The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
Predictors of childhood vaccination uptake and timeliness: a cross-sectional study in a diverse urban UK population.
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Basta Karol, Dodhia Hiten, Crompton James, Whitney David, Chu Petrina, Kilner Rachael, Iyasere Ese
Аннотация
BACKGROUND: Vaccination is a cornerstone of childhood public health. However, uptake has declined across the UK, with urban, deprived, and ethnically diverse communities facing unique barriers, exacerbated by the COVID-19 pandemic.
AIM: To identify socioeconomic and clinical predictors of incomplete and untimely childhood vaccination between 2010 and 2023.
DESIGN AND SETTING: This was a cross-sectional study using electronic health records from 40 general practices in Lambeth, an ethnically diverse London borough.
METHOD: Routinely collected data for 37 912 children eligible for vaccines by age 5 years were analysed. Multivariable logistic regression assessed associations between predictors and (a) vaccination uptake and (b) timeliness, defined as receipt within 3 months of the scheduled age.
RESULTS: Of eligible children, 61.0% (N = 23 119/37 912) were fully vaccinated; of these, 60.8% (N = 14 062/23 119) were vaccinated on time. Lower uptake was associated with deprivation (most versus least deprived: adjusted odds ratio [AOR] 0.66, 95% confidence interval (CI) = 0.51 to 0.84), born outside the UK versus UK born (AOR 0.10, 95% CI = 0.08 to 0.12), and ethnicities other than White British (for example, Black Caribbean: AOR 0.30, 95% CI = 0.25 to 0.36). Children with clinical comorbidities had higher uptake (for example primary care-managed comorbidity: AOR 1.58, 95% CI = 1.46 to 1.71). Timeliness patterns differed: among those vaccinated, children born outside the UK and those from African, Caribbean, and Mixed ethnic backgrounds had higher odds of timely vaccination.
CONCLUSION: Different predictors for uptake and timeliness highlight the need for strategies addressing both access and timely delivery. Local data should inform targeted, place-based interventions. Culturally competent services, integrated into routine primary care and codesigned with communities, are recommended.
AIM: To identify socioeconomic and clinical predictors of incomplete and untimely childhood vaccination between 2010 and 2023.
DESIGN AND SETTING: This was a cross-sectional study using electronic health records from 40 general practices in Lambeth, an ethnically diverse London borough.
METHOD: Routinely collected data for 37 912 children eligible for vaccines by age 5 years were analysed. Multivariable logistic regression assessed associations between predictors and (a) vaccination uptake and (b) timeliness, defined as receipt within 3 months of the scheduled age.
RESULTS: Of eligible children, 61.0% (N = 23 119/37 912) were fully vaccinated; of these, 60.8% (N = 14 062/23 119) were vaccinated on time. Lower uptake was associated with deprivation (most versus least deprived: adjusted odds ratio [AOR] 0.66, 95% confidence interval (CI) = 0.51 to 0.84), born outside the UK versus UK born (AOR 0.10, 95% CI = 0.08 to 0.12), and ethnicities other than White British (for example, Black Caribbean: AOR 0.30, 95% CI = 0.25 to 0.36). Children with clinical comorbidities had higher uptake (for example primary care-managed comorbidity: AOR 1.58, 95% CI = 1.46 to 1.71). Timeliness patterns differed: among those vaccinated, children born outside the UK and those from African, Caribbean, and Mixed ethnic backgrounds had higher odds of timely vaccination.
CONCLUSION: Different predictors for uptake and timeliness highlight the need for strategies addressing both access and timely delivery. Local data should inform targeted, place-based interventions. Culturally competent services, integrated into routine primary care and codesigned with communities, are recommended.