Dataset Information

Characteristics of 5-year-olds who catch-up with MMR: findings from the UK Millennium Cohort Study.

ABSTRACT:

Objectives

To examine predictors of partial and full measles, mumps and rubella (MMR) vaccination catch-up between 3 and 5 years.

Design

Secondary data analysis of the nationally representative Millennium Cohort Study (MCS).

Setting

Children born in the UK, 2000-2002.

Participants

751 MCS children who were unimmunised against MMR at age 3, with immunisation information at age 5.

Main outcome measures

Catch-up status: unimmunised (received no MMR), partial catch-up (received one MMR) or full catch-up (received two MMRs).

Results

At age 5, 60.3% (n=440) children remained unvaccinated, 16.1% (n=127) had partially and 23.6% (n=184) had fully caught-up. Children from families who did not speak English at home were five times as likely to partially catch-up than children living in homes where only English was spoken (risk ratio 4.68 (95% CI 3.63 to 6.03)). Full catch-up was also significantly more likely in those did not speak English at home (adjusted risk ratio 1.90 (1.08 to 3.32)). In addition, those from Pakistan/Bangladesh (2.40 (1.38 to 4.18)) or 'other' ethnicities (such as Chinese) (1.88 (1.08 to 3.29)) were more likely to fully catch-up than White British. Those living in socially rented (1.86 (1.34 to 2.56)) or 'Other' (2.52 (1.23 to 5.18)) accommodations were more likely to fully catch-up than home owners, and families were more likely to catch-up if they lived outside London (1.95 (1.32 to 2.89)). Full catch-up was less likely if parents reported medical reasons (0.43 (0.25 to 0.74)), a conscious decision (0.33 (0.23 to 0.48)), or 'other' reasons (0.46 (0.29 to 0.73)) for not immunising at age 3 (compared with 'practical' reasons).

Conclusions

Parents who partially or fully catch-up with MMR experience practical barriers and tend to come from disadvantaged or ethnic minority groups. Families who continue to reject MMR tend to have more advantaged backgrounds and make a conscious decision to not immunise early on. Health professionals should consider these findings in light of the characteristics of their local populations.

SUBMITTER: Pearce A

PROVIDER: S-EPMC3717465 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Characteristics of 5-year-olds who catch-up with MMR: findings from the UK Millennium Cohort Study.

Pearce Anna A Mindlin Miranda M Cortina-Borja Mario M Bedford Helen H

BMJ open 20130716 7

<h4>Objectives</h4>To examine predictors of partial and full measles, mumps and rubella (MMR) vaccination catch-up between 3 and 5 years.<h4>Design</h4>Secondary data analysis of the nationally representative Millennium Cohort Study (MCS).<h4>Setting</h4>Children born in the UK, 2000-2002.<h4>Participants</h4>751 MCS children who were unimmunised against MMR at age 3, with immunisation information at age 5.<h4>Main outcome measures</h4>Catch-up status: unimmunised (received no MMR), partial catc ...[more]

PMID: 23864213

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Project description:BACKGROUND:Positive mental health may support healthy development in childhood, although few studies have investigated this at a population level. We aimed to construct a measure of mental health competence (MHC), a skills-based assessment of positive mental health, using existing survey items in a representative sample of UK children, and to investigate its overlap with mental health difficulties (MHD), socio-demographic patterning, and relationships with physical health and cognitive development. METHODS:We analysed the UK Millennium Cohort Study (MCS) when children were aged 11 years. Maternal (n = 12,082) and teacher (n = 6739) reports of prosocial behaviours (PS) and learning skills (LS) were entered into latent class models to create MHC measures. Using descriptive statistics, we examined relationships between MHC and MHD, and the socio-demographic patterning of MHC. Associations between MHC and physical health and cognitive development were examined with relative risk ratios [RRR] (from multinomial models): BMI status (healthy weight, overweight, obesity); unintentional injuries since age 7 (none, 1, 2+); asthma symptoms (none, 1, 2+); and tertiles of test scores for verbal ability, spatial working memory and risk-taking. Models were adjusted for potential confounding. RESULTS:Four MHC classes were identified [percentages for maternal and teacher reports, respectively]: high MHC (high PS, high LS) [37%; 39%], high-moderate MHC (high PS, moderate LS) [36%; 26%]; moderate MHC (moderate PS, moderate LS) [19%; 19%]; low MHC (moderate PS, low LS) [8%; 16%]. Higher MHC was less common in socially disadvantaged children. While MHC and MHD were associated, there was sufficient separation to indicate that MHC captures more than the absence of MHD. Compared to children with high MHC, those in other MHC classes tended to have poorer physical health and cognitive development, particularly those with low MHC or high-moderate MHC. For example, children with maternal-report Low MHC were more likely to have experienced 2+ unintentional injuries (RRR: 1.5 [1.1-2.1]) and to have lower verbal ability scores (RRR: 2.5 [1.9-3.2]). Patterns of results were similar for maternal- and teacher-report MHC. CONCLUSION:MHC is not simply the inverse of MHD, and high MHC is associated with better physical health and cognitive development. Findings suggest that interventions to improve MHC may support healthy development, although they require replication.

Project description:Background and objectiveContinued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008-09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.DesignCross-sectional self-administered questionnaire with objective behavioural outcome.Setting and participants365 UK parents, whose children were aged 5-18 years and had received <2 MMR doses before the 2008-09 UK catch-up started.Main outcome measuresParents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).ResultsPerceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09-2.87) and younger child age (OR = 0.78, 95% CI = 0.68-0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.ConclusionsCatch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted through school-based programmes. A formal evaluation element should be incorporated into future catch-up campaigns to inform their continuing improvement.

Dataset Information

Characteristics of 5-year-olds who catch-up with MMR: findings from the UK Millennium Cohort Study.

Objectives

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Characteristics of 5-year-olds who catch-up with MMR: findings from the UK Millennium Cohort Study.

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