title: A model to estimate the impact of changes in MMR vaccine uptake on inequalities in measles susceptibility in Scotland.
abstract: An article published in 1998 by Andrew Wakefield in The Lancet (volume 351, pages 637-641) led to concerns surrounding the safety of the measles, mumps and rubella vaccine, by associating it with an increased risk of autism. The paper was later retracted after multiple epidemiological studies failed to find any association, but a substantial decrease in UK vaccination rates was observed in the years following publication. This paper proposes a novel spatio-temporal Bayesian hierarchical model with accompanying software (the R package CARBayesST) to simultaneously address three key epidemiological questions about vaccination rates: (i) what impact did the controversy have on the overall temporal trend in vaccination rates in Scotland; (ii) did the magnitude of the spatial inequality in measles susceptibility in Scotland increase due to the measles, mumps and rubella vaccination scare; and (iii) are there any covariate effects, such as deprivation, that impacted on measles susceptibility in Scotland. The efficacy of the model is tested by simulation, before being applied to measles susceptibility data in Scotland among a series of cohorts of children who were aged 2.5-4.5, in September of the years 1998 to 2014.
authors: School of Mathematics and Statistics, University of Glasgow, Scotland Gary.Napier@glasgow.ac.uk.
authors: Gary
authors: G
authors: Napier
authors: School of Mathematics and Statistics, University of Glasgow, Scotland.
authors: Duncan
authors: D
authors: Lee
authors: Department of Mathematics and Statistics, University of Strathclyde, Scotland Health Protection Scotland, Glasgow, Scotland International Prevention Research Institute, Lyon, France.
authors: Chris
authors: C
authors: Robertson
authors: Department of Public Health Sciences, Medical University of South Carolina, SC, USA.
authors: Andrew
authors: A
authors: Lawson
authors: Health Protection Scotland, Glasgow, Scotland.
authors: Kevin G
authors: KG
authors: Pollock
mesh_terms: D001321:Autistic Disorder / Q000209:etiology; D001499:Bayes Theorem; D002675:Child, Preschool; D015331:Cohort Studies; D004198:Disease Susceptibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008457:Measles / Q000453:epidemiology*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D012606:Scotland / Q000453:epidemiology; D062211:Spatio-Temporal Analysis; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D022542:Measles-Mumps-Rubella Vaccine
keywords: Bayesian hierarchical modelling; measles susceptibility; spatio-temporal patterns