Abstract
BackgroundThis study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states.ResultsVaccination coverage was 3–4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively).ConclusionDespite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.
Highlights
In Australia, childhood vaccination levels have increased substantially in the past few decades
This study used a register-based dataset in which the birth registrations and perinatal data records in Western Australia (WA) and New South Wales (NSW) were linked to the Australian Immunisation Register (AIR) using probability matching, with 99% linkage accuracy [21]
In terms of maternal age, the lowest vaccination coverage was among children of mothers giving birth before age 20 years
Summary
In Australia, childhood vaccination levels have increased substantially in the past few decades. Despite high overall vaccination coverage, pockets of under immunisation exist; with an increase in measles cases over the last 5 years [1]. In both the media and the scientific literature, vaccine hesitancy has been the main focus when tackling this issue [2,3,4]. Studying the social distribution of vaccination coverage is crucial in identifying these pockets of under immunised groups and preventing future outbreaks. This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states
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