Childhood vaccination schedule changes: equality impact assessment

Background

The main Protected Characteristics positively impacted by the change in policy is Age, specifically children and young people, with additional considerations for children from Religion and Belief groups, and women under the category of Sex. In addition, people from a lower Socio-economic background may benefit from the policy change.

Most varicella cases in children are relatively mild and the illness resolves without any need for treatment from a medical professional, though most children are unwell for several days and will miss five or more days from school or nursery. Learning from Covid-19 shows that the loss of time at school impacted children and younger people from socio-economic backgrounds more. While these illnesses are short, children from lower income households have a greater risk of not reaching their attainment through missing school days than children from more wealthy households.

On 14 May 2024, Public Health Scotland (PHS) published a report titled [link to report] - Understanding and addressing declines in childhood immunisations which highlighted that parents or carers may have to take time off work to care for their ill children. Therefore, for parents or carers from a lower socio-economic background there may be a greater impact if they lose work days without the financial resilience of more wealthy parents or carers. Parental responsibility for children is not split evenly between parents generally. For heterosexual couples, as most women take on the main caring responsibility for children, the cost for taking time off of work and losing personal time to provide care for an ill child disproportionately falls on women. This may be particularly impactful on female lone parents who work, where their sole income is impacted more markedly.

The main purpose of advancing the second dose of MMR vaccine is to improve coverage of the second dose, as well as providing more opportunity for the catch-up of missed doses at later appointments in the schedule, and therefore further reduce the likelihood of measles outbreaks. As the uptake of all routine vaccines remains of paramount importance, the JCVI considered that the probable benefit of increasing coverage in MMR justifies the additional routine immunisation visit.

For families who have beliefs that prohibit the use of pork or animal products, the current MMR programme provides a porcine gelatine-free alternative and UKHSA has confirmed that the MMRV policy will do the same to support vaccine choice. This also gives a neutral impact for the changes to the vaccine programme.