title: Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study.
abstract: BACKGROUND
  There are conflicting findings regarding the impact of residential mobility on immunisation status. Our aim was to determine whether there was any association between residential mobility and take up of immunisations and whether they were delayed in administration.
  
  
  METHODS
  We carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisation were collected electronically. We defined frequent movers as those who had moved: 2 or more times in the period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or more times in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal and meningitis C vaccinations. We defined immunisations due at 2-4 months delayed if they had not been given by age 1; and those due at 12-13 months as delayed if they had not been given by age 2.
  
  
  RESULTS
  Uptake rates of routine immunisations and whether they were given within the specified timeframe were high for both groups. There was no increased risk (odds ratios (95% confidence intervals) between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88-1.32); booster Meningitis C 1.65 (0.93-2.92); booster pneumococcal 1.60 (0.59-4.31); primary 5 in 1 1.28 (0.92-1.78); and timeliness: primary MMR 0.92 (0.79-1.07); booster Meningitis C 1.26 (0.77-2.07); booster pneumococcal 1.69 (0.23-12.14); and primary 5 in 1 1.04 (0.88-1.23).
  
  
  CONCLUSIONS
  Findings suggest that children who move home frequently are not adversely affected in terms of the uptake of immunisations and whether they were given within a specified timeframe. Both were high and may reflect proactive behaviour in the primary healthcare setting to meet Government coverage rates for immunisation.
authors.affiliation: Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK. Electronic address: h.a.hutchings@swansea.ac.uk.
authors.forename: Hayley A
authors.initials: HA
authors.lastname: Hutchings
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Heath Park, Cardiff, UK. Electronic address: EvansA50@cardiff.ac.uk.
authors.forename: Annette
authors.initials: A
authors.lastname: Evans
authors.affiliation: Abertawe Bromorgannwg University Health Board (ABM UHB), Singleton Park, Swansea, UK. Electronic address: Peter.Barnes2@wales.nhs.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Barnes
authors.affiliation: Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK. Electronic address: m.a.healy@swansea.ac.uk.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Healy
authors.affiliation: Abertawe Bromorgannwg University Health Board (ABM UHB), Singleton Park, Swansea, UK. Electronic address: Michelle.James-Ellison@wales.nhs.uk.
authors.forename: Michelle
authors.initials: M
authors.lastname: James-Ellison
authors.affiliation: Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK. Electronic address: R.A.Lyons@swansea.ac.uk.
authors.forename: Ronan A
authors.initials: RA
authors.lastname: Lyons
authors.affiliation: Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK. Electronic address: alisonmaddocks@gmail.com.
authors.forename: Alison
authors.initials: A
authors.lastname: Maddocks
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Heath Park, Cardiff, UK. Electronic address: ParanjothyS@cardiff.ac.uk.
authors.forename: Shantini
authors.initials: S
authors.lastname: Paranjothy
authors.affiliation: Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK. Electronic address: S.E.Rodgers@swansea.ac.uk.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Rodgers
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Heath Park, Cardiff, UK. Electronic address: frankdunstan72@gmail.com.
authors.forename: Frank
authors.initials: F
authors.lastname: Dunstan
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D017589:Immunization Programs / Q000592:standards; D007115:Immunization Schedule; D007117:Immunization, Secondary / Q000706:statistics & numerical data; D007223:Infant; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D022401:Meningococcal Vaccines / Q000008:administration & dosage; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011157:Population Dynamics; D014611:Vaccination / Q000706:statistics & numerical data*; D014852:Wales
chemical_list: D022542:Measles-Mumps-Rubella Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines
keywords: Children; Cohort; Immunisation status; Residential mobility