Measuring the timeliness of childhood vaccinations: Using cohort data and routine health records to evaluate quality of immunisation services.

Suzanne Walton,Mario Cortina-Borja,Karen Tingay,Ashley Akbari,Amrita Bandyopadhyay,Ronan A Lyons,Helen Bedford,Lucy J Griffiths,Carol Dezateux

doi:10.1016/j.vaccine.2017.10.085

Suzanne Walton, Mario Cortina-Borja + Show 7 more

Open Access

https://doi.org/10.1016/j.vaccine.2017.10.085

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Abstract

To achieve full benefits of vaccination programmes, high uptake and timely receipt of vaccinations are required. To examine uptake and timeliness of infant and pre-school booster vaccines using cohort study data linked to health records. We included 1782 children, born between 2000 and 2001, participating in the Millennium Cohort Study and resident in Wales, whose parents gave consent for linkage to National Community Child Health Database records at the age seven year contact. We examined age at receipt, timeliness of vaccination (early, on-time, delayed, or never), and intervals between vaccine doses, based on the recommended schedule for children at that time, of the following vaccines: primary (diphtheria, tetanus, pertussis (DTP), polio, Meningococcal C (Men C), Haemophilus influenzae type b (Hib)); first dose of measles, mumps and rubella (MMR); and pre-school childhood vaccinations (DTP, polio, MMR). We compared parental report with child health recorded MMR vaccination status at age three years. While 94% of children received the first dose of primary vaccines early or on time, this was lower for subsequent doses (82%, 65% and 88% for second and third doses and pre-school booster respectively). Median intervals between doses exceeded the recommended schedule for all but the first dose with marked variation between children. There was high concordance (97%) between parental reported and child health recorded MMR status. Routine immunisation records provide useful information on timely receipt of vaccines and can be used to assess the quality of childhood vaccination programmes. Parental report of MMR vaccine status is reliable.

Highlights

To achieve their full benefit, timely delivery of vaccines as well as high uptake are required [1]
Taking into account when mumps and rubella (MMR) vaccines were received in relation to the date of the Millennium Cohort Study (MCS) interview, at the time of the MCS age three interview, 89.8% of parental reports and 89.1% of National Community Child Health Database (NCCHD) records suggested that children had received the first dose of MMR
Routine community child health data contain rich information on the timeliness of vaccination and we have demonstrated the completeness and use of this to understand the distribution of delayed primary and preschool vaccinations in a large sample of children

Summary

Introduction

To achieve their full benefit, timely delivery of vaccines as well as high uptake are required [1]. In Belgium up to 32% of infants experienced delay in receiving the first dose of measles, mumps and rubella (MMR) vaccine and 95% for the third dose of diphtheria, tetanus and pertussis (DTP) vaccine [6]. Objectives: To examine uptake and timeliness of infant and pre-school booster vaccines using cohort study data linked to health records. We examined age at receipt, timeliness of vaccination (early, on-time, delayed, or never), and intervals between vaccine doses, based on the recommended schedule for children at that time, of the following vaccines: primary (diphtheria, tetanus, pertussis (DTP), polio, Meningococcal C (Men C), Haemophilus influenzae type b (Hib)); first dose of measles, mumps and rubella (MMR); and pre-school childhood vaccinations (DTP, polio, MMR). We compared parental report with child health recorded MMR vaccination status at age three years.

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