Comparison of social distribution of immunisation with measles, mumps, and rubella vaccine, England, 1991-2001

Abstract

Participants, methods, and results We selected 60 health authorities in England (defined by 1999 boundaries). The boundaries of these authorities remained stable over a decade. We calculated the Townsend material deprivation index for each area and used these scores to categorise authorities in to three groups of 20 authorities3: deprived (1.27 to 10.59), neither deprived nor affluent (−2.41 to 1.13), or affluent (−4.51 to −2.79). For each year from 1991 to 2001, we calculated coverage of MMR as the percentage of children who had been immunised by their second birthday. As explanatory variables we chose characteristics of general practitioners and practices that are known to be associated with inequity in coverage of preventive interventions. We calculated mean coverage for each group for each year and estimated inequality between the three groups of areas and change in inequality over time using log variances. Analysis of variance showed significant (P0.05) associations between the characteristics of practices and coverage in affluent areas. View larger version: In this window In a new window Mean coverage of MMR immunisation (percentage of children younger than 2 years immunised) in England from 1991 to 2001 From 1997 to 2001, coverage of MMR immunisation declined in all areas, but it decreased by a slightly greater proportion in affluent areas (by 5%) than in deprived areas (4.2%); and inequality decreased—log variance fell from 0.33 to 0.19 between 1997 and 2001. Over this period there were no significant (P>0.05) associations between practice variables and changes in the coverage of MMR immunisation for either affluent or deprived areas.