Inequalities in childhood vaccination timing and completion in London

Karen S. Tiley, Joanne M. White, Nick Andrews, Mary Ramsay, Michael Edelstein

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


The UK primary vaccination course includes vaccination against diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (DTaP/IPV/Hib) and is scheduled at ages four, 8 and 12 weeks, followed by a ‘preschool booster’ at age three years four months. Vaccine coverage is generally measured at age one, two and five years. In addition to high coverage, vaccination should be timely to maximise population protection. Vaccination histories for 315,381 children born March 2001 to April 2010 were extracted from Child Health Information Systems in nine London health service areas and grouped into first and fifth birthday cohorts. We assessed timeliness of receipt of DTaP/IPV/Hib and drop-out rates by ethnicity, deprivation and area. Most children received their first, second and third doses on time at two, three, and four months. Among children completing by one year and after adjusting for deprivation and health area, compared with White-British children, Somali and Bangladeshi children were less likely to have received three doses of DTaP/IPV/Hib by six months of age (−11% and −5% respectively). Differences in timeliness by deprivation and health area existed, but were smaller. Compared with White-British children, children of Polish, Somali and Caribbean ethnicities were less likely to return for preschool booster, with a drop-out rate at least 7% higher in these groups. Within the fifth birthday cohort, only 2.3% of children who were completely unvaccinated (575/25,095) at age one year were fully vaccinated by age five. Higher proportions of partially vaccinated (one or two doses) children at age one year went on to be fully vaccinated by age five ((836/3213) 26.0% and (3565/6076) 58.7% respectively). These inequalities suggest that tailored approaches may be required to target specific groups with regards to improving vaccine uptake.

Original languageEnglish
Pages (from-to)6726-6735
Number of pages10
Issue number45
StatePublished - 29 Oct 2018
Externally publishedYes

Bibliographical note

Funding Information:
We thank the following local collaborators and data managers within PCTs who provided data for this study: Khushbu Goulden and Oladapu Osubu (Oxleas/Bexley), Patricia Stephens and Ian Kirkwood (Camden), Johan van Wijgerden (Ealing), Khalida Aziz and David Griffiths (Hounslow), Gladys Xavier and Saleem Yasir (Outer North East London), Elizabeth Bell (Havering) and Fiona White and Chris Lovelace (Sutton and Merton).

Publisher Copyright:
© 2018


  • Deprivation
  • Ethnicity
  • Inequalities
  • Late
  • Timing
  • Vaccine coverage


Dive into the research topics of 'Inequalities in childhood vaccination timing and completion in London'. Together they form a unique fingerprint.

Cite this