Primary Submission Category: Infants/children/youth
Community socioeconomic context and measles vaccination in Denmark: A multi-level analysis of initiation trends across eight population-based birth cohorts
Authors: Richard Carpiano, Vibeke Christensen, Andrea Polonijo,
Presenting Author: Richard Carpiano*
Despite extensive evidence that measles vaccination is effective, safe, and cost-beneficial, vaccination hesitancy has become a growing challenge to achieving and maintaining herd immunity against this highly infectious and harmful disease. Notably, the spread of misinformation regarding the necessity and side effects of measles vaccination–particularly the now-refuted (yet persisting) claim linking the vaccine to autism–has undermined uptake overall and across different socioeconomic status (SES) groups. Understanding such hesitancy requires considering the social contexts in which parents make health decisions. These contexts offer both opportunities to be informed and misinformed, as well as to either encourage or inhibit parents’ choices concerning their children’s health.
In the present study, we apply this perspective to examine how a child’s receipt of their first Measles, Mumps, and Rubella vaccination (MMR1) varies by local community socioeconomic composition. We focus on Denmark, which has national health care and no vaccination mandates, yet SES disparities in child vaccinations and growing SES segregation by neighborhood, thus potentially pooling both infection risk and parents’ vaccination beliefs.
Analyzing Danish national health registry data for eight birth cohorts (2008-15), we evaluate the extent to which (a) the concentration of residents by income and education in a family’s local community (i.e., parish) influences a child’s receipt of MMR1 (age 15 month) and (b) such association may vary over this time period that followed significant growth in anti-vaccine activism. To quantify possible parish effects of measles vaccine misinformation, we compare our findings for MMR1 with those for a child’s receipt of their Diphtheria, Tetanus, and Pertussis (DTP) vaccination at 12 months. Unlike MMR1, DTP coincides with a well-baby consultation at their medical doctor and home visits by a health nurse.