提高在保留地接受第一剂疫苗的第一民族儿童的疫苗接种率：加拿大西部的一项回顾性队列研究。

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

机构信息

Faculty of Nursing & School of Public Health, University of Alberta, Edmonton, Alberta, Canada

Maskwacis Health Services, Maskwacis, Alberta, Canada.

出版信息

BMJ Glob Health. 2023 Dec 12;8(12):e013261. doi: 10.1136/bmjgh-2023-013261.

DOI:10.1136/bmjgh-2023-013261

PMID:38164705

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10729109/

Abstract

INTRODUCTION

Fragmentation 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.

METHODS

Partnering 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.

RESULTS

For 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%).

CONCLUSION

Initiating 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.

摘要

简介

免疫报告系统的碎片化给加拿大原住民儿童的疫苗接种率衡量带来了挑战。一些原住民社区已经与艾伯塔省卫生部达成了数据共享协议，这为计算疫苗接种率提供了新的机会。

方法

本回顾性队列研究与艾伯塔省的一个原住民社区合作，计算常规儿童疫苗接种率。将社区内和社区外接种的疫苗的行政数据进行链接，以计算 2013 年至 2019 年在社区居住的 2 岁和 7 岁儿童的部分和完全免疫接种率。我们还比较了每年以下两类儿童的疫苗接种率：（a）持续居住在社区内和（b）不在社区内的儿童；以及（b）在保留地社区卫生中心接种或未接种第一针疫苗的儿童。我们还计算了所有研究年份的完全接种率平均值和 95%置信区间。

结果

对于大多数疫苗，与在其他地方接种第一针疫苗的儿童相比，在原住民卫生中心接种第一针疫苗的儿童在 2 岁和 7 岁时的接种率更高（p<0.05）。例如，对于肺炎球菌疫苗，在社区内接种第一针疫苗的 2 岁儿童的完全接种率平均为 55.7%（52.5%-58.8%），而未接种的儿童为 33.3%（29.4%-37.3%）；7 岁时的接种率也更高（75.6%，72.7%-78.5%，而未接种的儿童为 55.5%，49.7%-61.3%）。