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Canadian Journal of Public Health

, Volume 108, Issue 2, pp e124–e128 | Cite as

Timeliness and completeness of routine childhood vaccinations in children by two years of age in Alberta, Canada

  • Vineet SainiEmail author
  • Shannon E. MacDonald
  • Deborah A. McNeil
  • Sheila W. McDonald
  • James D. Kellner
  • Sarah A. Edwards
  • Victoria Stagg
  • Suzanne Tough
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVES: Assessing timeliness and completeness of vaccine administration is important for evaluating the effectiveness of immunization programs. Few studies have reported timeliness, particularly in Canada. The objective of this study was to examine timeliness of the receipt of vaccination for each routine childhood recommended vaccine by 24 months of age among children in a community-based pregnancy cohort in Calgary, Alberta.

METHODS: Survey data from a community-based pregnancy cohort in Alberta were linked to Public Health vaccination records of children (n = 2763). The proportion of children receiving early, timely, delayed, or no vaccination was calculated. A dose was considered early if it was administered before the recommended age in days as per the vaccination schedule, timely if administered at any time from start of recommended age in days to age in days when delay counts were initiated, and delayed if it was administered on or after age in days when delay counts were initiated. Series completion rates were also calculated.

RESULTS: For multi-dose vaccines, over 80% of children had timely doses at 2, 4 and 6 months. By 12 months, this proportion decreased to 65% (95% CI: 63%–66%) for meningococcal conjugate group C, 61% (95% CI: 59%–62%) for measles antigen-containing vaccines and 64% (95% CI: 62%–65%) for varicella antigen-containing vaccines. At 18 months, only 55% (95% CI: 53%–56%) of the children had a timely 4th dose of diphtheria, acellular pertussis, tetanus, polio, and Haemophilus influenzae type b vaccine. Eventual series completion rate for all recommended vaccines was 77% (95% CI: 75%–79%).

CONCLUSION: The timeliness and completeness of routine childhood vaccination in preschool children in this community-based pregnancy cohort is lower than provincial targets. Data on timeliness of vaccination can inform further work on barriers and enablers to vaccination in order to meet provincial targets.

Key Words

Vaccination immunization timeliness completeness child 

Résumé

OBJECTIFS: Il est important de déterminer l’opportunité et l’intégralité de l’administration des vaccins pour évaluer l’efficacité des programmes d’immunisation. Peu d’études abordent l’opportunité, particulièrement au Canada. Notre objectif était donc d’examiner l’opportunité des vaccinations reçues pour chacun des vaccins systématiquement recommandés aux enfants avant l’âge de 24 mois dans une cohorte communautaire de grossesses de Calgary (Alberta).

MÉTHODE: Les données d’enquête d’une cohorte communautaire de grossesses en Alberta ont été liées aux dossiers de santé publique sur la vaccination des enfants (n = 2 763). Nous avons calculé la proportion d’enfants ayant reçu leurs vaccins tôt, à temps, en retard ou pas du tout. Une dose était jugée avoir été administrée tôt si elle l’avait été avant l’âge recommandé en jours dans le calendrier de vaccination, à temps si elle avait été administrée entre le début de l’âge recommandé en jours et l’âge en jours où l’on a commencé la comptabilisation des retards, et en retard si elle avait été administrée à l’âge ou après l’âge en jours où l’on a commencé la comptabilisation des retards. Nous avons aussi calculé les taux d’achèvement des séries vaccinales.

RÉSULTATS: Pour les vaccins à doses multiples, plus de 80 % des enfants avaient reçu leurs doses à temps à 2, 4 et 6 mois. À 12 mois, cette proportion baissait à 65 % (IC de 95 %: 63 %–66 %) pour le vaccin conjugué contre le méningocoque du groupe C, à 61 % (IC de 95 %: 59 %–62 %) pour les vaccins contenant un antigène contre la rougeole et à 64 % (IC de 95 %: 62 %–65 %) pour les vaccins contenant un antigène contre la varicelle. À 18 mois, seulement 55 % (IC de 95 %: 53 %–56 %) des enfants avaient reçu à temps la 4e dose du vaccin contre la diphtérie, la coqueluche acellulaire, le tétanos, la polio et l’Haemophilus influenzae de type b. Le taux d’achèvement éventuel des séries pour tous les vaccins recommandés était de 77 % (IC de 95 %: 75 %–79 %).

