Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England
Abstract
:1. Introduction
1.1. Epidemiology of Measles
1.2. History of Measles Vaccination Schedules in the UK
1.3. Measles Reporting and MMR Coverage Target for Measles Elimination in the UK
1.4. Vaccine Hesitancy
1.5. Aim of this Review
2. Materials and Methods
3. Results
3.1. Measles Cases in England from 2012 to 2021
3.2. MMR Coverage in England from 2012 to 2021
3.2.1. National MMR Coverage
3.2.2. Regional MMR Coverage in England
3.2.3. MMR Coverage in England by Socioeconomic Status
3.3. Literature Review: Potential Factors Associated with MMR Uptake
3.3.1. Convenience
Accessibility
Population Mobility
Information on Service Availability
Affordability and Funding
Inequalities and Sub-Populations
3.3.2. Confidence
Vaccine Safety and Effectiveness
Healthcare Professionals
Trusted Information
Mis- and Disinformation (Media and Autism)
Personal Experience
3.3.3. Complacency
Awareness of Severity of the Disease
Perceived Risk of Disease
3.4. Literature Review: Possible Interventions to Improve MMR Uptake
Barriers | Recommendations |
---|---|
General vaccine hesitancy | |
Lack of perceived trusted information [24,59,70]; concerns over combined vaccines [24,70,81]; concerns over side effects [44,65,82] |
|
Lack of awareness of measles severity and availability of MMR vaccination programme [23,24,59] |
|
Inequalities in service provision [22,65,73,74,75,76,77,103] |
|
Community-specific needs are not addressed [23,24,71,78] |
|
Inadequate immunisation training [9] |
|
Lack of advanced information technology for surveillance [13,40] |
|
Lack of funding [9] |
|
Vaccine availability and affordability [20,110] |
3.4.1. Convenience
3.4.2. Confidence
3.4.3. Complacency
4. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
List of Abbreviations
CASP | Critical Appraisal Skills Programme |
CHIS | Child Health Information Systems |
COVER | Cover of Vaccination Evaluated Rapidly |
DHSC | Department of Health and Social Care |
GP | General Practice |
HBM | Health Belief Model |
HPA | Health Protection Agency |
IBIM | Immunisation Beliefs and Intentions Measure |
ICS | Integrated Care System |
IMD | Index of Multiple Deprivation |
LA | Local Authority |
LAC | Looked-After Children |
MMR | Measles Mumps Rubella |
MMR1 | 1st dose of Measles Mumps Rubella vaccine |
MMR2 | 2nd dose of Measles Mumps Rubella vaccine |
MMRV | Measles Mumps Rubella Varicella |
NHS | National Health Service |
NHSE | National Health Service England |
ONS | Office for National Statistics |
PHE | Public Health England |
R0 | Reproductive number |
SDH | Social Determinants of Health |
UK | United Kingdom |
UK HAS | United Kingdom Health Security Agency |
WHO | World Health Organization |
Appendix A
# | Search Term | MeSH/ Free Text | Search Field Limits | MEDLINE (26 May 2022) | EMBASE (26 May 2022) | Cochrane (26 May 2022) |
---|---|---|---|---|---|---|
1 | Measles-Mumps-Rubella Vaccine | MeSH | All fields | 3034 | 8053 | 173 |
2 | Measles | MeSH | All fields | 14,556 | 19,682 | 296 |
3 | MeaslesVaccine | MeSH | All fields | 7174 | 9836 | 383 |
4 | Measles virus | MeSH | All fields | 6607 | 8861 | 81 |
5 | 1 OR 2 OR 3 OR 4 | 21,941 | 33,166 | 512 | ||
6 | England | MeSH | All fields | 92,384 | 32,558 | 2671 |
7 | 5 AND 6 | 295 | 57 | 5 | ||
8 | Vaccin * | Free text | Title or abstract or key word | 442,491 | 549,644 | 29,204 |
9 | 7 AND 8 | 237 | 47 | 5 | ||
10 | Uptake | Free text | Title or abstract or key word | 428,025 | 569,433 | 22,472 |
11 | Vaccination Coverage | MeSH | All fields | 2125 | 4281 | 31 |
12 | 10 OR 11 | 429,775 | 573171 | 22,493 | ||
13 | 9 AND 12 | 47 | 12 | 2 |
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Number of Confirmed Cases of Measles | |||||||||
---|---|---|---|---|---|---|---|---|---|
Region | North East | North West | Yorkshire and the Humber | East Midlands | West Midlands | East of England | London | South East | South West |
