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

Canadian Journal of Public Health volume 108, pages e124–e128 (2017)Cite this article

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.

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.

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Author information

Affiliations

  1. Scientist Lead, Communicable Disease Control and Environmental Public Health, Research and Innovation, Population Public and Indigenous Health, Alberta Health Services, Southport Atrium, 10101 Southport Road SW, Calgary, AB, T2W 3N2, Canada

    Vineet Saini PhD, DVM, Deborah A. McNeil PhD, RN, Sheila W. McDonald PhD, MSc, Sarah A. Edwards MHSc & Victoria Stagg MSc

  2. Scientist Lead, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada

    Vineet Saini PhD, DVM

  3. Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Shannon E. MacDonald PhD, RN, Sheila W. McDonald PhD, MSc, James D. Kellner MD, MSc & Suzanne Tough PhD, MSc

  4. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

    Shannon E. MacDonald PhD, RN

  5. Faculty of Nursing, University of Calgary, Calgary, AB, Canada

    Deborah A. McNeil PhD, RN

Authors
  1. Vineet Saini PhD, DVM
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  2. Shannon E. MacDonald PhD, RN
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  3. Deborah A. McNeil PhD, RN
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  4. Sheila W. McDonald PhD, MSc
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  5. James D. Kellner MD, MSc
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  6. Sarah A. Edwards MHSc
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  7. Victoria Stagg MSc
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  8. Suzanne Tough PhD, MSc
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Corresponding author

Correspondence to Vineet Saini PhD, DVM.

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Conflict of Interest: None to declare.

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Saini, V., MacDonald, S.E., McNeil, D.A. et al. Timeliness and completeness of routine childhood vaccinations in children by two years of age in Alberta, Canada. Can J Public Health 108, e124–e128 (2017). https://doi.org/10.17269/CJPH.108.5885

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  • DOI: https://doi.org/10.17269/CJPH.108.5885

Key Words

  • Vaccination
  • immunization
  • timeliness
  • completeness
  • child

Mots Clés

  • vaccination
  • immunisation
  • opportunité
  • intégralité
  • enfant