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Young mums and large families miss vaccines

By Cato Pedder

GPs can push up their childhood vaccination uptake rates by chasing up young mothers and those with large families, researchers advise.

Their study identified a number of factors raising a child's risk of incomplete vaccination, which also included deprivation and ethnic minority background.

Child health experts urged GPs to target high-risk mothers with home visits, text messages or personal phone calls to help ensure all children were fully immunised.

The researchers said their study, published online by the BMJ, was the first large-scale research to tease out the separate risk factors for being partially immunised or not immunised at all (see box, below).

The study, of 18,000 children born in the UK between September 2000 and July 2002, found 3.3 per cent of nine-month-old babies had only received some of their two-, three- and four-month vaccinations. Some 1.1 per cent of babies had not been immunised at all.

Children with three or more siblings were at a five-fold risk of being partially vaccinated, and those with young mothers at a 70 per cent increased risk. Deprivation and ethnic minority background raised risk by 30 and 60 per cent respectively.

By contrast, children with older, highly educated or black Caribbean mothers were at increased risk of not being immunised at all.

Study leader Dr Helen Bedford, senior lecturer at the Institute of Child Health in London, said the study showed parents of partially immunised children had to be approached differently to parents of unimmunised children.

Accessible immunisation ser- vices, including opportunistic immunisation and home visits, could help boost vaccination uptake in socially disadvantaged families, she said.

Dr David Elliman, consultant in community child health at Great Ormond Street Hospital in London, said: 'A phone call or text message may be more effective than an impersonal computer-generated invitation. Home immunisation may be appropriate in some cases.'

GPC negotiator Dr Andrew Dearden said the findings showed many factors affecting uptake rates were out of GPs' control, strengthening arguments against uptake-related target pay.

cpedder@cmpi.biz

Factors affecting immunisation

Risk factors for partial immunisation

· Residence in ethnic or disadvantaged wards

· Larger family size

· Lone or teenaged parenthood

· Maternal smoking in pregnancy

· Admission to hospital by nine months of age

Risk factors for no immunisation

· Mother educated to degree level or above

· Mother over 40

· Caribbean mother

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