Gilbert Nicolas L, Gilmour Heather, Wilson Sarah E, Cantin Lyne
a Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada , Ottawa , Ontario , Canada.
b School of Public Health, Université de Montréal , Montréal , Québec , Canada.
Hum Vaccin Immunother. 2017 Jun 3;13(6):1-7. doi: 10.1080/21645515.2016.1277847. Epub 2017 Jan 27.
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.
在加拿大，疫苗接种覆盖率仍未达到最佳水平，麻疹和百日咳等可通过疫苗预防的疾病仍时有散发疫情发生。本研究旨在确定加拿大2岁儿童中完全未接种疫苗（从未接种过任何疫苗）、未接种麻疹疫苗（0剂）以及百日咳疫苗接种不完全（<4剂）的社会人口学决定因素。使用了2013年儿童全国免疫接种覆盖率调查（CNICS）的数据。通过多元逻辑回归测量社会人口学因素与结果之间的关联，并计算调整后的优势比（aOR）。共有5477名儿童纳入完全未接种疫苗的分析，3899名儿童纳入未接种麻疹疫苗和百日咳疫苗接种不完全的分析。总体而言，2.7%的儿童（95%可信区间2.0 - 3.3）完全未接种过疫苗。父母教育程度较低，即应答父母拥有高中文凭、行业证书或更低学历（与大学毕业相比）与完全未接种疫苗相关（aOR 1.99，95%可信区间1.02 - 3.91）。单亲家庭的儿童未接种麻疹疫苗的情况更为常见（aOR 1.63，95%可信区间1.01 - 2.61），父母教育程度较低的儿童也是如此（aOR 1.86，95%可信区间1.26 - 2.76）。在加拿大境外出生的儿童、父母教育程度较低的儿童以及家庭收入在40,000加元至59,999加元之间（aOR 1.47；95%可信区间1.04 - 2.07）或低于40,000加元（aOR 1.58，95%可信区间1.13 - 2.22）的儿童中，百日咳疫苗接种不完全的几率更高。所有结果在地区上也存在显著差异。总之，尽管加拿大儿童可普遍免费接种疫苗，但仍观察到疫苗接种在地区上的差异以及社会经济不平等现象。有必要进行进一步分析以确定导致这些差异的障碍因素。
