Measuring the effectiveness of catch-up MMR delivered by school nurses compared to signposting to general practice on improving MMR coverage: A retrospective cohort study

Altinoluk-Davis, Filiz; Gray, Selena; Bray, Issy; Powell, Jane

Abstract

Aim: This study aims to determine the extent to which increased coverage of at least one dose and two doses of MMR differs between areas in which school nurses deliver catch-up MMR doses to adolescents in school settings, compared to signposting to general practice.

Background: In 2016 the number of cases reported in England had risen more than five times to 531 compared to 92 cases in 2015.1 Analysis suggests the burden of disease has shifted to older teenagers and young adults; the majority of whom are unimmunised.2,3

Methodology: A retrospective cohort study was conducted using secondary data from Child Health Information Services within the NHS England South (South Central) commissioning boundary. The sample population includes children born 1 September 2000–31 August 2001 who were in school year 9 during the 2014/15 academic year. Children attending schools in Berkshire, Buckinghamshire, Oxfordshire and Swindon were grouped together as Cohort 1 (school nurse delivery); and students from Bath & North East Somerset and Gloucestershire were grouped in to Cohort 2 (general practice delivery).

Results: The analysis included 27,527 records, and was completed using the chi-squared comparison of proportions test. The results show an increase in coverage of at least one dose of MMR by 1.60% between baseline (01/09/2014) and the end of the follow-up period (31/08/2016). Similarly, there is an increase of 1.45% in coverage of two doses of MMR. The findings also suggest that school nurse delivery of catch-up MMR may benefit children of BAME ethnicity and those from more deprived backgrounds, as coverage increased by 1.72% and 2.84%, respectively, in these groups.

Conclusions: The findings suggest school-based delivery of catch-up MMR improves coverage. Based on these findings it is recommended that commissioners of school-aged immunisation services incorporate the delivery of catch-up MMR doses within their contracts with school nurses.

References
1 PHE (2017a) Laboratory confirmed cases of measles, mumps and rubella, England: October to December 2016. Health Protection Report 11 (8).
2 PHE (2016a) Laboratory confirmed cases of measles, mumps and rubella, England: April to June 2016. Health Protection Report 10 (25).
3 PHE (2016b) Laboratory confirmed cases of measles, mumps and rubella, England: July to September 2016. Health Protection Report 10 (41).

• Presentation Conference Type: Other
• Conference Name: South West Public Health Scientific Conference 2018
• Start Date: Mar 13, 2018
• End Date: Mar 13, 2018
• Acceptance Date: Feb 1, 2018
• Deposit Date: Mar 7, 2018
• Peer Reviewed: Not Peer Reviewed
• Keywords: MMR, immunisation
• Public URL: https://uwe-repository.worktribe.com/output/871667
• Additional Information: Title of Conference or Conference Proceedings : South West Public Health Scientific Conference
• Contract Date: Mar 7, 2018