{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:56:46Z","timestamp":1787021806608,"version":"build-2736575974"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MRC","award":["MC_PC_19075"],"award-info":[{"award-number":["MC_PC_19075"]}]},{"name":"BREATHE: the Health Data Research Hub for Respiratory Health","award":["MC_PC_19004"],"award-info":[{"award-number":["MC_PC_19004"]}]}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"\n Background<\/jats:title>\n In 2020, the SARS-CoV-2 (COVID-19) pandemic and lockdown control measures threatened to disrupt routine childhood immunisation programmes with early reports suggesting uptake would fall. In response, public health bodies in Scotland and England collected national data for childhood immunisations on a weekly or monthly basis to allow for rapid analysis of trends. The aim of this study was to use these data to assess the impact of different phases of the pandemic on infant and preschool immunisation uptake rates.<\/jats:p>\n <\/jats:sec>\n \n Methods and findings<\/jats:title>\n We conducted an observational study using routinely collected data for the year prior to the pandemic (2019) and immediately before (22 January to March 2020), during (23 March to 26 July), and after (27 July to 4 October) the first UK \u201clockdown\u201d. Data were obtained for Scotland from the Public Health Scotland \u201cCOVID19 wider impacts on the health care system\u201d dashboard and for England from ImmForm.<\/jats:p>\n \n Five vaccinations delivered at different ages were evaluated; 3 doses of \u201c6-in-1\u201d diphtheria, tetanus, pertussis, polio,\n Haemophilus influenzae<\/jats:italic>\n type b, and hepatitis B vaccine (DTaP\/IPV\/Hib\/HepB) and 2 doses of measles, mumps, and rubella (MMR) vaccine. This represented 439,754 invitations to be vaccinated in Scotland and 4.1 million for England. Uptake during the 2020 periods was compared to the previous year (2019) using binary logistic regression analysis. For Scotland, uptake within 4 weeks of a child becoming eligible by age was analysed along with geographical region and indices of deprivation. For Scotland and England, we assessed whether immunisations were up-to-date at approximately 6 months (all doses 6-in-1) and 16 to 18 months (first MMR) of age.\n <\/jats:p>\n We found that uptake within 4 weeks of eligibility in Scotland for all the 5 vaccines was higher during lockdown than in 2019. Differences ranged from 1.3% for first dose 6-in-1 vaccine (95.3 versus 94%, odds ratio [OR] compared to 2019 1.28, 95% confidence intervals [CIs] 1.18 to 1.39) to 14.3% for second MMR dose (66.1 versus 51.8%, OR compared to 2019 1.8, 95% CI 1.74 to 1.87). Significant increases in uptake were seen across all deprivation levels.<\/jats:p>\n In England, fewer children due to receive their immunisations during the lockdown period were up to date at 6 months (6-in-1) or 18 months (first dose MMR). The fall in percentage uptake ranged from 0.5% for first 6-in-1 (95.8 versus 96.3%, OR compared to 2019 0.89, 95% CI 0.86\u2013 to 0.91) to 2.1% for third 6-in-1 (86.6 versus 88.7%, OR compared to 2019 0.82, 95% CI 0.81 to 0.83).<\/jats:p>\n The use of routinely collected data used in this study was a limiting factor as detailed information on potential confounding factors were not available and we were unable to eliminate the possibility of seasonal trends in immunisation uptake.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this study, we observed that the national lockdown in Scotland was associated with an increase in timely childhood immunisation uptake; however, in England, uptake fell slightly. Reasons for the improved uptake in Scotland may include active measures taken to promote immunisation at local and national levels during this period and should be explored further. Promoting immunisation uptake and addressing potential vaccine hesitancy is particularly important given the ongoing pandemic and COVID-19 vaccination campaigns.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pmed.1003916","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T13:38:40Z","timestamp":1645537120000},"page":"e1003916","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":30,"title":["Uptake of infant and preschool immunisations in Scotland and England during the COVID-19 pandemic: An observational study of routinely collected data"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-5084","authenticated-orcid":true,"given":"Fiona","family":"McQuaid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1020-3373","authenticated-orcid":true,"given":"Rachel","family":"Mulholland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuma","family":"Sangpang Rai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5181-6120","authenticated-orcid":true,"given":"Utkarsh","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0908-1380","authenticated-orcid":true,"given":"Helen","family":"Bedford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5263-3086","authenticated-orcid":true,"given":"J. Claire","family":"Cameron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Gibbons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partho","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7022-3056","authenticated-orcid":true,"given":"Aziz","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4101-4535","authenticated-orcid":true,"given":"Ting","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5194-8083","authenticated-orcid":true,"given":"Colin R.