cover of vaccination evaluated rapidly for wales: august 2003 · 2015-10-27 · pre-school mmr, mr...
TRANSCRIPT
COVER 67 Cover of Vaccination Evaluated Rapidly for Wales: August 2003 Evaluation date: 4th - 8th August 2003 Study groups: Children resident in Wales in August 2003 reaching either their first, second, 5th, 6th, 13th (girls only) or 14th (girls only) birthday between 1st April and 30th June 2003. Results 1. Quarterly uptake of D3, P3, and Hib3 at 12 months did not reach 95% for Wales this quarter
(Table 1). 2. This quarter, trust-specific D3 uptake at 12 months (Fig 1.i) ranged from 91.0% (Conwy &
Denbighshire) to 96.9% (North West Wales). P3 uptake at 12 months (Fig 1.ii) ranged from 85.5% (Bro Morgannwg) to 96.9% (North West Wales). MenC uptake at 12 months (Fig 1.iii) ranged from 90.6% (Conwy & Denbighshire) to 96.7% (North West Wales).
3. At 5 years the all Wales uptake of pre-school diphtheria booster (D4) was 81.8% (region
range 77.4 – 83.5%), tetanus booster (T4) was 81.9% (region range 77.4 – 83.6%), and polio booster (Po4) was also 81.7% (region range 77.5– 83.4%) (Table 1).
4. Uptake of primary MMR (MMR1) at 24 months (77.7%) did not reach the 95% target for
Wales as a whole this quarter (Table 1) and ranged from 67.5% (Swansea) to 83.3% (Gwent Healthcare) (fig 1.iv).
5. Uptake of at least one measles-containing vaccine (primary MMR only, primary MMR and
pre-school MMR, MR only or MR and MMR) at 5 years was 90.2% for Wales as a whole this quarter (Table 1). Uptake of any two doses of measles-containing vaccine was 74.0% at 5 years.
6. All-Wales quarterly trends (Fig 2) show uptake of MMR at 24 months has decreased from
78.1% in the last quarter to 77.7% for this quarter. However, uptake of D3, P3 and Hib3 this quarter have remained almost constant.
7. All-Wales uptake of MenC3 at 12 months was 93.0% (Table 1) which is slightly lower than in
the previous quarter (93.3%). Uptake of MenC increased in 4 trusts, remained the same in one and decreased in the remaining 8 trusts. The largest increase in uptake was in North East Wales (from 89.9% to 92.7%) whilst the largest decrease in uptake was in Gwent Healthcare (from 95.4% to 93.0%).
Comment Immunisation update data in this report relate to the first quarter since the reorganisation of health services in Wales and the disappearance of the health authorities. Data are presented on this occasion, variously, by NHS trust catchment areas and by the regional subdivisions of the National Public Health Service. Whereas uptake of other childhood immunisations, by age 2 years, has continued in the 90-95% range, MMR uptake has continued it s decline to 77.7%. Cases of both measles and mumps continue to occur. However, for the second quarter in a row, enhanced surveillance of the proportion of children aged 15-17 months who have already received their MMR vaccination has increased and now stands at 69.3%, up from 62.6%, six months before. This implies that the level of cover in children reaching their second birthday should improve in some 9 months time. R Hughes D Rh Thomas M R Evans PHLS Communicable Disease Surveillance Centre (Welsh Unit) 13th August 2003 cov033.doc
Table 1.Total number of children resident in the region in August 2003 reaching either their 1st, 2nd, 5th, 6th, 13th (girls only) or 14th (girls only) birthday between 01/04/03 and 30/06/03 and proportion of those having been immunised by their birthday.
