Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7, Canada; Toronto Western Family Health Team, University Health Network, 440 Bathurst Street, 3rd Floor, Toronto, Ontario M5T 2S6, Canada.
Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Department of Paediatrics, University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8.
Vaccine. 2022 Mar 15;40(12):1790-1798. doi: 10.1016/j.vaccine.2022.02.008. Epub 2022 Feb 8.
The COVID-19 pandemic has caused a disruption in childhood immunization coverage around the world. This study aimed to determine the change in immunization coverage for children under 2 years old in Ontario, Canada, comparing time periods pre-pandemic to during the first year of the pandemic.
Observational retrospective open cohort study, using primary care electronic medical record data from the University of Toronto Practice-Based Research Network (UTOPIAN) database, from January 2019 to December 2020. Children under 2 years old who had at least 2 visits recorded in UTOPIAN were included. We measured up-to-date (UTD) immunization coverage rates, overall and by type of vaccine (DTaP-IPV-Hib, PCV13, Rota, Men-C-C, MMR, Var), and on-time immunization coverage rates by age milestone (2, 4, 6, 12, 15, 18 months). We compared average coverage rates over 3 periods of time: January 2019-March 2020 (T1); March-July 2020 (T2); and August-December 2020 (T3).
12,313 children were included. Overall UTD coverage for all children was 71.0% in T1, dropped by 5.7% (95% CI: -6.2, -5.1) in T2, slightly increased in T3 but remained lower than in T1. MMR vaccine UTD coverage slightly decreased in T2 and T3 by approximately 2%. The largest decreases were seen at ages 15-month and 18-month old, with drops in on-time coverage of 14.7% (95% CI: -18.7, -10.6) and 16.4% (95% CI: -20.0, -12.8) respectively during T2. When stratified by sociodemographic characteristics, no specific subgroup of children was found to have been differentially impacted by the pandemic.
Childhood immunization coverage rates for children under 2 years in Ontario decreased significantly during the early period of the COVID-19 pandemic and only partially recovered during the rest of 2020. Public health and educational interventions for providers and parents are needed to ensure adequate catch-up of delayed/missed immunizations to prevent potential outbreaks of vaccine-preventable diseases.
COVID-19 大流行导致全球儿童免疫接种覆盖率中断。本研究旨在确定加拿大安大略省 2 岁以下儿童的免疫接种覆盖率在大流行前和大流行第一年的变化。
这是一项观察性回顾性开放队列研究，使用多伦多大学实践基础研究网络（UTOPIAN）数据库中的初级保健电子病历数据，时间范围为 2019 年 1 月至 2020 年 12 月。纳入至少在 UTOPIAN 中有 2 次就诊记录的 2 岁以下儿童。我们测量了最新（UTD）免疫接种覆盖率，按疫苗类型（DTaP-IPV-Hib、PCV13、轮状病毒、Men-C-C、MMR、Var）进行了分类，并按年龄里程碑（2、4、6、12、15、18 个月）进行了及时免疫接种覆盖率。我们比较了三个时间段的平均覆盖率：2019 年 1 月至 3 月（T1）；2020 年 3 月至 7 月（T2）；2020 年 8 月至 12 月（T3）。
共纳入 12313 名儿童。所有儿童的整体 UTD 覆盖率在 T1 为 71.0%，在 T2 下降了 5.7%（95%CI：-6.2，-5.1），在 T3 略有上升，但仍低于 T1。MMR 疫苗的 UTD 覆盖率在 T2 和 T3 略有下降，约为 2%。在 T2 期间，15 个月和 18 个月大的儿童的及时接种覆盖率降幅最大，分别下降了 14.7%（95%CI：-18.7，-10.6）和 16.4%（95%CI：-20.0，-12.8）。按社会人口特征分层，未发现任何特定亚组的儿童受到 COVID-19 大流行的不同影响。
安大略省 2 岁以下儿童的儿童免疫接种覆盖率在 COVID-19 大流行的早期显著下降，在 2020 年剩余时间仅部分恢复。需要为提供者和家长提供公共卫生和教育干预措施，以确保及时补种延迟/错过的免疫接种，以防止疫苗可预防疾病的潜在爆发。
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