Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia; School of Psychological Science, University of Western Australia, Perth, WA;
Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia.
Public Health Res Pract. 2021 Mar 10;31(1):3112104. doi: 10.17061/phrp3112104.
Objectives and importance of study: Young children are at higher risk for serious influenza outcomes but, historically, Australian children aged less than 5 years have had low seasonal influenza vaccine uptake. In 2018, most Australian jurisdictions implemented funded influenza vaccine programs targeted at improving vaccine uptake in this age group. Our aim was to determine how successful these programs were at improving self-reported seasonal influenza vaccine uptake at the community level by comparing vaccination rates in each Australian jurisdiction before and after the introduction of funded vaccines for children aged 6 months to less than 5 years, as well as other age groups.
Volunteer observational cohort study.
Flutracking is an email-based surveillance tool for influenza-like illness that collects information about symptoms and influenza vaccination. We used historical data from 2014 to 2017 to estimate baseline vaccination status before funding of childhood influenza vaccines was introduced. We compared self-reported vaccine uptake in children younger than 5 years, children aged 5-17 years and adults (18-64 years, and 65 years and older) in 2018 and 2019 by state or territory. Mixed effects logistic regressions were used to measure the association between vaccination and a number of predictors, including whether the child was eligible for free vaccines, and whether adults resided with children or not.
We found large increases in vaccine uptake for children younger than 5 years in 2018 in all jurisdictions except Western Australia (where vaccines were already funded) and the Northern Territory (where funded vaccines were not introduced until 2019) that coincided with vaccine policy changes. Self-reported vaccination rates for young children in 2018 increased 2.7-4.2-fold in jurisdictions that funded the vaccine (compared with the previous, unfunded period). Being eligible for the funded vaccine was associated with much higher odds (odds ratio [OR] 4.75; 95% confidence interval [CI] 4.57, 4.79) of a young child being vaccinated. Older children and adults younger than 65 years were also more likely to receive the vaccine following policy changes.
The seasonal influenza vaccine is an important protective measure for those at risk of serious outcomes, including young children. Flutracking data demonstrates that government-funded vaccines can lead to an almost five-fold increase in self-reported vaccine uptake of the targeted age group, as well as previously unreported flow-on effects to older children. This suggests that funded vaccines for young children may encourage caregivers to also vaccinate themselves and their older children.
幼儿患严重流感的风险更高，但在历史上，澳大利亚 5 岁以下的儿童季节性流感疫苗接种率一直较低。2018 年，大多数澳大利亚司法管辖区实施了针对这一年龄组的资助流感疫苗计划，以提高疫苗接种率。我们的目的是通过比较在为 6 个月至 5 岁以下儿童接种资助疫苗之前和之后，每个澳大利亚司法管辖区的社区层面自我报告的季节性流感疫苗接种率，来确定这些计划在提高疫苗接种率方面的成功程度，以及其他年龄组的疫苗接种率。
志愿者观察队列研究。
Flutracking 是一种基于电子邮件的流感样疾病监测工具，用于收集症状和流感疫苗接种信息。我们使用了 2014 年至 2017 年的历史数据，在为儿童接种流感疫苗提供资金之前，估计了基线疫苗接种状况。我们比较了 2018 年和 2019 年在以下方面自我报告的疫苗接种率：5 岁以下儿童、5-17 岁儿童和成年人（18-64 岁和 65 岁及以上）。按州或领地比较。混合效应逻辑回归用于衡量疫苗接种与一系列预测因素之间的关联，包括儿童是否有资格获得免费疫苗，以及成年人是否与儿童居住在一起。
我们发现，在所有司法管辖区，除了已经为疫苗提供资金的西澳大利亚州（那里已经为疫苗提供资金）和北领地（直到 2019 年才为疫苗提供资金）之外，2018 年所有 5 岁以下儿童的疫苗接种率都大幅上升，这与疫苗政策的变化相吻合。在为疫苗提供资金的司法管辖区，幼儿自我报告的疫苗接种率增加了 2.7-4.2 倍（与之前未提供资金的时期相比）。有资格获得资助疫苗与幼儿接种疫苗的可能性高出许多（优势比 [OR] 4.75；95%置信区间 [CI] 4.57, 4.79）。政策变化后，年龄较大的儿童和 65 岁以下的成年人也更有可能接种疫苗。
季节性流感疫苗是预防严重后果（包括幼儿）的重要保护措施。Flutracking 数据表明，政府资助的疫苗可以使目标年龄组的自我报告疫苗接种率增加近五倍，并且还会产生以前未报告的对年龄较大儿童的影响。这表明，为幼儿提供资助疫苗可能会鼓励照顾者也为自己和年龄较大的儿童接种疫苗。
