Child in vest being given vaccination in the army by a healthcare professional

A new study has revealed that children receiving services under a care and support plan had higher overall vaccination rates and were more up to date with immunisations than the general child population in Wales.

Published in Frontiers in Public Health, the research by experts at Population Data Science at Swansea University in collaboration with experts at Cardiff University and University College London represents the first data linkage study to explore vaccination coverage in children under social care services in Wales.

In the UK, a robust childhood immunisation programme ensures children are offered protection against serious infections; identifying inequalities in vaccination coverage is essential. The team explored coverage of primary, as well as preschool boosters and second doses of MMR vaccines.

The analysis included records from the Children Receiving Care and Support (CRCS) Census and the National Community Child Health Database, which contains vaccination records for all children in Wales registered for NHS care.

The study analysed data from the Secure Anonymised Information Linkage (SAIL) Databank and examined the immunisation status of children living in Wales between April 2016 and March 2021. 

Its key findings were:

  • Children receiving care or support were less likely to have missing vaccines than those within the population comparison group;
  • Children receiving care or support were more likely to be up to date with all six vaccines compared to children in the comparison group;
  • However, those vaccinated were less likely to be vaccinated in a timely manner; both early and delayed vaccinations were more common; and,
  • Immunisation flags were accurate for around 70 per cent of children’s records within the CRCS Census.  An immunisation flag is a notation in a person's health record that shows whether they are considered up to date with their vaccinations or not.  Exploring accuracy of immunisation flags is important as inaccurate immunisation flags can have significant consequences - if vaccinations are missed for certain diseases, children may be left vulnerable to preventable infections.

Grace Bailey, from Population Data Science at Swansea University, said: "Our study reveals that looked after children in Wales are more likely to be up to date with immunisations than the general child population.

“Early and delayed vaccinations were common - demonstrating that more inter-disciplinary coordination and planning are needed to improve outcomes.

“This work provides vital insights that can inform targeted interventions and help prioritise efforts in areas that need catch-up programmes." 

Sally Holland, from the Children’s Social Care Research and Development Centre at Cardiff University, added: "Our findings suggest that social services and health colleagues’ efforts to support children who have faced more challenges than the general population are paying dividends when it comes to immunisation.  

“Immunisation programmes are a key intervention for improving population health. Our research can inform and contribute to ongoing efforts to improve immunisation programs across Wales, ensuring that all children, regardless of social care status, receive timely and comprehensive protection against serious infections."

Helen Bedford, from UCL Great Ormond Street Institute of Child Health, said “Historically, vaccine uptake among disadvantaged groups of children particularly those in the care of the local authority, has been poorer than that of other children, leaving them vulnerable to potentially serious infections.

The results of this research are therefore very encouraging and hopefully can be built on to improve the health of looked after children more widely.”   

Read the full publication here

This study, funded by CASCADE, was a collaboration between researchers at Population Data Science at Swansea University, Public Health Wales, UCL Great Ormond Street Institute of Child Health and the Children’s Social Care Research and Development Centre, Cardiff University.


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