Predictors of universal influenza vaccination uptake in grades 1 and 2 Toronto school children: Effective vaccination strategies should not end with at risk children

Foty, Richard; Guttmann, Astrid; Kwong, Jeffrey C.; Maaten, Sarah; Dujovny, Manuel; Stieb, David M.; Dell, Sharon D.

doi:10.1016/j.vaccine.2010.06.097

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…Ontario has an ethnically diverse population with approximately 28% of residents born outside of Canada [ 41 ]. We found that infants of mothers who had immigrated to Canada within five years of the cohort child’s birth were more likely to initiate the series (aOR = 1.47; 95%CI, 1.05–2.04), consistent with other studies demonstrating a high degree of vaccine acceptance among new Canadians [ 42 , 43 ]. We are unable to explain the observation that children receiving care from a physician who trained outside of Canada were less likely to complete the series.…”

Section: Discussionsupporting

confidence: 89%

Rotavirus vaccine coverage and factors associated with uptake using linked data: Ontario, Canada

et al. 2018

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BackgroundIn August 2011, Ontario, Canada introduced a rotavirus immunization program using Rotarix™ vaccine. No assessments of rotavirus vaccine coverage have been previously conducted in Ontario.MethodsWe assessed vaccine coverage (series initiation and completion) and factors associated with uptake using the Electronic Medical Record Administrative data Linked Database (EMRALD), a collection of family physician electronic medical records (EMR) linked to health administrative data. Series initiation (1 dose) and series completion (2 doses) before and after the program’s introduction were calculated. To identify factors associated with series initiation and completion, adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated using logistic regression.ResultsA total of 12,525 children were included. Series completion increased each year of the program (73%, 79% and 84%, respectively). Factors associated with series initiation included high continuity of care (aOR = 2.15; 95%CI, 1.61–2.87), maternal influenza vaccination (aOR = 1.55; 95%CI,1.24–1.93), maternal immmigration to Canada in the last five years (aOR = 1.47; 95% CI, 1.05–2.04), and having no siblings (aOR = 1.62; 95%CI,1.30–2.03). Relative to the first program year, infants were more likely to initiate the series in the second year (aOR = 1.71; 95% CI 1.39–2.10) and third year (aOR = 2.02; 95% CI 1.56–2.61) of the program. Infants receiving care from physicians with large practices were less likely to initiate the series (aOR 0.91; 95%CI, 0.88–0.94, per 100 patients rostered) and less likely to complete the series (aOR 0.94; 95%CI, 0.91–0.97, per 100 patients rostered). Additional associations were identified for series completion.ConclusionsFamily physician delivery achieved moderately high coverage in the program’s first three years. This assessment demonstrates the usefulness of EMR data for evaluating vaccine coverage. Important insights into factors associated with initiation or completion (i.e. high continuity of care, smaller roster sizes, rural practice location) suggest areas for research and potential program supports.

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Section: Discussionsupporting

confidence: 89%

Rotavirus vaccine coverage and factors associated with uptake using linked data: Ontario, Canada

et al. 2018

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“…There is evidence in the recent literature to suggest that more highly educated elites in the Netherlands (Hak et al, 2005), the United States (Gilkey et al, 2014, Jones et al, 2010), and Canada (Foty et al, 2010) hold vaccine skeptic views, which is in keeping with the highest level of education of surveyed respondents (masters/PhD) having the same vaccine importance sentiment as those with no or little education. Further systematic reviews have highlighted the variability of correlations found between education and vaccine confidence, with no clear pattern except to show that education does not always imply confidence (Brown et al, 2010, Larson et al, 2014a, Larson et al, 2014b).…”

Section: Discussionmentioning

confidence: 93%

The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey

et al. 2016

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BackgroundPublic trust in immunization is an increasingly important global health issue. Losses in confidence in vaccines and immunization programmes can lead to vaccine reluctance and refusal, risking disease outbreaks and challenging immunization goals in high- and low-income settings. National and international immunization stakeholders have called for better monitoring of vaccine confidence to identify emerging concerns before they evolve into vaccine confidence crises.MethodsWe perform a large-scale, data-driven study on worldwide attitudes to immunizations. This survey – which we believe represents the largest survey on confidence in immunization to date – examines perceptions of vaccine importance, safety, effectiveness, and religious compatibility among 65,819 individuals across 67 countries. Hierarchical models are employed to probe relationships between individual- and country-level socio-economic factors and vaccine attitudes obtained through the four-question, Likert-scale survey.FindingsOverall sentiment towards vaccinations is positive across all 67 countries, however there is wide variability between countries and across world regions. Vaccine-safety related sentiment is particularly negative in the European region, which has seven of the ten least confident countries, with 41% of respondents in France and 36% of respondents in Bosnia & Herzegovina reporting that they disagree that vaccines are safe (compared to a global average of 13%). The oldest age group (65+) and Roman Catholics (amongst all faiths surveyed) are associated with positive views on vaccine sentiment, while the Western Pacific region reported the highest level of religious incompatibility with vaccines. Countries with high levels of schooling and good access to health services are associated with lower rates of positive sentiment, pointing to an emerging inverse relationship between vaccine sentiments and socio-economic status.ConclusionsRegular monitoring of vaccine attitudes – coupled with monitoring of local immunization rates – at the national and sub-national levels can identify populations with declining confidence and acceptance. These populations should be prioritized to further investigate the drivers of negative sentiment and to inform appropriate interventions to prevent adverse public health outcomes.

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“…To address the question of such historically low vaccination rates among those with asthma, many studies employed cross‐sectional surveys to analyze the socio‐demographic variables that predict vaccine uptake. The strongest factors associated with higher vaccine coverage were older age, recent contact with healthcare providers, nonsmoking status, presence of comorbidities, more severe asthma, and (surprisingly) lower household income, although there are conflicting reports for the latter . Variables that were associated with lower vaccination uptake included younger age groups, belonging to certain ethnic groups, and lack of awareness about the vaccine .…”

Section: Current Influenza Vaccine Recommendations and Coverage For Pmentioning

confidence: 99%

Influenza burden, prevention, and treatment in asthma‐A scoping review by the EAACI Influenza in asthma task force

Schwarze

Openshaw

Jha

et al. 2018

Allergy

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To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.

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Predictors of universal influenza vaccination uptake in grades 1 and 2 Toronto school children: Effective vaccination strategies should not end with at risk children

Cited by 10 publications

References 33 publications

Rotavirus vaccine coverage and factors associated with uptake using linked data: Ontario, Canada

Rotavirus vaccine coverage and factors associated with uptake using linked data: Ontario, Canada

The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey

Influenza burden, prevention, and treatment in asthma‐A scoping review by the EAACI Influenza in asthma task force

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