Child poverty and declining measles, mumps and rubella (MMR) vaccination in England, 2015 to 2024. A longitudinal ecological study at local area level.



Chua, Yu Wei ORCID: 0000-0002-2174-6149, Munford, Luke ORCID: 0000-0003-4540-6744, Pearce, Olivia ORCID: 0009-0007-5482-0812, Skirrow, Helen ORCID: 0000-0002-4383-0616, Taegtmeyer, Miriam ORCID: 0000-0002-5377-2536, French, Neil ORCID: 0000-0003-4814-8293, Ashton, Matthew ORCID: 0000-0003-1959-5094, Hungerford, Daniel ORCID: 0000-0002-9770-0163 and Taylor-Robinson, David ORCID: 0000-0002-5828-7724
(2026) Child poverty and declining measles, mumps and rubella (MMR) vaccination in England, 2015 to 2024. A longitudinal ecological study at local area level. [Preprint]

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Abstract

OBJECTIVE: To assess the contribution of changing child poverty rates to trends in measles, mumps and rubella (MMR) vaccination. DESIGN: Longitudinal area-level analysis using within-between models to assess the association of increases in child poverty within-areas on MMR vaccination. SETTING: 148 upper-tier local authorities in England from 2015 and 2024. PARTICIPANTS: Children aged 5 years or younger eligible for MMR vaccination in England between 2015 and 2024. 6,468,620 children aged 24 months were included in the study and 6,907,640 aged 5 years. EXPOSURES: Child poverty rates for each upper-tier local authority, measured as the percentage of children aged 0 to 15 living in households below 60% of Organisation for Economic Co-operation and Development (OECD) median, before housing costs. OUTCOME MEASURES: MMR 1st and 2nd dose uptake rates by 24 months 5 years of age respectively, at upper-tier local authority. RESULTS: Over the study period, MMR 1st dose fell by 4.0 percentage-points (%) (range: -20.8 to 7.7) and MMR 2nd dose by 4.9% (range: -23.4 to 10.1) while child poverty rose by 5.6% (range: 0.2 to 13.9) on average. A 1 percentage-point (%) increase in child poverty was associated with a 0.17% [95%CI: -0.29; -0.06] fall in MMR 1st dose rates and a 0.26% [95%CI: -0.42; -0.10] fall in MMR 2nd dose rates. CONCLUSION: Rising child poverty rates have contributed to a decrease in MMR vaccination in children in England. Action to reduce child poverty is needed to improve childhood vaccination uptake alongside policies and interventions specific to vaccination and infectious disease prevention.

Item Type: Preprint
Uncontrolled Keywords: 32 Biomedical and Clinical Sciences, 4206 Public Health, 42 Health Sciences, Emerging Infectious Diseases, Social Determinants of Health, Vaccine Related, Infectious Diseases, Immunization, Prevention, Pediatric Research Initiative, Rare Diseases, 3 Good Health and Well Being
Divisions: Faculty of Health & Life Sciences
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: 12 Mar 2026 14:09
Last Modified: 23 May 2026 11:01
DOI: 10.64898/2026.03.10.26348016
Open Access URL: https://doi.org/10.64898/2026.03.10.26348016
Related Websites:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3197474
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