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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...

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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
first_indexed 2026-05-14T10:30:49Z
last_indexed 2026-05-14T10:30:49Z
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recordtype RisThesis
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spelling v2 71895 2026-05-14 Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets 1ebe1594ad1e94a04ae16cad04aa6294 MALORIE PERRY MALORIE PERRY true false 2026-05-14 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. E-Thesis Swansea COVID-19 Vaccines, Vaccination, Immunisation, Socioeconomic factors, measles, MMR, mumps, effectiveness, Data-linkage 16 4 2026 2026-04-16 10.23889/SUThesis.71895 COLLEGE NANME COLLEGE CODE Swansea University Griffiths, L. J., and Gravenor, M. B. Doctoral Ph.D 2026-05-14T11:34:23.8737167 2026-05-14T11:17:59.5169397 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine MALORIE PERRY 1 71895__36727__0d6f2881274740f7aa328776592b4300.pdf 2026_Perry_M.final.71895.pdf 2026-05-14T11:28:52.1930612 Output 3330830 application/pdf E-Thesis – open access true Copyright: the author, Malorie Perry, 2026 true eng
title Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
spellingShingle Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
MALORIE PERRY
title_short Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
title_full Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
title_fullStr Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
title_full_unstemmed Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
title_sort Assessing equity and effectiveness of vaccination programmes in Wales, utilising linkage of administrative datasets
author_id_str_mv 1ebe1594ad1e94a04ae16cad04aa6294
author_id_fullname_str_mv 1ebe1594ad1e94a04ae16cad04aa6294_***_MALORIE PERRY
author MALORIE PERRY
author2 MALORIE PERRY
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publishDate 2026
institution Swansea University
doi_str_mv 10.23889/SUThesis.71895
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description 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.
published_date 2026-04-16T11:34:25Z
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score 11.10555

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