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Canadian Journal of Public Health

, Volume 95, Issue 2, pp 133–137 | Cite as

Immunization Programs in Non-traditional Settings

  • Shelagh A. WeatherillEmail author
  • Jane A. Buxton
  • Patricia C. Daly
Public Health In Action

Abstract

Background

The Downtown Eastside (DTES) of Vancouver is an inner-city neighbourhood of 10 square blocks where poverty, crowded housing, homelessness, poor nutrition and hygiene, chronic illness, and substance abuse put residents at risk for communicable diseases. The objective of the program was to minimize the burden of illness from vaccine-preventable diseases in this vulnerable population. This article describes the process and lessons learned to enable others to implement similar programs.

Intervention

Influenza and pneumococcal vaccinations were offered in community settings to all persons living in, working in, or visiting the DTES by teams of public health nurses and volunteers in the fall of 1999. Hepatitis A and B vaccinations were offered in January/February 2000. All 4 vaccines were offered in Fall 2000, influenza vaccine alone was offered in Fall 2001 and 2002; and pneumococcal, hepatitis A and B vaccines were offered in June 2002.

Results

During the initial 5-week influenza/pneumococcal immunization blitz, 8,723 persons were immunized; 79% received both vaccines. There was a reduction in visits for pneumonia to local emergency departments in the 3 months following this blitz. During the 5-week 2000 hepatitis A and B vaccination blitz, 3,542 persons were immunized; 58% received both vaccines. A reduction in reported cases of hepatitis A followed. Uptake of influenza vaccine was considerably reduced when offered in combination with 3 other vaccines. To maximize uptake, influenza vaccine was offered alone in subsequent years.

Conclusions

Immunizations can be successfully delivered to high-risk inner-city populations in non-traditional settings, using public health nursing outreach in a blitz format.

Résumé

Contexte

Le Downtown Eastside est un quartier défavorisé de 10 pâtés de maisons au centre-ville de Vancouver. En raison de la pauvreté, des logements surpeuplés, de la clochardise, des problèmes de nutrition et d’hygiène, des maladies chroniques et de l’abus d’alcool ou d’autres drogues qui sévissent dans ce quartier, les résidents y sont vulnérables aux maladies transmissibles. Notre programme visait à réduire le fardeau des maladies évitables par la vaccination pour ce segment démographique vulnérable. Nous en avons décrit le processus et les leçons apprises afin d’aider d’autres intervenants à mettre en oeuvre des programmes semblables.

Mesure d’intervention

À l’automne 1999, des équipes d’infirmières et d’infirmiers de santé publique et de bénévoles ont offert les vaccins antigrippal et antipneumococcique en milieu communautaire à tous les habitants, travailleurs et visiteurs du quartier. Les vaccins contre l’hépatite A et B ont été offerts en janvier-février 2000. On a offert les quatre vaccins à l’automne 2000, le vaccin antigrippal seulement à l’automne 2001 et 2002, et les vaccins antipneumococcique et contre l’hépatite A et B en juin 2002.

Résultats

Durant les cinq premières semaines de la campagne-éclair d’immunisation antigrippale/antipneumococcique, 8 723 personnes ont été vaccinées; 79 % ont reçu les deux vaccins. Une baisse des visites à l’urgence pour cause de pneumonie a été constatée dans les hôpitaux locaux au cours des trois mois qui ont suivi la campagne. En 2000, durant les cinq semaines de la campagne-éclair d’immunisation contre l’hépatite A et B, 3 542 personnes ont été vaccinées; 58 % ont reçu les deux vaccins. Il s’en est suivi une baisse des cas déclarés d’h’epatite A. L’acceptation du vaccin antigrippal était considérablement réduite lorsque celui-ci était offert en combinaison avec les trois autres vaccins. Pour maximiser l’acceptation, on a donc offert le vaccin antigrippal tout seul les années suivantes.

Conclusions

Il est possible d’immuniser les populations très vulnérables des quartiers déshérités des centres-villes dans un contexte non traditionnel en faisant appel aux services infirmiers de santé publique dans le cadre de campagnes-éclairs.

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Copyright information

© The Canadian Public Health Association 2004

Authors and Affiliations

  • Shelagh A. Weatherill
    • 1
    Email author
  • Jane A. Buxton
    • 2
    • 3
  • Patricia C. Daly
    • 4
  1. 1.Vancouver Coastal HealthVancouverCanada
  2. 2.Federal Field Epidemiology Training Program, Laboratory Centre for Disease ControlHealth CanadaOttawaCanada
  3. 3.Dept Health Care and EpidemiologyUniversity of British ColumbiaCanada
  4. 4.Vancouver Coastal HealthVancouverCanada

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