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-4690","authenticated-orcid":true,"given":"Judith","family":"Tait","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2712-7971","authenticated-orcid":true,"given":"Elise","family":"Tessier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8393-5060","authenticated-orcid":true,"given":"Steve","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-4067","authenticated-orcid":true,"given":"Jaime","family":"Villacampa Ortega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4453-623X","authenticated-orcid":true,"given":"Rachael","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"pmed.1003916.ref001","unstructured":"United Kingdom Government. Prime minister\u2019s statement on coronavirus (COVID 19) Press release. 2020 Mar 23 [cited 2021 May 25]. Available from: https:\/\/www.gov.uk\/government\/speeches\/pm-address-to-the-nation-on-coronavirus-23-march-2020"},{"key":"pmed.1003916.ref002","unstructured":"The Scottish Government. Re-mobilise, Recover, Re-design: the framework for NHS Scotland. 2020 May [cited 2021 May 25]. Available from: https:\/\/www.gov.scot\/publications\/re-mobilise-recover-re-design-framework-nhs-scotland\/"},{"issue":"11","key":"pmed.1003916.ref003","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1177\/0141076820962447","article-title":"Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis","volume":"113","author":"RH Mulholland","year":"2020","journal-title":"J R Soc Med"},{"key":"pmed.1003916.ref004","unstructured":"Joint Committee on Vaccination and Immunisation. Satement from JCVI on immunisation prioritisation. 2020 Apr 17 [cited 2021 May 25]. Available from: https:\/\/www.gov.uk\/government\/publications\/jcvi-statement-on-immunisation-prioritisation\/statement-from-jcvi-on-immunisation-prioritisation"},{"issue":"9","key":"pmed.1003916.ref005","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S2352-4642(20)30177-2","article-title":"COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study","volume":"4","author":"F G\u00f6tzinger","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"issue":"2","key":"pmed.1003916.ref006","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1001\/jamapediatrics.2020.4573","article-title":"Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults: A Systematic Review and Meta-analysis","volume":"175","author":"RM Viner","year":"2021","journal-title":"JAMA Pediatr"},{"key":"pmed.1003916.ref007","article-title":"The potential impact of the COVID-19 pandemic on child growth and development: a systematic review","author":"LA Ara\u00fajo","year":"2020","journal-title":"J Pediatr"},{"key":"pmed.1003916.ref008","unstructured":"Royal College of Paediatrics and Child Health workforce team. The impact of COVID\u201419 on child health services\u2014report. 2020 May 7 [cited 2021 May 25]. Avilable from https:\/\/www.rcpch.ac.uk\/sites\/default\/files\/managed-pdf\/Impact%20-of-COVID-19-child-health-services-web.pdf.pdf"},{"key":"pmed.1003916.ref009","doi-asserted-by":"crossref","first-page":"m2392","DOI":"10.1136\/bmj.m2392","article-title":"Routine vaccination during covid-19 pandemic response","volume":"369","author":"S Saxena","year":"2020","journal-title":"BMJ"},{"key":"pmed.1003916.ref010","unstructured":"World Health Organization, WHO and UNICEF warn of a decline in vaccinations during COVID-19 Press release. 2020 Jul 15 [cited 2021 May 25]. Geneva\/New York. Available from https:\/\/www.who.int\/news\/item\/15-07-2020-who-and-unicef-warn-of-a-decline-in-vaccinations-during-covid-19"},{"issue":"19","key":"pmed.1003916.ref011","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2020.25.19.2000848","article-title":"Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020","volume":"25","author":"HI McDonald","year":"2020","journal-title":"Euro Surveill."},{"issue":"45","key":"pmed.1003916.ref012","doi-asserted-by":"crossref","first-page":"7146","DOI":"10.1016\/j.vaccine.2020.08.019","article-title":"Impact of COVID-19 pandemic response on uptake of routine immunizations in Sindh, Pakistan: An analysis of provincial electronic immunization registry data","volume":"38","author":"S Chandir","year":"2020","journal-title":"Vaccine"},{"issue":"0","key":"pmed.1003916.ref013","first-page":"13185","article-title":"Child health services during a COVID-19 outbreak in KwaZulu-Natal Province, South Africa","volume":"0","author":"C Jensen","year":"2020","journal-title":"S Afr Med J"},{"issue":"5","key":"pmed.1003916.ref014","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.vaccine.2020.12.054","article-title":"Childhood vaccinations: Hidden impact of COVID-19 on children in Singapore","volume":"39","author":"Y Zhong","year":"2021","journal-title":"Vaccine"},{"issue":"19","key":"pmed.1003916.ref015","doi-asserted-by":"crossref","first-page":"591","DOI":"10.15585\/mmwr.mm6919e2","article-title":"Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration\u2014United States, 2020","volume":"69","author":"JM Santoli","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"pmed.1003916.ref016","unstructured":"Department of Health. Immunisation against infectious disease: The Green book. Public Health England; 2021."