ArticleBMC public health2025
COVID-19 and regional inequalities in childhood vaccination uptake in England: a spline regression.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Inequalities in adolescent HPV, Td/IPV and MenACWY vaccination coverage by socio-economic status: an ecological study, England, 2017 to 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- Impact of a community-led intervention on the uptake of childhood vaccines in Liverpool: a protocol for a synthetic control evaluation.BMJ open · 2026Article
- Geographic and age-specific trends in vaccine-preventable diseases in Qatar: A primary health care-based study (2021-2024).Qatar medical journal · 2026Article
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5 authors.
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Abstract
backgroundIn recent years, the uptake of childhood vaccinations before the age of five has declined globally. In England, the decline in measles, mumps, and rubella (MMR) vaccination coverage is concerning and has subsequently been followed by an increase in measles outbreaks. This study analysed the sustained and additional impact of the COVID-19 pandemic on area-level inequalities in childhood vaccination uptake across regions in England.
methodsSpline regressions with three-way interaction terms were used to assess the impact of COVID-19, from the first lockdown, on local authorities across regions and deprivation quartiles. Cover of Vaccination Evaluated Rapidly data was used for the uptake statistics, and the Indices of Multiple Deprivation 2019 for the deprivation quartiles. The lowest coverage vaccines were analysed: the pre-school booster (one dose) and MMR (two doses, cumulative) from July - September 2014 to October - December 2022.
resultsThe findings suggest the odds of childhood vaccination uptake were declining in England prior to the first lockdown, but there was an additional decrease associated with this event by 12% (OR:0.88, CI:0.79-0.99, p < .05) for the pre-school booster and 13% (OR:0.87, CI:0.77-0.99, p < .05) for the MMR vaccine. For local authorities classified as the most deprived 25% (Quartile 1), there was a 15% (OR: 0.85, CI: (0.72-0.99, p < .05) post-lockdown-associated decline in the odds of MMR uptake, but not the pre-school booster. Post-lockdown and region interaction effects for the pre-school booster were as follows: Yorkshire and the Humber, 39% decreased odds (OR:0.61, CI:0.54-0.68, p < .001); East Midlands, 22% decreased odds (OR:0.77 OR, CI:0.62-0.95, p < .05); and West Midlands, 19% increased odds (OR:1.19, CI:1.00-1.40, p < .05). For the MMR vaccine, these were: Yorkshire and the Humber, 41% decreased odds (OR:0.59, CI:0.52-0.67, p < .001); North West, 30% increased odds (OR:1.3, CI:1.04-1.64, p < .05); West Midlands, 21% increased odds (OR:1.21, CI:1-1.46, p < .05); and South East, 19% decreased odds (OR:0.67, CI:0.98, p < .05). Evidence of three-way post-lockdown interaction effects for deprivation quartile and region was also identified for both vaccines.
conclusionsThe results highlight the need for national vaccination uptake analyses to consider regional variation, as similarly deprived local authorities do not necessarily exhibit the same COVID-19-associated effects.
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