Determinants of non-vaccination and incomplete vaccination in Canadian toddlers

Abstract

Vaccination coverage remains suboptimal in Canada and sporadic outbreaks of vaccine-preventable diseases such as measles and pertussis continue to occur. This study was undertaken to identify sociodemographic determinants of total non-vaccination (having never received any vaccine), non-vaccination for measles (0 doses) and incomplete vaccination for pertussis (< 4 doses) among 2-year-old Canadian children. Data from the 2013 Childhood National Immunization Coverage Survey (CNICS) were used. Associations between sociodemographic factors and outcomes were measured by multiple logistic regressions and adjusted odds ratios (aOR) were calculated. A total of 5,477 children were included in the analyses of total non-vaccination, and 3,899 children were included in the analysis of non-vaccination for measles and incomplete vaccination for pertussis. Overall, 2.7% of children (95% CI 2.0–3.3) had received no vaccine at all. Lower parental education, i.e., the responding parent having a high school diploma, trade certificate or less (compared with university graduation) was associated with total non-vaccination (aOR 1.99, 95% CI 1.02–3.91). Non-vaccination for measles was more frequent among children of single parent families (aOR 1.63, 95% CI 1.01–2.61) and those of parents with lower education (aOR 1.86, 95% CI 1.26–2.76). The odds of incomplete vaccination for pertussis was greater among children born outside Canada (aOR 3.10, 95% CI 1.73–5.58), of parents with lower education (aOR 1.92, 95% CI 1.41–2.62), and those whose household income was between $40,000 and $59,999 (aOR 1.47; 95% CI 1.04–2.07) or lower than $40,000 (aOR 1.58, 95% CI 1.13–2.22). Significant regional variation was also found for all outcomes. In conclusion, despite universal access to free childhood vaccines in Canada, regional variation and socioeconomic inequalities in vaccine uptake were still observed. Further analyses are warranted to identify barriers contributing to these variations.

Investigating Italian parents' vaccine hesitancy: A cross-sectional survey

“…These results are in accordance with previous studies. 18,25,[32][33][34][35][36] The results of the multivariate regression analysis showed that vaccine hesitancy was more likely among parents who were worried about the side effects and safety of the vaccines. Thus, these findings highlight the need to develop educational materials promoting vaccinations and also suggest that health care workers are encouraged to inform the parents about the childhood vaccine's importance to potentially increase parental knowledge regarding the safety of vaccines.…”

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

“…This subpopulation was also shown as more likely to be incompletely vaccinated against pertussis in a separate analysis conducted using the same survey data. 17 One of the plausible explanations for this finding is that the routine vaccination schedule for infants can be different in the child's country of origin. For instance, the first dose of monovalent measles vaccine is routinely recommended at nine months of age in several African, Eastern Mediterranean, South East Asian and Western Pacific countries 19 and in our analysis, doses given prior to 12 months of age were considered invalid and second doses received after 12 months of age would have been considered delayed, which was the case for only 4% children, who were not all born outside Canada.…”

“…4 , 16 In Canada in 2013, no written proof of a dose of measles-containing vaccine was found in 10.3% (95% CI 8.9–11.6) of two-year-old children. 17 Sporadic outbreaks of measles still occur in Canada and the majority of the recent pediatric cases were unvaccinated. 18 Delayed vaccination may contribute to under-immunization in children, but the extent of delayed measles vaccination in two-year-old children in Canada is unknown.…”

Measurement of coverage, compliance and determinants of uptake in a publicly funded rotavirus vaccination programme: a retrospective cohort study

“…However, we were the first to identify an interaction between location of residence and income, where income effected the odds of someone living in a rural area getting vaccinated. Canada sees similar socioeconomic disparities in vaccine uptake in other publicly available vaccines, including pertussis 29. Specifically, Gilbert et al 29 found lower income household, parents with lower education and children born out of Canada had higher odds of being partially immunised for pertussis 29.…”

“…Canada sees similar socioeconomic disparities in vaccine uptake in other publicly available vaccines, including pertussis 29. Specifically, Gilbert et al 29 found lower income household, parents with lower education and children born out of Canada had higher odds of being partially immunised for pertussis 29. The low rotavirus vaccination rate in those with lower-income rural communities is particularly concerning as this population is at a higher risk of gastrointestinal illness 30.…”