Total D3 D4 P3 T3 T4 Po3 Po4 Hib3 MMR(1 dose) MMR(2 doses) Rubella MenC n %
n
%
n %
n %
n
%
n %
n %
n %
n %
n %
n %
n %
South & East Region 1 year olds 3452 3218 93.2 3190 92.4 3221 93.3 3219 93.3 3213 93.1 24 0.7 3211 93.02 year olds 3441 3309 96.2 3264 94.9 3310 96.2 3309 96.2 3296 95.8 2822 82.0 3288
95.6
5 year olds 4063 3877 95.4 3366 82.8 3792 93.3 3883 95.6 3367 82.9 3887 95.7 3358 82.6 3860 95.0 3744 92.1 3114 76.6 3715 91.46 year olds 4221 3877 91.9 3391 80.3 13 year olds (girls only) 2383 2205 92.5 14 year olds (girls only) 2479 2237 90.2 Mid & West region 1 year olds 2319 2165 93.4 2111 91.0 2139 92.2 2168 93.5 2160 93.1 13 0.6 2155 92.92 year olds 2475 2346 94.8 2320 93.7 2344 94.7 2347 94.8 2336 94.4 1806 73.0 2319
93.7
5 year olds 2712 2562 94.5 2264 83.5 2495 92.0 2568 94.7 2267 83.6 2566 94.6 2261 83.4 2547 93.9 2369 87.4 1983 73.1 2433 89.76 year olds 2880 2538 88.1 2104 73.1 13 year olds (girls only) 1678 1556 92.7 14 year olds (girls only) 1685 1536 91.2 North Wales Region 1 year olds 1643 1534 93.4 1526 92.9 1534 93.4 1532 93.2 1532 93.2 5 0.3 1530 93.12 year olds 1741 1645 94.5 1635 93.9 1646 94.5 1645 94.5 1641 94.3 1318 75.7 1637
94.0
5 year olds 1981 1856 93.7 1533 77.4 1815 91.6 1859 93.8 1533 77.4 1857 93.7 1536 77.5 1843 93.0 1789 90.3 1379 69.6 1775 89.66 year olds 1990 1785 89.7 1443 72.5 13 year olds (girls only) 1172 1071 91.4 14 year olds (girls only) 1160 1047 90.3 WALES 1 year olds 7414 6917 93.3 6827 92.1 6894 93.0 6919 93.3 6905 93.1 42 0.6 6896 93.0 2 year olds 7657 7300 95.3 7219 94.3 7300 95.3 7301 95.4 7273 95.0 5946 77.7 7244 94.6 5 year olds 8756 8295 94.7 7163 81.8 8102 92.5 8310 94.9 7167 81.9 8310 94.9 7155 81.7 8250 94.2 7902 90.2 6476 74.0 7923 90.5 6 year olds 9091 8200 90.2 6938 76.3 13 year olds (girls only) 5233 4832 92.3 14 year olds (girls only) 5324 4820 90.5
* Immunisation of MenC includes children who have completed the full course of vaccinations (3 doses for 1 year olds and 1 dose for children aged 2 to 5 years old when the vaccine was introduced)
Figure 1. Uptake of sentinel antigens by trust, August 2003
i D3 at 12 months
60 65 70 75 80 85 90 95 100
North East Wales
Ceredigion & Mid Wales
Carmarthenshire
Pembrokeshire
Gw ent Healthcare
Conw y & Denbighshire
North West Wales
North Glamorgan
Bro Morgannw g
Pontypridd & Rhondda
Pow ys Healthcare
Cardiff & Vale
Sw ansea
ii P3 at 12 months
60 65 70 75 80 85 90 95 100
North East Wales
Ceredigion & Mid Wales
Carmarthenshire
Pembrokeshire
Gw ent Healthcare
Conw y & Denbighshire
North West Wales
North Glamorgan
Bro Morgannw g
Pontypridd & Rhondda
Pow ys Healthcare
Cardiff & Vale
Sw ansea
iii MenC at 12 months
60 65 70 75 80 85 90 95 100
North East Wales
Ceredigion & Mid Wales
Carmarthenshire
Pembrokeshire
Gw ent Healthcare
Conw y & Denbighshire
North West Wales
North Glamorgan
Bro Morgannw g
Pontypridd & Rhondda
Pow ys Healthcare
Cardiff & Vale
Sw ansea
iv MMR at 24 months
60 65 70 75 80 85 90 95 100
North East Wales
Ceredigion & Mid Wales
Carmarthenshire
Pembrokeshire
Gw ent Healthcare
Conw y & Denbighshire
North West Wales
North Glamorgan
Bro Morgannw g
Pontypridd & Rhondda
Pow ys Healthcare
Cardiff & Vale
Sw ansea
Figure 2. Uptake of childhood immunisations in Wales, quarter 4 1990 to quarter 2 2003. Data are for children reaching 1 year old in the quarter for diphtheria, pertussis and Hib and children reaching 2 years old for MMR.