CONCLUSION: L’opportunité et l’intégralité de la vaccination systématique des enfants d’âge préscolaire dans cette cohorte communautaire de grossesses sont inférieures aux cibles provinciales. Les données sur l’opportunité de la vaccination peuvent éclairer d’autres travaux sur les obstacles et les incitateurs à la vaccination afin de respecter les cibles provinciales.

Mots Clés

vaccination immunisation opportunité intégralité enfant 

References

  1. 1.
    Hull BP, McIntyre PB. Timeliness of childhood immunisation in Australia. Vaccine 2006;24(20):4403–8. PMID: 16569467. doi: 10.1016/j.vaccine.2006. 02.049.CrossRefGoogle Scholar
  2. 2.
    Seither R, Calhoun K, Knighton CL, Mellerson J, Meador S, Tippins A, et al. Vaccination coverage among children in kindergarten–United States, 2014–15 school year. MMWR Morb Mortal Wkly Rep 2015;64(33):897–904. PMID: 26313471. doi: 10.15585/mmwr.mm6433a2.CrossRefGoogle Scholar
  3. 3.
    Public Health Agency of Canada. Vaccine Coverage in Canadian Children: Highlights from the 2013 Childhood National Immunization Coverage Survey (cNICS). Ottawa, ON: PHAC, 2015.Google Scholar
  4. 4.
    Hull BP, Dey A, Beard FH, Menzies RI, Brotherton JM, McIntyre PB. Annual Immunisation Coverage Report 2013. Canberra, Australia: National Centre for Immunisation Research & Surveillance, 2013.Google Scholar
  5. 5.
    World Health Organization. WHO Vaccine-Preventable Diseases: Monitoring System, 2016 Global Summary. Geneva, Switzerland: The Department of Immunization, Vaccines and Biologicals, WHO, 2016.Google Scholar
  6. 6.
    Public Health Agency of Canada. Canadian Immunization Guide. Ottawa, ON: PHAC, 2014.Google Scholar
  7. 7.
    Luman ET, Barker LE, Shaw KM, McCauley MM, Buehler JW, Pickering LK. Timeliness of childhood vaccinations in the United States: Days undervaccinated and number of vaccines delayed. JAMA 2005; 293(10):1204–11. doi: 10.1001/jama.293.10.1204.CrossRefGoogle Scholar
  8. 8.
    Kurosky SK, Davis KL, Krishnarajah G. Completion and compliance of childhood vaccinations in the United States. Vaccine 2016;34(3):387–94. doi: 10.1016/j.vaccine.2015.11.011.CrossRefGoogle Scholar
  9. 9.
    Kroger AT, Sumaya CV, Pickering LK, Atkinson WL. General recommendations on immunization–Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60(2):1–64.Google Scholar
  10. 10.
    Luman ET, Mason McCauley M, Stokley S, Chu SY, Pickering LK. Timeliness of childhood immunizations. Pediatrics 2002;110(5):935–39. doi: 10.1542/peds.110.5.935.CrossRefGoogle Scholar
  11. 11.
    Strine TW, Luman ET, Okoro CA, Mason McCauley M, Barker LE. Predictors of age-appropriate receipt of DTaP dose 4. Am J Prev Med 2003;25(1):45–49. doi: 10.1016/S0749-3797(03)00093-X.CrossRefGoogle Scholar
  12. 12.
    Dombkowski KJ, Lantz PM, Freed GL. The need for surveillance of delay in age-appropriate immunization. Am J Prev Med 2002;23(1):36–42. doi: 10.1016/ S0749-3797(02)00442-7.CrossRefGoogle Scholar
  13. 13.
    Dannetun E, Tegnell A, Hermansson G, Törner A, Giesecke J. Timeliness of MMR vaccination–Influence on vaccination coverage. Vaccine 2004;22(31–32):4228–32. doi: 10.1016/j.vaccine.2004.04.018.CrossRefGoogle Scholar
  14. 14.
    Lernout T, Theeten H, Hens N, Braeckman T, Roelants M, Hoppenbrouwers K, Van Damme P. Timeliness of infant vaccination and factors related with delay in Flanders, Belgium. Vaccine 2014;32(2):284–89. doi: 10.1016/j.vaccine. 2013.10.084.CrossRefGoogle Scholar
