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Canadian Journal of Public Health

, Volume 94, Issue 3, pp 218–223 | Cite as

Pourquoi certains enfants sont incomplètement vaccinés à l’âge de 2 ans ?

  • Nicole BoulianneEmail author
  • Geneviève Deceuninck
  • Bernard Duval
  • France Lavoie
  • Marc Dionne
  • John Carsley
  • Louise Valiquette
  • Louis Rochette
  • Gaston De Serres
Article

Abstract

Objective: A survey was conducted in the Province of Quebec to document the factors associated with an incomplete immunization status among 2-year-old children.

Methods: Parents of 430 completely and 266 partially vaccinated children selected from the computerized vaccination register agreed to participate.

Results: The non-simultaneous administration of the 2nd MMR and 4th DPT-P-Hib at 18 months of age was responsible for 46% of incompleteness. The following characteristics were significantly associated with an incomplete immunization status: being a single parent, ≥ 2 children in the family, an older age at first immunization (≥ 3 months), parent’s preference for postponing the second vaccine when two injections are scheduled for the same visit, perception of lack of information about vaccination, and disagreement with immunization recommendations.

Conclusion: One of the key points of this study is the impact of the non-simultaneous administration of the two vaccines at 18 months. Factors such as being a single parent and older age at first immunization might be used to design an early intervention for children who are most likely to be incompletely immunized. Even if parents are favourable towards immunization, they need to be well informed about the associated risks and benefits.

Résumé

Objectif: Une enquête postale a été réalisée au Québec pour connaître les facteurs associés à une vaccination incomplète à l’âge de 2 ans.

Méthodes: Les parents de 430 enfants complètement vaccinés et 266 enfants incomplètement vaccinés ont été sélectionnés à partir des registres de vaccination.

Résultats: Le fait de ne pas avoir reçu simultanément le 2e RRO et le 4e DCT-P-Hib prévus à l’âge de 18 mois était responsable de 46 % des incomplétudes au calendrier vaccinal. Les caractéristiques suivantes étaient également associées au statut vaccinal incomplet: la monoparentalité, être dans une famille de 2 enfants ou plus, l’âge au premier vaccin (≥3 mois), la préférence des parents de ne pas faire donner 2 vaccins le même jour, la perception d’un manque d’information et un désaccord avec les recommandations vaccinales.

Conclusion: Le fait saillant de cette étude est l’impact de ne pas administrer le même jour les deux vaccins prévus à 18 mois. La monoparentalité et l’âge tardif au premier vaccin pourraient être utilisées comme marqueurs pour intervenir précocement auprès des enfants plus à risque de ne pas compléter leur calendrier vaccinal. On constate aussi que même si les parents sont généralement favorables à la vaccination, ils ont besoin d’être bien informés sur les avantages et les risques associés.

