Abstract
Background: Vaccination is a cornerstone of childhood public health. However, uptake has declined across the UK, with urban, deprived, and ethnically diverse communities facing unique barriers, exacerbated by the COVID-19 pandemic. Aim: To identify socioeconomic and clinical predictors of incomplete and untimely childhood vaccination between 2010 and 2023. Design and setting: Cross-sectional study using electronic health records from 40 general practices in Lambeth, an ethnically diverse London borough. Method: Routinely collected data for 37,837 children eligible for vaccines by age five were analysed. Multivariable logistic regression assessed associations between predictors and (1) vaccination uptake and (2) timeliness, defined as receipt within three months of the scheduled age. Results: Of eligible children, 60.1% (n=23,119) were fully vaccinated; of these, 60.8% (n=14,062) were vaccinated on time. Lower uptake was associated with deprivation (most vs least deprived: AOR 0.66, 95% CI 0.51–0.84), born outside the UK vs UK born (AOR 0.10, 95% CI 0.08–0.12), and non-white British ethnicity (e.g. Black Caribbean: AOR 0.30, 95% CI 0.25–0.36). Children with clinical comorbidities had higher uptake (e.g. primary care-managed comorbidity: AOR 1.58, 95% CI 1.46–1.71). Timeliness patterns differed: among those vaccinated, children born outside the UK and those from African, Caribbean, and mixed ethnic backgrounds had higher odds of timely vaccination. Conclusion: Different predictors for uptake and timeliness highlight the need for strategies addressing both access and timely delivery. Local data should inform targeted, place-based interventions. Culturally competent services, integrated into routine primary care and co-designed with communities are recommended.
- Received May 21, 2025.
- Accepted September 15, 2025.
- Copyright © 2025, The Authors
