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Comparison of social distribution of immunisation with measles, mumps, and rubella vaccine, England, 1991-2001

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7394.854 (Published 19 April 2003) Cite this as: BMJ 2003;326:854
  1. Elizabeth Middleton, statistician,
  2. Deborah Baker, senior research fellow (d.j.baker@salford.ac.uk)
  1. National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL
  1. Correspondence to: D Baker
  • Accepted 30 August 2002

Since the late 1990s, the possible adverse effects of the combined measles, mumps, and rubella (MMR) vaccine have caused intense public debate. After the vaccine was introduced in 1988, coverage was high, increasing from 80% in 1989 to 92% in 1997. After 1997 coverage began to decline,1 and by 2001 had fallen by 4.1%, which gave some cause for concern.2 We examined the extent to which these trends reflect different patterns of uptake in affluent and deprived areas and changes in the equitable coverage of immunisation for MMR.

Participants, methods, and results

We selected 60 health authorities in England (defined by 1999 boundaries). The boundaries of these authorities remained stable over a decade. We calculated the Townsend material deprivation index for each area and used these scores to categorise authorities in to three groups of 20 authorities …

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