Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden.
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
BMC Public Health. 2021 Jul 7;21(1):1337. doi: 10.1186/s12889-021-11345-z.
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.
Vaccination 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).
Despite 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.
本研究描述了在澳大利亚西部(WA)和新南威尔士州(NSW),第一剂麻疹-腮腺炎-风疹(MMR1)疫苗接种覆盖率方面社会不平等现象的趋势。利用对 2002 年至 2011 年间出生的 120 万名儿童进行的概率性链接行政数据,我们比较了两个州按母亲出生国、原住民身份、分娩时母亲年龄、社会经济地位和偏远程度衡量的 24 月龄 MMR1 疫苗接种覆盖率的水平和趋势。
与不属于这些社会群体的儿童相比,20 岁以下分娩的母亲、海外出生的母亲、有原住民背景的母亲以及社会经济地位较低的父母所生的儿童的疫苗接种率低 3-4 个百分点。在这两个州,2007 年至 2011 年间,母亲海外出生的儿童 MMR1 疫苗接种覆盖率下降了 2.1 个百分点。2011 年,WA 的原住民人口(89.5%)和年轻母亲的儿童(89.3%)的覆盖率低于 NSW(分别为 92.2%和 92.1%)。
尽管 MMR1 疫苗接种总体覆盖率较高,但尤其是海外出生母亲的儿童的覆盖率不平等现象有所增加。战略性免疫计划和政策干预措施对于公平的疫苗接种水平非常重要。未来的政策应针对海外出生的母亲和原住民儿童的儿童。