75
80
85
90
95
100
1990
-419
91-2
1991
-419
92-2
1992
-4
Hib Diptheria
MMR
Pertussis1993
-219
93-4
1994
-219
94-4
1995
-219
95-4
1996
-219
96-4
1997
-219
97-4
1998
-219
98-4
1999
-219
99-4
2000
-220
00-4
2001
-220
01-4
2002
-220
02-4
2003
-2
Table 2.i. Total number of children resident by trust area in August 2003 reaching either their 1st, 2nd, 5th, 6th, 13th (girls only) or 14th (girls only) birthday between 01/04/03 and 30/06/03and proportion of those having been immunised by their birthday Total D3 D4 P3 T3 T4 Po3 Po4 Hib3 MMR(1 dose) MMR(2 doses) Rubella MenC
n % n % n % n % n % n % n % n % n % n % n % n %North East Wales (610) 1 year olds 668 620 92.8 615 92.1 620 92.8 619 92.7 618 92.5 0 0.0 619 92.72 year olds 726 664 91.5 660 90.9 665 91.6 665 91.6 663 91.3 524 72.2 664
91.5
5 year olds 877 811 92.5 661 75.4 800 91.2 812 92.6 661 75.4 812 92.6 662 75.5 805 91.8 788 89.9 579 66.0 777 88.66 year olds 880 785 89.2 578 65.7 13 year olds (girls only) 469 438 93.4 14 year olds (girls only) 456 416 91.2 Ceredigion & Mid Wales(621) 1 year olds 150 138 92.0 134 89.3 139 92.7 138 92.0 138 92.0 0 0.0 136 90.72 year olds 167 161 96.4 161 96.4 160 95.8 162 97.0 160 95.8 137 82.0 161
96.4
5 year olds 170 165 97.1 154 90.6 157 92.4 165 97.1 154 90.6 165 97.1 153 90.0 162 95.3 155 91.2 134 78.8 156 91.86 year olds 153 136 88.9 115 75.2 13 year olds (girls only) 109 104 95.4 14 year olds (girls only) 102 99 97.1 Carmarthenshire (622) 1 year olds 415 381 91.8 376 90.6 382 92.0 381 91.8 380 91.6 1 0.2 380 91.62 year olds 453 421 92.9 416 91.8 425 93.8 423 93.4 421 92.9 325 71.7 411
90.7
5 year olds 448 428 95.5 371 82.8 418 93.3 430 96.0 372 83.0 427 95.3 371 82.8 427 95.3 386 86.2 314 70.1 396 88.46 year olds 480 414 86.3 338 70.4 13 year olds (girls only) 270 254 94.1 14 year olds (girls only) 287 266 92.7 Pembrokeshire (624) 1 year olds 251 230 91.6 228 90.8 230 91.6 231 92.0 230 91.6 6 2.4 229 91.22 year olds 295 277 93.9 278 94.2 278 94.2 277 93.9 277 93.9 227 76.9 273
92.5
5 year olds 326 308 94.5 268 82.2 304 93.3 310 95.1 268 82.2 309 94.8 268 82.2 307 94.2 298 91.4 247 75.8 291 89.36 year olds 341 307 90.0 256 75.1 13 year olds (girls only) 218 199 91.3 14 year olds (girls only) 223 188 84.3 Gwent Healthcare (630) 1 year olds 1572 1466 93.3 1455 92.6 1466 93.3 1465 93.2 1463 93.1 15 1.0 1462 93.02 year olds 1529 1472 96.3 1450 94.8 1473 96.3 1471 96.2 1464 95.7 1273 83.3 1458
95.4
5 year olds 1793 1704 95.0 1494 83.3 1656 92.4 1708 95.3 1494 83.3 1710 95.4 1493 83.3 1697 94.6 1653 92.2 1393 77.7 1661 92.66 year olds 1959 1807 92.2 1588 81.1 13 year olds (girls only) 1041 973 93.5 14 year olds (girls only) 1058 937 88.6 Conwy & Denbighshire (RT8) 1 year olds 523 476 91.0 474 90.6 476 91.0 476 91.0 476 91.0 4 0.8 474 90.62 year olds 549 526 95.8 525 95.6 526 95.8 526 95.8 526 95.8 407 74.1 524
95.4
5 year olds 589 556 94.4 428 72.7 546 92.7 556 94.4 428 72.7 556 94.4 428 72.7 555 94.2 530 90.0 393 66.7 524 89.06 year olds 614 560 91.2 475 77.4 13 year olds (girls only) 395 345 87.3 14 year olds (girls only) 370 327 88.4 North West Wales (RT7) 1 year olds 452 438 96.9 437 96.7 438 96.9 437 96.7 438 96.9 1 0.2 437 96.72 year olds 466 455 97.6 450 96.6 455 97.6 454 97.4 452 97.0 387 83.0 449
96.4