},{"key":"pmed.1003916.ref017","unstructured":"United Kingdom Government. PM annouces easing of lockdown restrictions press release. 2020 June 23 [cited 2021 May 25]. Available from: https:\/\/www.gov.uk\/government\/news\/pm-announces-easing-of-lockdown-restrictions-23-june-2020"},{"key":"pmed.1003916.ref018","unstructured":"The Scottish Government. Scotland\u2019s routemap through and out of the crisis. 2020 May 21 [cited 2021 May 25]. Available from: https:\/\/www.gov.scot\/publications\/coronavirus-covid-19-framework-decision-making-scotlands-route-map-through-out-crisis\/pages\/2\/2020"},{"key":"pmed.1003916.ref019","unstructured":"The Scottish Government. Introducing the Scottish Index of Multiple Deprivation 2020. National statistics publication. 2020 Jan 28 [cited 2021 May 21]. Available from: https:\/\/www.gov.scot\/publications\/scottish-index-multiple-deprivation-2020\/documents\/"},{"issue":"10","key":"pmed.1003916.ref020","doi-asserted-by":"crossref","first-page":"e1001885","DOI":"10.1371\/journal.pmed.1001885","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement","volume":"12","author":"EI Benchimol","year":"2015","journal-title":"PLoS Med."},{"issue":"37","key":"pmed.1003916.ref021","doi-asserted-by":"crossref","first-page":"5614","DOI":"10.1016\/j.vaccine.2019.07.080","article-title":"Identifying inequalities in childhood immunisation uptake and timeliness in southeast Scotland, 2008\u20132018: A retrospective cohort study","volume":"37","author":"EA Haider","year":"2019","journal-title":"Vaccine"},{"key":"pmed.1003916.ref022","unstructured":"Royal Society for Public Health. Moving the needle: Promoting vaccination uptake across the life course. 2019 January [cited 2021 May 25]. Available from: https:\/\/www.rsph.org.uk\/static\/uploaded\/3b82db00-a7ef-494c-85451e78ce18a779.pdf"},{"key":"pmed.1003916.ref023","unstructured":"HM revenus and Customs. Coronavirus Job Retention Scheme Official Statistics. 2020 May 12 [cited 2021 May 25]. Available from: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/891249\/Coronavirus_Job_Retention_Scheme_Statistics_June_2020.pdf"},{"issue":"4","key":"pmed.1003916.ref024","doi-asserted-by":"crossref","first-page":"P459","DOI":"10.1016\/S1473-3099(20)30991-9","article-title":"Keeping childhood immunisation rates stable during the COVID-19 pandemic","volume":"21","author":"AA Jarchow-MacDonald","year":"2021","journal-title":"Lancet Infect Dis"},{"issue":"22","key":"pmed.1003916.ref025","doi-asserted-by":"crossref","first-page":"2979","DOI":"10.1016\/j.vaccine.2017.03.089","article-title":"Changing attitudes to childhood immunisation in English parents","volume":"35","author":"H Campbell","year":"2017","journal-title":"Vaccine"},{"issue":"3","key":"pmed.1003916.ref026","first-page":"CD003941","article-title":"Patient reminder and patient recall systems to improve immunization rates","author":"JC Jacobson Vann","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"pmed.1003916.ref027","doi-asserted-by":"crossref","first-page":"e0244049","DOI":"10.1371\/journal.pone.0244049","article-title":"Parents\u2019 and guardians\u2019 views and experiences of accessing routine childhood vaccinations during the coronavirus (COVID-19) pandemic: A mixed methods study in England.","volume":"15","author":"S Bell","year":"2020","journal-title":"PLoS ONE"},{"issue":"12","key":"pmed.1003916.ref028","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.1016\/S2213-2600(20)30502-6","article-title":"Physical distancing in schools for SARS-CoV-2 and the resurgence of rhinovirus","volume":"8","author":"S Poole","year":"2020","journal-title":"Lancet Respir Med"},{"issue":"6","key":"pmed.1003916.ref029","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1136\/jech-2016-207366","article-title":"Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research","volume":"71","author":"AS Forster","year":"2017","journal-title":"J Epidemiol Community Health"},{"key":"pmed.1003916.ref030","unstructured":"Public Health Scotland Data and Intelligence. Childhood Immunisation Statistics Scotland. 2019 Dec 10 [cited 2021 May 25]. Available from: https:\/\/www.isdscotland.org\/Health-Topics\/Child-Health\/publications\/data-tables2017.asp?id=2574#2574"}],"container-title":["PLOS Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1003916","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T13:39:20Z","timestamp":1645537160000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1003916"}},"subtitle":[],"editor":[{"given":"Lars \u00c5ke","family":"Persson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,22]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmed.1003916","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.07.19.21260770","asserted-by":"object"}]},"ISSN":["1549-1676"],"issn-type":[{"value":"1549-1676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,22]]}}}