Vaccine coverage of children in care of the child welfare system

Hermann, Jennifer; Simmonds, Kimberley; Bell, Christopher; Rafferty, Ellen; MacDonald, Shannon E.

doi:10.17269/s41997-018-0135-5

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…The lowest coverage at kindergarten entry was for vaccines with doses due at 4–6 years of age (DTaP-containing vaccine [47.5%], MMR/MMRV [49.1%]), versus vaccines due at 18 months (PCV [84.1%]) or 12 months (Men C [87.0%]). This finding of decreased coverage with increasing age of scheduled dose is consistent with previous findings (Hermann et al, 2019 ). A possible explanation for this phenomenon could be that mothers in Canada often return to work after a subsidized maternity leave after 1 year (Bell et al, 2015 ; Saini et al, 2017 ).…”

Section: Discussionsupporting

confidence: 93%

Immunization status of children at kindergarten entry in Alberta, Canada

Dhungana

Hoben

O’Brien

et al. 2022

Can J Public Health

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Objectives Little is known about immunization coverage among kindergarten-aged children in jurisdictions that do not require children’s immunization records to be provided at school entry. Thus, we assessed immunization coverage and associated characteristics of a 2008 birth cohort of Alberta children at kindergarten entry as compared with at the end of grade one. Methods This retrospective cohort study used population-based administrative health data for childhood vaccines in Alberta, Canada. We categorized and compared immunization status of children as follows: (a) complete at kindergarten entry; (b) incomplete at kindergarten entry, but complete at the end of grade one; and (c) still incomplete at the end of grade one. To assess factors associated with immunization status, we used multinomial logistic regression. Results Immunization coverage for the complete vaccine series for children (N = 41,515) at kindergarten entry was suboptimal (44.5%, 95% CI 44.0–45.0) and substantially lower than for children at the end of grade one (74.8%, 95% CI 74.3–75.2). Young maternal age, not living with a partner, and having > 1 child in a household were associated with incomplete immunization status at kindergarten entry. Midwife-assisted hospital and home delivery was strongly associated with incomplete immunization status at the end of grade one. Conclusion Immunization coverage at kindergarten entry was strikingly low. Risk factors for incomplete immunization status were identified that require particular attention when addressing immunization coverage. The school-based catch-up immunization program in grade one seems to have substantially improved coverage among children, suggesting a potential benefit of shifting the catch-up program from grade one to kindergarten entry.

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Section: Discussionsupporting

confidence: 93%

Immunization status of children at kindergarten entry in Alberta, Canada

Dhungana

Hoben

O’Brien

et al. 2022

Can J Public Health

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“…Health related questions were refined based on emerging COVID-19 considerations. For example, the item that pertains to vaccine interruption was added as awareness emerged that children were not receiving routine vaccinations and the knowledge that children involved in the child welfare system were also likely to be under vaccinated ( Hermann et al, 2018 .…”

Section: Resultsmentioning

confidence: 99%

Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response

Fallon

Lefebvre

Collin‐Vézina

et al. 2020

Child Abuse & Neglect

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Background Pandemics have a wide range of economic, health and social consequences related to both the spread of a disease and efforts made by government leaders to contain it which may be particularly detrimental for the child welfare-involved population. This is because child welfare agencies serve some of the highest needs children and families. A significant proportion of these families face economic hardship, and as a result of containment measures for COVID-19, more families inevitably will. Objective Given the range of negative consequences related to the pandemic and the evolving supports available to families, child protection workers needed a clinical tool to guide and support work with families informed by an understanding of economic hardship. The objective of this paper is to report on the development and implementation strategy of a tool to be used for practice intervention during the pandemic. Methods Action research methodology was utilized in the creation of the clinical tool. The tool’s development and implementation occurred through an academic/child welfare sector partnership involving child welfare agencies representing diverse regions and populations in Ontario, Canada. Factor analysis of representative child welfare data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018) on economic hardship was used to inform the development of questions on the clinical tool. Results The development and implementation strategy of the clinical tool are described, including the results from analyses of the OIS-2018. Conclusions Future directions for the project are discussed, including considerations for using this tool beyond the pandemic.

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“…This is a common pattern seen in studies of the general population, explained by structural and logistic barriers to accessing immunisation services, which becomes more pronounced for completion of a multidose series 23 24. This issue is exacerbated in subpopulations that experience multiple competing priorities (eg, large number of children, lack of stable housing) to accessing vaccine services,24 25 and even more so when movement in and out of the community poses challenges to health centre staff in contacting guardians with immunisation reminders 22…”

Section: Discussionmentioning

confidence: 98%

Improved vaccine coverage for First Nations children receiving first dose on-reserve: a retrospective cohort study in western Canada

MacDonald,

Graham,

King

et al. 2023

BMJ Glob Health

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IntroductionFragmentation in immunisation reporting systems pose challenges in measuring vaccine coverage for First Nations children in Canada. Some Nations have entered into data-sharing agreements with the province of Alberta’s health ministry, enabling novel opportunities to calculate coverage.MethodsPartnering with a First Nations community in Alberta, this retrospective cohort study calculated routine childhood vaccine coverage. Administrative data for vaccines delivered within and outside the community were linked to calculate partial and complete immunisation coverage in 2013–2019 at ages 2 and 7 years for children living in the community. We also compared vaccine coverage each year for (a) children who were and were not continuous community residents and (b) children who received or not their first vaccine at the on-reserve community health centre. We also calculated the mean complete coverage across all study years with 95% CIs.ResultsFor most vaccines, coverage was higher (p<0.05) at ages 2 and 7 years for children that received their first vaccine at the First Nations health centre, compared with those who received their first dose elsewhere. For example, for pneumococcal vaccine, the mean level of complete coverage in 2-year-olds was 55.7% (52.5%–58.8%) for those who received their first vaccine in the community, compared with 33.3% (29.4%–37.3%) for those who did not; it was also higher at 7 years (75.6%, 72.7%–78.5%, compared with 55.5%, 49.7%–61.3%).ConclusionInitiating the vaccine series at the on-reserve community health centre had a positive impact on coverage. The ability to measure accurate coverage through data-sharing agreements and vaccine record linkage will support First Nations communities in identifying individual and community immunity. The findings also support the transfer of health funding and service delivery to First Nations to improve childhood immunisation uptake.

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Vaccine coverage of children in care of the child welfare system

Cited by 8 publications

References 20 publications

Immunization status of children at kindergarten entry in Alberta, Canada

Immunization status of children at kindergarten entry in Alberta, Canada

Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response

Improved vaccine coverage for First Nations children receiving first dose on-reserve: a retrospective cohort study in western Canada

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