5 year olds 515 489 95.0 444 86.2 469 91.1 491 95.3 444 86.2 489 95.0 446 86.6 483 93.8 471 91.5 407 79.0 474 92.06 year olds 496 440 88.7 390 78.6 13 year olds (girls only) 308 288 93.5 14 year olds (girls only) 334 304 91.0
Table 2.ii. Total number of children resident by trust area in August 2003 reaching either their 1st, 2nd, 5th, 6th, 13th (girls only) or 14th (girls only) birthday between 01/04/03 and 30/06/03and proportion of those having been immunised by their birthday
Total D3 D4 P3 T3 T4 Po3 Po4 Hib3 MMR(1 dose) MMR(2 doses) Rubella MenC
n % n % n % n % n % n % n % n % n % n % n % n %
North Glamorgan (651)1 year olds 304 287 94.4 280 92.1 287 94.4 287 94.4 286 94.1 0 0.0 286 94.12 year olds 270 258 95.6 254 94.1 258 95.6 258 95.6 257 95.2 208 77.0 258
95.6
5 year olds 368 353 95.9 331 89.9 345 93.8 353 95.9 331 89.9 356 96.7 329 89.4 350 95.1 338 91.8 300 81.5 337 91.66 year olds 383 354 92.4 306 79.9 13 year olds (girls only) 236 230 97.5 14 year olds (girls only) 223 212 95.1 Bro Morgannwg (654) 1 year olds 352 334 94.9 301 85.5 305 86.6 334 94.9 333 94.6 1 0.3 333 94.62 year olds 355 352 99.2 342 96.3 345 97.2 352 99.2 350 98.6 290 81.7 349
98.3
5 year olds 381 363 95.3 337 88.5 351 92.1 362 95.0 337 88.5 365 95.8 335 87.9 363 95.3 353 92.7 316 82.9 358 94.06 year olds 440 411 93.4 356 80.9 13 year olds (girls only) 266 237 89.1 14 year olds (girls only) 263 236 89.7 Pontypridd & Rhondda (655) 1 year olds 467 435 93.1 432 92.5 436 93.4 436 93.4 435 93.1 0 0.0 437 93.62 year olds 487 478 98.2 473 97.1 478 98.2 479 98.4 477 97.9 390 80.1 478
98.2
5 year olds 515 505 98.1 431 83.7 501 97.3 505 98.1 431 83.7 505 98.1 428 83.1 504 97.9 490 95.1 404 78.4 477 92.66 year olds 561 522 93.0 470 83.8 13 year olds (girls only) 320 305 95.3 14 year olds (girls only) 339 308 90.9 Powys Healthcare (660) 1 year olds 273 253 92.7 250 91.6 254 93.0 254 93.0 253 92.7 1 0.4 251 91.92 year olds 266 248 93.2 246 92.5 248 93.2 248 93.2 247 92.9 193 72.6 244
91.7
5 year olds 357 320 89.6 282 79.0 315 88.2 322 90.2 282 79.0 320 89.6 281 78.7 319 89.4 300 84.0 253 70.9 297 83.26 year olds 399 352 88.2 300 75.2 13 year olds (girls only) 200 175 87.5 14 year olds (girls only) 219 201 91.8 Cardiff & Vale (670) 1 year olds 1109 1030 92.9 1023 92.2 1032 93.1 1031 93.0 1029 92.8 9 0.8 1026 92.5 2 year olds 1155 1101 95.3 1087 94.1 1101 95.3 1101 95.3 1098 95.1 951 82.3 1094
94.7
5 year olds 1387 1315 94.8 1110 80.0 1290 93.0 1317 95.0 1111 80.1 1316 94.9 1108 79.9 1309 94.4 1263 91.1 1017 73.3 1240 89.4 6 year olds 1318 1194 90.6 1027 77.9 13 year olds (girls only) 786 697 88.7 14 year olds (girls only) 859 780 90.8 Swansea (680) 1 year olds 878 829 94.4 822 93.6 829 94.4 830 94.5 826 94.1 4 0.5 826 94.12 year olds 939 887 94.5 877 93.4 888 94.6 885 94.2 881 93.8 634 67.5 881
93.8
5 year olds 1030 978 95.0 852 82.7 950 92.2 979 95.0 854 82.9 980 95.1 853 82.8 969 94.1 877 85.1 719 69.8 935 90.86 year olds 1067 918 86.0 739 69.3 13 year olds (girls only) 615 587 95.4 14 year olds (girls only) 591 546 92.4 WALES 1 year olds 7414 6917 93.3 6827 92.1 6894 93.0 6919 93.3 6905 93.1 42 0.6 6896 93.0 2 year olds 7657 7300 95.3 7219 94.3 7300 95.3 7301 95.4 7273 95.0 5946 77.7 7244
94.6
5 year olds 8756 8295 94.7 7163 81.8 8102 92.5 8310 94.9 7167 81.9 8310 94.9 7155 81.7 8250 94.2 7902 90.2 6476 74.0 7923 90.5 6 year olds 9091 8200 90.2 6938 76.3 13 year olds (girls only) 5233 4832 92.3 14 year olds (girls only) 5324 4820 90.5
