Amin, Mohammed Sherif 
ORCID: 0009-0009-7228-830X, Zhang, Xingna ORCID: 0000-0002-8849-2112, Green, Mark Alan ORCID: 0000-0002-0942-6628, Holford, Dawn, Hemingway, Charlotte, Ismail, Amina, Moran, James, Doyle, Vicki, Taylor, Cait, Taegtmeyer, Miriam et al (show 1 more authors)
(2026)
Impact of a community-led intervention on the uptake of childhood vaccines in Liverpool: a protocol for a synthetic control evaluation
BMJ OPEN, 16 (1).
e111500-.
ISSN 2044-6055, 2044-6055
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589cba3a-1304-2909-2274-76872e23ada2.pdf - Open Access published version Download (842kB) | Preview |
Abstract
Introduction Vaccines are our best defence against infectious diseases, yet uptake of childhood immunisation programmes has consistently declined in the UK, with growing concerns around socioeconomic inequalities. Liverpool, in particular, demonstrated some of the lowest uptake rates in England since 2019. In response, the Health Equity Liverpool Project (HELP) implemented a hyper-localised community-led initiative between September 2023 and June 2024 to tackle vaccine hesitancy. Activities included outreach events and school-based engagement across nine sites within Liverpool. Despite promising qualitative evidence, the intervention’s impact on childhood vaccine uptake has not yet been quantified. We aim to evaluate the population level impact of the HELP intervention on the uptake of five childhood vaccines (first and second doses of the measles, mumps and rubella vaccine (MMR1, MMR2), 6-in-1 vaccine (diphtheria, tetanus, pertussis, polio, haemophilus influenzae type b and hepatitis B), pneumococcal conjugate vaccine booster dose (PCV) and rotavirus vaccine) using synthetic control methods. Methods and analysis We will analyse publicly available quarterly vaccine uptake data (between April 2019 and March 2025) from the Cover of Vaccination Evaluated Rapidly programme for general practices (GPs) in England. The intervention group will be defined as practices located within a 1km radius of the intervention sites. A synthetic control group will be constructed using non-intervention GPs matched on pre-intervention vaccine uptake, and linked demographic, socioeconomic and healthcare capacity covariates. Primary outcomes are the uptake of MMR1 and MMR2 vaccines. Secondary outcomes include the uptake of 6-in-1, PCV and rotavirus vaccines. Average treatment effects will be estimated as the post-intervention difference in uptake between intervention and synthetic control groups. Sensitivity analyses will examine spillover effects, alternative spatial definitions of exposure, the biasing effect of concurrent interventions and the feasibility of analysis at small area neighbourhood level. Ethics and dissemination This study will be conducted as part of the ReCITE project, which has received ethical approval from the Liverpool School of Tropical Medicine Research Ethics Committee (Reference: 24–018) and is funded by the UK Arts and Humanities Research Council (Project Number: AH/Z505341/1). Findings will be shared with the project funder and submitted for publication in a peer-reviewed journal.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Vaccination, PAEDIATRICS, EPIDEMIOLOGY, Public health, Primary Prevention |
| Divisions: | Faculty of Health & Life Sciences Faculty of Science & Engineering Faculty of Science & Engineering > School of Environmental Sciences Faculty of Science & Engineering > School of Environmental Sciences > Geography and Planning Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences > Inst. Infection, Vet & Ecological Sciences (T&R Staff) Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences > Clinical Infection, Microbiology & Immunology Faculty of Health & Life Sciences > Inst. Population Health Faculty of Health & Life Sciences > Inst. Population Health > Public Health, Policy & Systems Faculty of Health & Life Sciences > Inst. Population Health > Inst. Population Health (T&R Staff) |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 23 Jan 2026 09:53 |
| Last Modified: | 16 Jun 2026 07:30 |
| DOI: | 10.1136/bmjopen-2025-111500 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3196729 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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