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References

  1. 1.
    Bentsi-Enchill A. National Estimates of Vaccination Coverage at Two Years of Age — Canada. Ottawa, ON: Division of Immunization, Bureau of Infectious Diseases, Laboratory Centre for Disease Control, 1997.Google Scholar
  2. 2.
    CCNI. Lignes directrices relatives à l’immunisation des enfants. RMTC 1997;23:1–12.Google Scholar
  3. 3.
    Dillman DA. Mail and Telephone Surveys — The Total Design Method. New York, NY: John Wiley & Sons, 1978.Google Scholar
  4. 4.
    Green LW, Kreuter MW. Health Promotion Today and a Framework for Planning. Health Promotion Planning — An Educational and Environmental Approach, Second Edition. Mountainview: Mayfield Publishing Company, 1991.Google Scholar
  5. 5.
    Rothman KJ, Greenland S. Modern Epidemiology, Second edition. Philadelphia, PA: Lippincott-Raven Publishers, 1998.Google Scholar
  6. 6.
    Wood D, Saarlas KN, Inkelas M, Matyas BT. Immunization registries in the United States: Implications for the practice of public health in a changing health care system. Annu Rev Public Health 1999;20:231–55.CrossRefGoogle Scholar
  7. 7.
    Richards A, Sheridan J. Reasons for delayed compliance with the childhood vaccination schedule and some failings of computerised vaccination registers. Austr N Z J Public Health 1999;23(3):315–17.CrossRefGoogle Scholar
  8. 8.
    Nounawon E, De Serres G, Boulianne N, Duval B. Impact d’une recherche active d’information vaccinale chez les enfants ayant un carnet de vaccination incomplet ou chez ceux qui l’ont perdu. Rev can santé publique 2001;92(4):267–71.Google Scholar
  9. 9.
    Williams IT, Milton JD, Farrell JB, Graham MH. Interaction of socioeconomic status and provider practices as predictors of immunization coverage in Virginia children. Pediatrics 1995;96(3):439–46.PubMedGoogle Scholar
  10. 10.
    Anonymous. Current trends impact of missed opportunities to vaccinate preschool-aged children on vaccination coverage levels — Selected U.S. sites, 1991–1992. MMWR 1994;43(39):709–11,17-18.Google Scholar
  11. 11.
    Sabnis SS, Pomeranz AJ, Lye PS, Amateau MM. Do missed opportunities stay missed? A 6-month follow-up of missed vaccine opportunities in inner city Milwaukee children. Pediatrics 1998;101(5):e5.CrossRefGoogle Scholar
  12. 12.
    Dietz VJ, Stevenson J, Zell ER, Cochi S, Hadler S, Eddins D. Potential impact on vaccination coverage levels by administering vaccines simultaneously and reducing dropout rates. Arch Pediatr Adolesc Med 1994;148(9):943–48.CrossRefGoogle Scholar
  13. 13.
    Lieu TA, Black SB, Sorel ME, Ray P, Shinefield HR. Would better adherence to guidelines improve childhood immunization rates? Pediatrics 1996;98(6):1062–68.PubMedGoogle Scholar
  14. 14.
    Bobo JK, Gale JL, Thapa PB, Wassilak SGF. Risk factors for delayed immunization in a random sample of 1163 children from Oregon and Washington. Pediatrics 1993;91(2):308–14.PubMedGoogle Scholar
  15. 15.
    Santoli JM, Szilagyi PG, Rodewald LE. Barriers to immunization and missed opportunities. Pediatr Ann 1998;27(6):366–74.CrossRefGoogle Scholar
  16. 16.
    Wood D, Pereyra M, Halfon N, Hamlin J, Grabowsky M. Vaccination levels in Los Angeles public health centers: The contribution of missed opportunities to vaccinate and other factors. Am J Public Health 1995;85(6):850–53.CrossRefGoogle Scholar
  17. 17.
    Weese CB, Krauss MR. A “barrier free” health care system does not ensure adequate vaccination of 2-year-old children. Arch Pediatr Adolesc Med 1995;149:1130–35.CrossRefGoogle Scholar
  18. 18.
    New SJ, Senior ML. “I don’t believe in needles”: Qualitative aspects of a study into the uptake of infant immunisation in two English health authorities. Soc Sci Med 1991;33(4):509–18.CrossRefGoogle Scholar
  19. 19.
    Anonymous. The Peckham Report — National Immunisation Study: Factors Influencing Immunisation Uptake in Childhood. London: The Department of Paediatric Epidemiology, Institute of Child Health, 1989.Google Scholar
  20. 20.
    Lieu TA, Black SB, Ray P, Chellino M, Shinefield HR, Adler NE. Risk factors for delayed immunization among children in an HMO. Am J Public Health 1994;84(10):1621–25.CrossRefGoogle Scholar
  21. 21.
    Strobino D, Keane V, Holt E, Hughart N, Guyer B. Parental attitudes do not explain underimmuization. Pediatrics 1996;98(6):1076–83.PubMedGoogle Scholar
  22. 22.
    Hughart N, Strobino D, Holt E, Guyer B, Hou W, Huq A, et al. The relation of parent and provider characteristics to vaccination status of children in private practices and managed care organizations in Maryland. Med Care 1999;37(1):44–55.CrossRefGoogle Scholar
  23. 23.
    Bates AS, Wolinsky FD. Personal, financial, and structural barriers to immunization in socio-economically disadvantaged urban children. Pediatrics 1998;101(4):591–96.CrossRefGoogle Scholar
  24. 24.
    Dionne M, Boulianne N, Duval B, Lavoie F, Laflamme N, De Serres G, et al. Étude des connaissances, attitudes et pratiques des vaccinateurs québécois à l’égard de la vaccination primaire. Québec: Direction régionale de la santé publique de Québec, Institut national de santé publique du Québec, 1999.Google Scholar
  25. 25.
    Udovic SL, Lieu TA. Evidence on office-based interventions to improve childhood immunization delivery. Pediatr Ann 1998;27(6):355–61.CrossRefGoogle Scholar
  26. 26.
    Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA, Bernier RR, et al. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am J Prev Med 2000;18(1S):97–140.CrossRefGoogle Scholar
  27. 27.
    Task Force on Community Preventive Service. Recommendations regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am J Prev Med 2000;18(1S):92–96.Google Scholar
  28. 28.
    Gyorkos TW, Tannenbaum TN, Abrahamowicz M, Bedard L, Carsley J, Franco ED, et al. Evaluation of the effectiveness of immunization delivery methods. Can J Public Health 1994;85(Suppl. 1):S14–S30.PubMedGoogle Scholar

Copyright information

© The Canadian Public Health Association 2003

Authors and Affiliations

  • Nicole Boulianne
    • 1
    • 2
  • Geneviève Deceuninck
    • 3
  • Bernard Duval
    • 1
    • 2
  • France Lavoie
    • 3
  • Marc Dionne
    • 1
    • 2
  • John Carsley
    • 1
    • 4
  • Louise Valiquette
    • 1
    • 4
  • Louis Rochette
    • 3
  • Gaston De Serres
    • 1
    • 2
  1. 1.Institut National de Santé Publique du QuébecQuébecCanada
  2. 2.Direction régionale de santé publique de QuébecCanada
  3. 3.Unité de recherche en santé publiqueCHUQ-Pavillon CHULCanada
  4. 4.Direction régionale de santé publique de Montréal-CentreCanada

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