Appendix 1
Enhanced surveillance of primary measles-mumps-rubella (MMR) vaccination in Wales: August 2003
Evaluation date: 4th – 8th August 2003 Study groups: 1. Welsh resident children aged 15-17 months as at end June 2003, 2. Welsh resident children aged 24-26 months as at end June 2003. Method Percentage uptake was calculated using the number of children in each three month birth cohort, resident in Wales on the evaluation date, as the denominator and the number who had been vaccinated by the evaluation date as the numerator. Data were obtained from the Child Health System, Health Solutions Wales. Results • The uptake of primary MMR in Welsh resident children aged 24-26 months at the end of June
2003 was 78.6% (region range: 73.9-82.9%) which is 0.6% lower than the uptake in children aged 24-26 months at the end of March 2003 (region range 73.3-84.4%) (Table 1).
• The uptake of primary MMR in Welsh resident children aged 15-17 months at the end of June
2003 was 69.3% (region range: 63.1-75.6%) (Table 2) compared with 66.1% (region range: 59.9-72.3%) in children aged 15-17 months at the end of March 2003.
• Uptake at 15-17 months increased in all three regions (Table 2). The North Wales region had
the largest increase in uptake (from 72.3 to 75.6%) whilst the smallest increase in uptake was in the Mid & West region (from 61.5 to 63.1%).
Table 1. Proportion of Welsh resident children aged 24-26 months receiving primary MMR vaccination by the end of the corresponding quarters.
Apr-Jun 02
Jul-Sept 02
Oct-Dec 02
Jan-Mar 03
Apr-Jun 03
Total n % Total n % Total n % Total n % Total n %
South & East Region 3584 3106 86.7 3759 3210 85.4 3489 2929 83.9 3530 2981 84.4 3435 2848 82.9 Mid & West Region 2407 1906 79.2 2594 2061 79.5 2510 1875 74.7 2500 1833 73.3 2471 1827 73.9 North Wales Region 1771 1493 84.3 1830 1473 80.5 1796 1409 78.5 1783 1377 77.2 1737 1329 76.5 WALES 7762 6505 83.8 8183 6744 82.4 7795 6213 79.7 7813 6191 79.2 7643 6004 78.6
Table 2. Proportion of Welsh resident children aged 15-17 months receiving primary MMR vaccination by the end of the corresponding
quarters.
Apr-Jun 02 Jul-Sept 02 Oct-Dec 02 Jan-Mar 03 Apr-Jun 03
Total n % Total n % Total n % Total n % Total n %
South & East Region 3514 2563 72.9 3415 2455 71.9 3543 2427 68.5 3539 2560 72.3 3359 2538 75.6 Mid & West Region 2459 1515 61.6 2424 1532 63.2 2502 1519 60.7 2481 1527 61.5 2390 1508 63.1 North Wales Region 1746 1079 61.8 1721 1025 59.6 1741 928 53.3 1722 1032 59.9 1652 1085 65.7 WALES 7719 5157 66.8 7560 5012 66.3 7786 4874 62.6 7742 5119 66.1 7401 5131 69.3
Figure 1. Four quarter rolling average of the proportion of Welsh resident children aged 15-17months and 24-26 months receiving primary MMR vaccination by evaluation date. Evaluation date is one month following the evaluation quarter e.g. children aged 15-17 months receiving primary MMR by the end of March 1999 were evaluated in May 1999.
50556065707580859095
100
Feb-
99M
ay-9
9Au
g-99
Nov
-99
Feb-
00M
ay-0
0Au
g-00
Nov
-00
Feb-
01M
ay-0
1Au
g-01
Nov
-01
Feb-
02M
ay-0
2Au
g-02
Nov
-02
Feb-
03M
ay-0
3Au
g-03
Evaluation Date
% u
ptak
e
15-17 mths 24-26 mths
R Hughes, D Rh Thomas, B Mason, RL Salmon (CDSC Wales) C Rees, D Jones, R Brown (Health Solutions Wales) 13/08/03