  15. 15.
    Akmatov MK, Kretzschmar M, Krämer A, Mikolajczyk RT. Timeliness of vaccination and its effects on fraction of vaccinated population. Vaccine 2008; 26(31):3805–11. doi: 10.1016/j.vaccine.2008.05.031.CrossRefGoogle Scholar
  16. 16.
    Dummer TJ, Cui Y, Strang R, Parker L. Immunization completeness of children under two years of age in Nova Scotia, Canada. Can J Public Health 2012;103(5):e363–67.PubMedGoogle Scholar
  17. 17.
    McDonald SW, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SM, et al. The All Our Babies pregnancy cohort: Design, methods, and participant characteristics. BMC Pregnancy Childbirth 2013;13(Suppl 1):S2. doi: 10.1186/ 1471-2393-13-S1-S2.CrossRefGoogle Scholar
  18. 18.
    Alberta Health and Wellness. Alberta Immunization Strategy 2007–2017. Edmonton, AB: Alberta Health and Wellness, 2007.Google Scholar
  19. 19.
    Public Health Agency of Canada. Canadian National Reports on Immunization, 2006. Can Commun Dis Rep 2006;32S3:1–44.Google Scholar
  20. 20.
    Ministry of Health and Long-Term Care. Immunization 2020: Modernizing Ontario’s Publicly Funded Immunization Program. Toronto, ON: Government of Ontario, 2015.Google Scholar
  21. 21.
    Ministry of Health. ImmunizeBC: A Strategic Framework for Immunization in B.C. Vancouver, BC: Government of British Columbia, 2007.Google Scholar
  22. 22.
    Canadian Immunization Registry Network. National Standards for Immunization Coverage Assessment: Recommendations from the Canadian Immunization Registry Network. Ottawa, ON: Government of Canada, 2015.Google Scholar
  23. 23.
    Kershaw T, Suttorp V, Simmonds K, St. Jean T. Outbreak of measles in a non-immunizing population, Alberta 2013. Can Commun Dis Rep 2014; 40(12):219–26.CrossRefGoogle Scholar
  24. 24.
    The Canadian Press. Whooping Cough Outbreak Slow to Leave Central Alberta. Calgary, AB: Herald 9 January 2015.Google Scholar
  25. 25.
    Bell CA, Simmonds KA, MacDonald SE. Exploring the heterogeneity among partially vaccinated children in a population-based cohort. Vaccine 2015; 33(36):4572–78. doi: 10.1016/j.vaccine.2015.07.004.CrossRefGoogle Scholar
  26. 26.
    Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kolasa M. National, state, and selected local area vaccination coverage among children aged 19–35 months–United States, 2014. MMWR Morb Mortal Wkly Rep 2015; 64(33):889–96. doi: 10.15585/mmwr.mm6433a1.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  • Vineet Saini
    • 1
    • 2
    Email author
  • Shannon E. MacDonald
    • 3
    • 4
  • Deborah A. McNeil
    • 1
    • 5
  • Sheila W. McDonald
    • 1
    • 3
  • James D. Kellner
    • 3
  • Sarah A. Edwards
    • 1
  • Victoria Stagg
    • 1
  • Suzanne Tough
    • 3
  1. 1.Communicable Disease Control and Environmental Public Health, Research and Innovation, Population Public and Indigenous HealthAlberta Health ServicesCalgaryCanada
  2. 2.Faculty of Veterinary MedicineUniversity of CalgaryCalgaryCanada
  3. 3.Department of Paediatrics, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
  4. 4.Faculty of NursingUniversity of AlbertaEdmontonCanada
  5. 5.Faculty of NursingUniversity of CalgaryCalgaryCanada

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