E-Thesis 12 views
Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets / MALORIE PERRY
Swansea University Author: MALORIE PERRY
DOI (Published version): 10.23889/SUThesis.71895
Abstract
Vaccinations have been extremely successful in reducing the burden of infectious disease and a number of disease elimination goals rely on sustaining high vaccination coverage. Generating evidence demonstrating gaps in coverage is key to tailoring vaccination programmes, and ongoing vaccine effectiv...
| Published: |
Swansea
2026
|
|---|---|
| Institution: | Swansea University |
| Degree level: | Doctoral |
| Degree name: | Ph.D |
| Supervisor: | Griffiths, L. J., and Gravenor, M. B. |
| URI: | https://cronfa.swan.ac.uk/Record/cronfa71895 |
| Abstract: |
Vaccinations have been extremely successful in reducing the burden of infectious disease and a number of disease elimination goals rely on sustaining high vaccination coverage. Generating evidence demonstrating gaps in coverage is key to tailoring vaccination programmes, and ongoing vaccine effectiveness studies are needed to improve vaccine confidence and guide public health policy. Using the Secure Anonymised Information Linkage Databank, this project aimed to develop methods for evaluating equity and effectiveness of vaccination programmes through linkage of routine administrative datasets. These methods were put into practice with the roll-out of novel vaccines against COVID-19 in adults, and the longstanding childhood programme against Measles, Mumps and Rubella. Through linkage of ten demographic, education and public health datasets this work has contributed to the evidence base via three peer-reviewed publications, with a fourth under review, and other dissemination activities within policy. Using multivariable logistic regression, factors associated with lower vaccine coverage were identified, including ethnicity, birth order and place of birth. Using Cox regression in a robust cohort design, encouraging effectiveness estimates against severe COVID-19 infection were available in the first few months of the campaign. It was possible for the first time to quantify vaccine waning against mumps and demonstrate that vaccination against measles remains highly effective, improving confidence in elimination targets.Strengths and limitations of using routine administrative datasets for evaluating vaccine programmes are discussed, alongside recommendations and considerations for public health policy. Data linkage provides the opportunity to produce a wealth of evidence to support vaccine programme evaluation. The methodology developed here should be considered by other public health organisations, potentially through the development of strong academic links. More focus is needed on how evidence is disseminated to the general public, as well as those involved in vaccine policy or delivery. |
|---|---|
| Keywords: |
COVID-19 Vaccines, Vaccination, Immunisation, Socioeconomic factors, measles, MMR, mumps, effectiveness, Data-linkage |
| College: |
Faculty of Medicine, Health and Life Sciences |