Région du Bas du fleuve : Les enjeux éthiques et les éthiques sous-jacentes au débat actuel autour de la réforme des services de santé et des services sociaux au Québec

Boulianne, Bruno

doi:10.7202/032428ar

Cited by 8 publications

(9 citation statements)

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“…The present study is based on the data from six cross-sectional surveys conducted in Quebec in 2006, 2008, 2010, 2012, 2014 and 2016 [ 15 , 19 – 23 ]. With the authorization of the Quebec Access to Information Commission, children in these studies were randomly selected from the Quebec Universal Health Insurance database which includes all children from the province.…”

Section: Methodsmentioning

confidence: 99%

Impact of vaccine delays at the 2, 4, 6 and 12 month visits on incomplete vaccination status by 24 months of age in Quebec, Canada

et al. 2018

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BackgroundTimeliness in the administration of recommended vaccines is often evaluated using vaccine delays and provides more information regarding the susceptibility of children to vaccine-preventable diseases compared with vaccine coverage at a given age. The importance of on-time administration of vaccines scheduled at the first visit is well documented, but data are scarce about the impact of vaccine delays at other visits on vaccination status by 24 months of age. Using vaccine delays for the first three doses of DTaP-containing vaccines and for the first dose of measles-containing vaccines as markers of timeliness at the 2, 4, 6 and 12 month visits, we estimated the proportion of incomplete vaccination status by 24 months of age attributable to a vaccine delay at each of these visits.MethodsWe used the data from six cross-sectional coverage surveys conducted in the Province of Quebec from 2006 to 2016 which included 7183 children randomly selected from the universal health insurance database. A vaccine dose was considered delayed if received 30 days or more after the recommended age. The impact of new vaccine delays at each visit on incomplete vaccination status by 24 months of age was estimated with the attributable risk in the population.ResultsThe proportion of children with vaccine delay was 5.4% at 2 months, 13.3% at 4 months, 23.1% at 6 months and 23.6% at 12 months. Overall, 72.5% of all 2-year-old children with an incomplete status by 24 months were attributable with a vaccine delay, of which 16.1% were attributable with a first vaccine delay at 2 months, 10.6% at 4 months, 14.0% at 6 months and 31.8% at 12 months.ConclusionsWhile great emphasis has been put on vaccine delays at the first vaccination visit, the prevalence of vaccine delays was greater with later visits and most children with an incomplete vaccination status by 24 months had a vaccine delay occurring during these later visits. Interventions to improve timeliness should address vaccine delays at each visit and not only focus on the first visit.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6235-6) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Impact of vaccine delays at the 2, 4, 6 and 12 month visits on incomplete vaccination status by 24 months of age in Quebec, Canada

et al. 2018

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“…The 10-valent PCV (PCV-10) replaced PCV-7 in 2009 and soon after, in 2011, the 13-valent vaccine (PCV-13) replaced PCV-10 with no catch-up in either instance [7, 8]. Since the beginning of the universal programme in December 2004, vaccine uptake has been high and stable over time, with >90% infants receiving the recommended number of doses [9].…”

Section: Introductionmentioning

confidence: 99%

Hospitalisation for lower respiratory tract infection in children in the province of Quebec, Canada, before and during the pneumococcal conjugate vaccine era

et al. 2017

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Streptococcus pneumoniae is an important cause of community-acquired pneumonia and pneumococcal conjugate vaccines (PCVs) may reduce this burden. This study's goal was to analyse trends in lower respiratory tract infections (LRTI) hospitalisations before and during a routine vaccination programme targeting all newborns with PCV was started in the province of Quebec, Canada in December 2004. The study population included hospital admissions with a main diagnosis of LRTI among 6-59 month-old Quebec residents from April 2000 to December 2014. Trends in proportions and rates were analysed using Cochran-Armitage tests and Poisson regression models. We observed a general downward trend in all LTRI hospitalisations rate: from 11·55/1000 person-years in 2000-2001 to 9·59/1000 in 2013-2014, a 17·0% reduction, which started before the introduction of PCV vaccination. Downward trends in hospitalisation rates were more pronounced for all-cause of pneumonia (minus 17·8%) than for bronchiolitis (minus 15·4%). There was also a decrease in the mean duration of hospital stay. There was little evidence that all-cause pneumonia decreased over the study period due mainly to the introduction of PCVs. Trends may be related to changes in clinical practice. This study casts doubt on the interpretation of ecological analyses of the implementation of PCV vaccination programmes.

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“…RV1 is offered to all infants in 2 doses, administered orally, given at 2 and 4 months of age. Before its introduction into the universal immunization program, rotavirus vaccine coverage was low in Quebec as only 13.6% of children aged 1 y old were vaccinated on January 1 st 2012 10 . Following its introduction in 2011, vaccine coverage rapidly increased to reach 85.9% in 2014.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of rotavirus vaccine in preventing severe gastroenteritis in young children according to socioeconomic status

Gosselin

Généreux

Gagneur

et al. 2016

Human Vaccines & Immunotherapeutics

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In 2011, the monovalent rotavirus vaccine was introduced into a universal immunization program in Quebec (Canada). This retrospective cohort study assessed vaccine effectiveness (VE) in preventing acute gastroenteritis (AGE) and rotavirus gastroenteritis (RVGE) hospitalizations among children <3 y living in the Quebec Eastern Townships region according to socioeconomic status (SES). Data were gathered from a tertiary hospital database paired with a regional immunization registry. Three cohorts of children were followed: (1) vaccinated children born in post-universal vaccination period (2011–2013, n = 5,033), (2) unvaccinated children born in post-universal vaccination period (n = 1,239), and (3) unvaccinated children born in pre-universal vaccination period (2008–2010, n = 6,436). In each cohort, AGE and RVGE hospitalizations were identified during equivalent follow-up periods to calculate VE globally and according to neighborhood-level SES. Using multivariable logistic regression, adjusted odds ratios (OR) were computed to obtain VE (1-OR). Adjusted VE of 2 doses was 62% (95% confidence interval [CI]: 37%–77%) and 94% (95%CI: 52%–99%) in preventing AGE and RVGE hospitalization, respectively. Stratified analyses according to SES showed that children living in neighborhoods with higher rates of low-income families had significantly lower VE against AGE hospitalizations compared to neighborhoods with lower rates of low-income families (30% vs. 78%, p = 0.027). Our results suggest that the rotavirus vaccine is highly effective in preventing severe gastroenteritis in young children, particularly among the most well-off. SES seems to influence rotavirus VE, even in a high-income country like Canada. Further studies are needed to determine factors related to lower rotavirus VE among socioeconomically disadvantaged groups.

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Région du Bas du fleuve : Les enjeux éthiques et les éthiques sous-jacentes au débat actuel autour de la réforme des services de santé et des services sociaux au Québec

Abstract: Le rôle des hôpitaux psychiatriques Volume 22, numéro 2, automne 1997 URI : id.erudit.org/iderudit/032428ar

Cited by 8 publications

References 0 publications

Impact of vaccine delays at the 2, 4, 6 and 12 month visits on incomplete vaccination status by 24 months of age in Quebec, Canada

Impact of vaccine delays at the 2, 4, 6 and 12 month visits on incomplete vaccination status by 24 months of age in Quebec, Canada

Hospitalisation for lower respiratory tract infection in children in the province of Quebec, Canada, before and during the pneumococcal conjugate vaccine era

Effectiveness of rotavirus vaccine in preventing severe gastroenteritis in young children according to socioeconomic status

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