2012 | 50 | 881 | 152 | 51 | 122 | 49 | 135 | 383 | 97 |
2013 | 379 | 381 | 88 | 49 | 64 | 76 | 189 | 26 | 162 |
2014 | 6 | 7 | 2 | 4 | 7 | 10 | 51 | 12 | 3 |
2015 | 2 | 2 | 2 | 0 | 2 | 1 | 65 | 4 | 13 |
2016 | 1 | 3 | 12 | 4 | 8 | 24 | 318 | 60 | 96 |
2017 | 2 | 42 | 40 | 1 | 38 | 14 | 68 | 23 | 37 |
2018 | 14 | 33 | 84 | 13 | 81 | 33 | 389 | 181 | 140 |
2019 | 3 | 51 | 28 | 48 | 14 | 102 | 461 | 68 | 22 |
2020 | 0 | 9 | 0 | 4 | 0 | 5 | 39 | 19 | 2 |
Rate of Measles Infection per 100,000 Population | |||||||||
---|---|---|---|---|---|---|---|---|---|
Region | North East | North West | Yorkshire and the Humber | East Midlands | West Midlands | East of England | London | South East | South West |
2012 | 1.92 | 12.44 | 2.86 | 1.12 | 2.16 | 0.83 | 1.62 | 4.39 | 1.82 |
2013 | 14.52 | 5.36 | 1.65 | 1.07 | 1.13 | 1.28 | 2.25 | 0.30 | 3.01 |
2014 | 0.23 | 0.10 | 0.04 | 0.09 | 0.12 | 0.17 | 0.60 | 0.14 | 0.06 |
2015 | 0.08 | 0.03 | 0.04 | 0.00 | 0.03 | 0.02 | 0.75 | 0.04 | 0.24 |
2016 | 0.04 | 0.04 | 0.22 | 0.08 | 0.14 | 0.39 | 3.63 | 0.66 | 1.74 |
2017 | 0.08 | 0.58 | 0.73 | 0.02 | 0.65 | 0.23 | 0.77 | 0.25 | 0.67 |
2018 | 0.53 | 0.45 | 1.53 | 0.27 | 1.37 | 0.53 | 4.37 | 1.98 | 2.50 |
2019 | 0.11 | 0.69 | 0.51 | 0.99 | 0.24 | 1.64 | 5.14 | 0.74 | 0.39 |
2020 | 0.00 | 0.12 | 0.00 | 0.08 | 0.00 | 0.08 | 0.43 | 0.21 | 0.04 |
Percentage of Children Vaccinated with MMR by Their Second Birthday | |||||||||
---|---|---|---|---|---|---|---|---|---|
Region | North East | North West | Yorkshire and the Humber | East Midlands | West Midlands | East of England | London | South East | South West |
2012 | 93.0 | 93.4 | 93.1 | 92.9 | 92.0 | 91.8 | 86.1 | 92.1 | 91.7 |
2013 | 94.1 | 94.9 | 94.2 | 94.0 | 92.7 | 92.8 | 87.1 | 92.6 | 93.5 |
2014 | 95.5 | 94.8 | 94.7 | 94.9 | 93.6 | 93.7 | 87.5 | 91.8 | 94.2 |
2015 | 95.2 | 94.0 | 94.3 | 94.3 | 93.5 | 93.9 | 87.3 | 91.1 | 93.7 |
2016 | 95.0 | 92.9 | 94.0 | 94.1 | 93.1 | 93.5 | 86.4 | 91.9 | 92.9 |
2017 | 94.9 | 93.6 | 94.0 | 93.6 | 93.2 | 93.8 | 85.1 | 90.8 | 93.1 |
2018 | 94.5 | 92.9 | 93.3 | 93.1 | 91.2 | 92.4 | 85.1 | 91.5 | 93.3 |
2019 | 94.5 | 92.4 | 92.8 | 92.0 | 90.6 | 91.3 | 83.0 | 91.4 | 93.0 |
2020 | 95.1 | 91.9 | 92.6 | 92.3 | 90.3 | 91.7 | 83.6 | 92.7 | 93.3 |
2021 | 95.3 | 91.0 | 92.3 | 92.4 | 90.2 | 92.6 | 82.4 | 92.3 | 93.3 |
Percentage of Children Vaccinated with MMR by Their Fifth Birthday | |||||||||
---|---|---|---|---|---|---|---|---|---|
Region | North East | North West | Yorkshire and the Humber | East Midlands | West Midlands | East of England | London | South East | South West |
MMR1 | 97.0 | 95.2 | 95.8 | 95.7 | 94.4 | 95.5 | 88.8 | 95.3 | 96.0 |
MMR2 | 92.5 | 87.4 | 90.0 | 89.0 | 85.6 | 90.4 | 75.1 | 89.5 | 91.2 |
Factors | Complacency | Confidence | Convenience |
---|---|---|---|
Accessibility | X | ||
Awareness of disease severity | X | ||
Affordability and funding | X | ||
Healthcare professionals | X | ||
Inequalities and sub-populations | X | ||
Information on service availability | X | ||
Trusted information | X | ||
Mis- and disinformation (autism) | X | ||
Perceived risk of disease | X | ||
Personal experience | X | ||
Population mobility | X | ||
Vaccine safety and effectiveness | X |
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Thompson, S.; Meyer, J.C.; Burnett, R.J.; Campbell, S.M. Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England. Vaccines 2023, 11, 288. https://doi.org/10.3390/vaccines11020288
Thompson S, Meyer JC, Burnett RJ, Campbell SM. Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England. Vaccines. 2023; 11(2):288. https://doi.org/10.3390/vaccines11020288
Chicago/Turabian StyleThompson, Sarah, Johanna C. Meyer, Rosemary J. Burnett, and Stephen M. Campbell. 2023. "Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England" Vaccines 11, no. 2: 288. https://doi.org/10.3390/vaccines11020288