Childhood immunisation uptake : geographical perspectives.
Efforts to control and eradicate infectious disease
have concentrated on the provision of childhood
vaccination. Unfortunately, the uptake of childhood
vaccination continues to vary and infectious diseases
continue to cause differential morbidity and mortality.
Limited research has assessed the factors that underlie the
uptake of vaccination.
The present research undertakes an analysis of the
patterns and determinants of vaccination uptake within the
Portsmouth and South East Hampshire Health Authority,
located in the south of England. In so doing, the research
employs different analytical approaches, from the
traditional ecological analysis through descriptive mapping
and multivariate regression, to the innovative multi-level
The ecological analysis shows a distinct geography to
the uptake of vaccination which reflects characteristics of
socioeconomic deprivation. Further analysis through multilevel
modelling, emphasizes two influences on the uptake of
vaccination. First, parental characteristics, which affect
their role as decision maker and their ability to overcome
certain time-space constraints to attend. Second, the ways
in which the service is provided, including the influence
of the health professional as adviser and provider of
vaccination and the initiatives employed to improve uptake.
These findings have implications for the future provision
of childhood vaccination. Specifically, the research
provides the opportunity to identify and target children
unlikely to complete their vaccination schedule and the
need to improve and standardise health professional
knowledge and advice to parents.