Vaccination uptake among Traveller communities significantly lower than in general population

Traveller communities have significantly lower uptake of vaccinations compared to the general population, suggesting that more work needs to be done to promote understanding and appreciation of the benefits of vaccination among this population, according to researchers at the University of Cambridge.

In a study published today in the Journal of Public Health, researchers from the Primary Care Unit at Cambridge examined records at a General Practice in the East of England to compare uptake of vaccination with the Traveller and non-Traveller communities.

For the majority of vaccines – including the MMR, rotavirus and combined Tetanus, diphtheria, polio and pertussis vaccines – only around five out of ten eligible children in the Traveller community had completed the relevant vaccination schedule, compared to nine out of ten children in the non-Traveller community.

Substantial health inequalities exist between the Traveller and general population, with the life expectancy of Travellers being 10-12 years lower than non-Traveller equivalents. Several studies have shown that there is lower vaccine uptake in Traveller children but this is the first study to present recent, accurate data in the UK.

The findings show that this community is at risk of vaccine-preventable diseases. Ireland, Scotland and Wales and pockets of England are implementing strategies to improve vaccination coverage in the general population, but there is no national strategy in place in England to target Traveller, Gypsy and Roma communities.

The 2011 census recorded just under 58,000 Gypsies and Irish Travellers in England and Wales; however, the true number is more likely to be between 150,000 and 300,000, as many Travellers do not identify their ethnicity due to fear of discrimination.

"There is clearly much work needed to improve uptake of vaccinations among the Traveller community," says Kathryn Dixon, a student doctor at the School of Clinical Medicine, University of Cambridge. "Vaccinations are incredibly important to help protect children from potentially serious diseases, and we need to work with the Traveller communities to promote better understanding and appreciation of the long-term benefits."

Literacy levels within the Traveller community can be low, meaning that information often spreads by word-of-mouth, according to the authors. This can lead to a rapid change in vaccine uptake if one person in the community hears something good or bad about vaccination from, for example, another Traveller site.

It was estimated in 2006 that around one in ten Travellers live in the East of England.

"There have been cases in the past of Travellers being refused healthcare by GPs, but the practice involved has made a particular effort to engage with the local Traveller communities," explains Dr Tanya Blumenfeld, Senior Clinical Tutor at the University. "This could mean that vaccination rates elsewhere are even lower. We need to better understand the barriers that limit vaccination coverage and so help reduce the health inequalities that currently exist."