The University of Southampton
University of Southampton Institutional Repository

Understanding variation in measles-mumps-rubella immunization coverage - a population based study

Wright, James A. and Polack, Clare (2006) Understanding variation in measles-mumps-rubella immunization coverage - a population based study European Journal of Public Health, 16, (2), pp. 137-142. (doi:10.1093/eurpub/cki194).

Record type: Article


Background: Coverage of the Measles–Mumps–Rubella combined vaccine (MMR) has declined in recent years in the UK, following adverse publicity about possible links between the vaccine, autism, and Crohn's disease. The objectives of this study were to assess geographical variation in trends in MMR coverage and to identify the factors affecting MMR uptake at population level. Methods: We conducted an ecological study of immunization coverage by second birthday, based on routinely collected data from 1993–2004 for England. Trends in MMR uptake were assessed in 95 District Health Authorities in England over the study period. We investigated the relationship between MMR immunization uptake and deprivation, ethnicity, education, population density, rurality, and socioeconomic class. Results: Since 2000, MMR coverage has declined significantly in virtually all areas of England. Population density and deprivation were both strongly correlated with low MMR uptake. The decline in coverage since 1993–94 was significantly related to the proportion of educated population and was greater in densely populated areas. Conclusion: Decline in MMR coverage now affects most areas of England. The lowest rates of MMR coverage remain in urban areas, particularly in inner cities, which also tend to show high levels of deprivation. Public health resources should continue to target inner city areas, as well as focus on the concerns of the better educated about vaccine safety.

Full text not available from this repository.

More information

Published date: April 2006
Keywords: censuses, geographic information systems, immunization, measles
Organisations: Geography & Environment, Medical Education, PHEW – S (Spatial analysis and modelling), Population, Health & Wellbeing (PHeW), Remote Sensing & Spatial Analysis


Local EPrints ID: 60854
ISSN: 1101-1262
PURE UUID: 82047e9d-355e-4cc3-a20c-493d04723c29

Catalogue record

Date deposited: 10 Sep 2008
Last modified: 17 Jul 2017 14:23

Export record


Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.