Delayed measles vaccination of toddlers in Canada: Associated socio-demographic factors and parental knowledge, attitudes and beliefs

Abstract

Delaying vaccination increases the period of vulnerability of children against vaccine-preventable diseases. We used a nationally representative sample of Canadian two-year-old children to explore factors associated with delays in the uptake of the first dose of measles-containing vaccine, recommended in Canada for children at 12 months of age. Distribution of delays was determined using data from the 2013 Childhood National Immunization Coverage Survey. Logistic regression was used to examine sociodemographic factors and knowledge, attitudes and beliefs (KAB) associated with the two outcomes of interest: delays of one to six months (vaccination at 13 to 18 months of age) and delays of seven to 18 months (vaccination at 19 to 23 months of age). Overall, 69% (95% confidence interval [CI] 67–71) of children received their first valid dose on time. Twenty-nine percent (95% CI 27–31) and 11% (95% CI 9–12) of children were unvaccinated before turning 13 and 16 months of age, respectively. Factors associated with delays of one to six months were being a girl, being born outside Canada, and the jurisdiction of residence. Being from a single-parent family, being born outside Canada and the jurisdiction of residence were associated with delays of seven to 18 months, suggesting that potential barriers might be at play. Associations between KAB and vaccination delays indicate that vaccine hesitancy could contribute to measles vaccination delays in Canada. Barriers in accessing vaccination services and the role of vaccine hesitancy in timely vaccination must be better understood to reduce vaccination delays in toddlers in Canada.

Low coverage of HPV vaccination in the national immunization programme in Brazil: Parental vaccine refusal or barriers in health-service based vaccine delivery?

“…However, there is no data available to indicate which one of these reasons (or whether combination of them) is to blame for that. Previous studies in other countries show vaccine delays and low uptake related to vaccine hesitancy and barriers in access to vaccines[ 8 – 12 ].…”

Vaccine hesitancy among parents of preschoolers in Canada: a systematic literature review

“…As shown in Table 1, three studies used data from the CNICS (Carpiano et al 2019;Gilbert et al 2017;Perinet et al 2018). This survey is administered every two years by Statistics Canada, asking parents to provide vaccine data, which is then verified by medical records (Statistics Canada 2019).…”

“…Sample sizes ranged from 200 to more than 170,000. The CNICS sample (Carpiano et al 2019;Gilbert et al 2017;Perinet et al 2018) consisted of 52% male respondents; 24% had secondary education or less, 31.5% post-secondary, 42.2% university graduate; 19.7% had an income of less than $39,000, 44% between $40,000 and $99,999, 34.6% greater than $100,000; and 87% reported being married/commonlaw. The remainder of the studies had similar distributions with three studies reporting ethnicity as being largely Caucasian (Bell et al 2015) with a smaller proportion of non-Caucasian respondents (24%) in one study (Kuwaik et al 2014) and Aboriginal status (4.4%) in another study (MacDonald et al 2014).…”

“…Studies whose samples were within one province assessed vaccine status according to the provincial recommendations (Bell et al 2015;Dubé et al 2016c;Dummer et al 2012;Kiely et al 2018;Kuwaik et al 2014;MacDonald et al 2014;Martens et al 2014;O'Donnell et al 2017). Studies using national-level data assessed vaccine status using specific vaccines that are routinely provided across Canada (i.e., measles or MMR) (Greenberg et al 2017;Perinet et al 2018) or a combination of measles and pertussis vaccines (Carpiano et al 2019;Gilbert et al 2017).…”

Knowledge, Attitudes and Practice (KAP) Study Among Parents about Vaccination in Tertiary Care Hospital of Karachi, Pakistan

“…Vaccine coverage in Canadian children: Results from the 2013 childhood National Immunization Coverage Survey 10 . Two doses of the measles-mumps-rubella (MMR)are recommended to children before starting school: one between 12 and 15 months and other after or at 18 months of age by The National Advisory Committee on Immunization (NACI) however first dose of MMR or MMRV is recommended at 12 months and other at 18 months, 36 months or between 4 and 6 years of age by all provincial and territorial vaccination schedules 11 . Vaccination of children has really reduced the burden of infectious diseases 12 but these Disease could not be proscribed without improving the health education of parents and without proper key family practice of the child vaccination 13 .…”