% vs. 71.3%; ME = 0.58, 95% CI = 0.08–0.09, p < 0.001). Validation of the CRCS immunisation flag showed moderate levels of accuracy. Around 70% of immunisation flags were correct across all three groups.Discussion: Findings suggest a positive association between receiving services under a care and support plan and being up-to-date with immunisations; children receiving support under a care and support plan were more likely to have experienced early or late vaccinations, demonstrating that there is still more inter-disciplinary co-ordination and planning needed to improve these outcomes. Thus, identifying inequalities in vaccination coverage is essential to target interventions and to prioritise geographic areas for catch-up.
published_date 2023-07-31T15:52:13Z
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