Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.
Immunization & Communicable Disease Control, Alberta Health, Edmonton, Alberta, Canada.
Can J Public Health. 2023 Feb;114(1):82-92. doi: 10.17269/s41997-022-00663-3. Epub 2022 Jul 21.
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.
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.
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.
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.
在不要求入学时提供儿童免疫记录的司法管辖区，对于幼儿园年龄儿童的免疫接种覆盖率知之甚少。因此，我们评估了安大略省 2008 年出生队列的儿童在幼儿园入学时与一年级结束时的免疫接种覆盖率及其相关特征。
这项回顾性队列研究使用了加拿大安大略省基于人群的儿童疫苗行政健康数据。我们对儿童的免疫状况进行了分类和比较，如下所示：(a)在幼儿园入学时完全接种；(b)在幼儿园入学时不完全接种但在一年级结束时完全接种；和(c)在一年级结束时仍未完全接种。为了评估与免疫状况相关的因素，我们使用了多项逻辑回归。
在幼儿园入学时，儿童完全接种疫苗系列的免疫接种率（N=41515）并不理想（44.5%，95%CI 44.0-45.0），明显低于一年级结束时（74.8%，95%CI 74.3-75.2）。母亲年龄较小、没有伴侣、家中有超过 1个孩子与幼儿园入学时未完全免疫有关。助产士协助的医院和家庭分娩与一年级结束时未完全免疫密切相关。
幼儿园入学时的免疫接种率低得惊人。确定了未完全免疫的风险因素，在解决免疫接种覆盖率问题时需要特别注意这些因素。一年级的基于学校的补种免疫计划似乎大大提高了儿童的覆盖率，这表明将补种计划从一年级转移到幼儿园入学可能会带来潜在的好处。
