Phased introduction of a universal childhood influenza vaccination programme in England: Population-level factors predicting variation in national uptake during the first year, 2013/14

Helen Green, Nicholas Andrews, L. Letley, A. Sunderland, Joanne White, Richard Pebody*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Introduction: Through a phased rollout, the UK is implementing annual influenza vaccination for all healthy children aged 2-16 years old. In the first year of the programme in England in 2013/14, all 2-3 year olds were offered influenza vaccine through primary care and a primary school age programme was piloted, mainly through schools, in geographically distinct areas. Equitable delivery is a key aim of the programme; it is unclear if concerns by some religious groups over influenza vaccine content have impacted on uptake. Methods: At the end of the 2013/14 season, variations in uptake for 2-3 year olds and 4-11 year olds were assessed and stratified by population-level predictors: deprivation, ethnicity, religious beliefs and rurality. GP practice or school level uptake was linearly regressed against these variables to determine potential predictors and changes in uptake, adjusting for significant factors. Results: Uptake varied considerably by geographic locality for both 2-3 year olds and 4-11 year olds. Lower uptake was seen in increasingly deprived areas, with an adjusted uptake in the most deprived quintile 12% and 8% lower than the least deprived areas by age-group respectively. By ethnicity, the highest non-white population quartile had an adjusted uptake 9% and 14% lower than the lowest non-white quartile by age-group respectively. Uptake also varied according to religious beliefs, with adjusted uptake in 4-11 year olds in the highest Muslim population tertile 8% lower than the lowest Muslim population tertile. Conclusion: In the first season of the childhood influenza vaccination programme, uptake was not uniform across the country, with deprivation and ethnicity both predictors of low uptake in pre-school and primary school age children, and religious beliefs also an important factor, particularly the latter group. With the continued rollout of the programme, these population-level factors should be addressed to achieve sustained successful uptake, along with assessment of contribution of individual and household-level factors.

Original languageEnglish
Pages (from-to)2620-2628
Number of pages9
JournalVaccine
Volume33
Issue number22
DOIs
Publication statusPublished - 21 May 2015

Bibliographical note

Funding Information:
This work was supported by Public Health England where the lead author and corresponding author are employees. This work was supported through core surveillance funding from the Department of Health . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2015.

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

Keywords

  • Children
  • Epidemiology
  • Influenza
  • Vaccination

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