A new study into the immunisation status of children in Wales has found that children under a care and support plan had higher overall vaccination rates than the general population and were more up to date with their immunisations.

The UK’s childhood immunisation programme ensures children are offered protection against serious infection. However, identifying inequalities in vaccination coverage is essential.

The study, funded by Cardiff University’s Children’s Social Care Research and Development Centre (CASCADE), was a collaboration between CASCADE, Swansea University, University College London (UCL) and Public Health Wales.

Researchers used data from the Secure Anonymised Information Linkage (SAIL) Databank to examine the immunisation status of children living in Wales between April 2016 and March 2021. They included records from the Children Receiving Care and Support (CRCS) Census and the National Community Child Health Database, which contains vaccination records for all children in Wales registered for NHS care.

They explored coverage of preschool and primary booster vaccinations, as well as second doses of MMR vaccines, in the first data linkage study to explore vaccination coverage in children under social care services in Wales.

The study found that children receiving care or support were less likely to have missing vaccines than those within the population comparison group, and were more likely to be up to date with all six vaccines compared to children in the comparison group.

It also found that so-called immunisation flags – which indicate whether individuals are considered up to date with their vaccinations – were only accurate for around 70% of children. Inaccurate immunisation flags can lead to vaccinations being missed, leaving children vulnerable to preventable infections.

Lead author Grace Bailey, Population Data Science at Swansea University, said:

Our study reveals that children receiving care and support from children’s social services in Wales are more likely to be up to date with immunisations than the general child population.
Early and delayed vaccinations were common – demonstrating that more interdisciplinary coordination and planning are needed to improve outcomes.
This work provides vital insights that can inform targeted interventions and help prioritise efforts in areas that need catch-up programmes.

Co-author Professor Sally Holland, Cardiff University, said:

Our findings suggest that social services and health colleagues’ efforts to support children who have faced more challenges than the general population are paying dividends when it comes to immunisation.
Immunisation programmes are a key intervention for improving population health. Our research can inform and contribute to ongoing efforts to improve immunisation programmes across Wales, ensuring that all children, regardless of social care status, receive timely and comprehensive protection against serious infections.

Professor Helen Bedford, UCL Great Ormond Street Institute of Child Health, said:

Historically, vaccine uptake among disadvantaged groups of children – particularly those in the care of the local authority – has been poorer than that of other children, leaving them vulnerable to potentially serious infections.
The results of this research are therefore very encouraging and hopefully can be built on to improve the health of looked after children more widely.