2019年冠状病毒病疫情对加拿大安大略省儿童和青少年常规免疫接种覆盖率的影响
Impact of the COVID-19 pandemic on routine immunization coverage of children and teenagers in Ontario, Canada.
作者信息
Ji Catherine, Senthinathan Arrani, Apajee Jemisha, Dubey Vinita, Forte Milena, Kwong Jeffrey C, Morris Shaun K, Piche-Renaud Pierre-Philippe, Wilson Sarah E, Tu Karen
机构信息
Department of Family and Community Medicine, Temerty Faculty of 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.
Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada.
出版信息
Vaccine. 2025 Mar 7;49:126811. doi: 10.1016/j.vaccine.2025.126811. Epub 2025 Jan 30.
OBJECTIVES
To assess immunization coverage for routine vaccinations in children (aged 4-7 years) and teenagers (aged 14-17 years) during the COVID-19 pandemic compared to the pre-pandemic period, in Ontario, Canada.
METHODS
Retrospective cohort study using primary care electronic medical records data from the University of Toronto Practice-Based Research Network database from January 2018 to June 2022. Monthly estimates of vaccine up-to-date (UTD) coverage (defined as 1 dose of tetanus, diphtheria, and acellular pertussis (Tdap)-containing and 1 dose of measles, mumps and rubella-containing vaccines received after the 4th birthday for children; and 1 dose of Tdap-containing vaccine received after the 14th birthday for teenagers) and time series regression analysis were used to compare changes in mean coverage before and during the pandemic. We also examined if changes in coverage estimates over time were associated with sociodemographic factors.
RESULTS
30,010 children and 31,624 teenagers were included. Mean monthly UTD coverage for children decreased significantly from 48.7 % (SD 2.1) pre-pandemic (January 2018 - February 2020) to 44.3 % (SD 1.3) in mid-pandemic period (July 2020-June 2021), and remained significantly lower in later pandemic period (July 2021 - June 2022). Mean monthly UTD coverage for teenagers was 34.6 % (SD 0.9) pre-pandemic and decreased to 16.7 % (SD 0.6) in later pandemic period. When adjusted for baseline differences, teenagers from neighborhoods with higher income, lower proportions of racialized and newcomer populations and from rural areas experienced larger decreases in UTD coverage during the pandemic. No significant differences were found in UTD coverage among children across the various sociodemographic factors.
CONCLUSION
Significant declines in immunization coverage for children and teenagers in Ontario were still observed by June 2022, highlighting the need to further study the long-term impact of the pandemic and implement effective catch-up interventions to increase immunization coverage and prevent outbreaks of vaccine-preventable diseases.
目的
评估在加拿大安大略省，与新冠疫情大流行前相比，新冠疫情期间儿童（4至7岁）和青少年（14至17岁）常规疫苗接种的覆盖率。
方法
采用回顾性队列研究，使用来自多伦多大学基于实践的研究网络数据库2018年1月至2022年6月的初级保健电子病历数据。每月估算疫苗最新接种（UTD）覆盖率（定义为儿童4岁生日后接种1剂含破伤风、白喉和无细胞百日咳（Tdap）疫苗以及1剂含麻疹、腮腺炎和风疹疫苗；青少年14岁生日后接种1剂含Tdap疫苗），并通过时间序列回归分析比较疫情大流行前和期间平均覆盖率的变化。我们还研究了随着时间推移覆盖率估算的变化是否与社会人口学因素相关。
结果
纳入了30,010名儿童和31,624名青少年。儿童的平均每月UTD覆盖率从疫情大流行前（2018年1月至2020年2月）的48.7%（标准差2.1）显著下降至疫情中期（2020年7月至2021年6月）的44.3%（标准差1.3），在疫情后期（2021年7月至2022年6月）仍显著较低。青少年的平均每月UTD覆盖率在疫情大流行前为34.6%（标准差0.9），在疫情后期降至16.7%（标准差0.6）。在对基线差异进行调整后，来自高收入社区、种族化和新移民人口比例较低社区以及农村地区的青少年在疫情大流行期间UTD覆盖率下降幅度更大。在不同社会人口学因素的儿童中，UTD覆盖率未发现显著差异。
结论
到2022年6月，安大略省儿童和青少年的疫苗接种覆盖率仍显著下降，这突出表明需要进一步研究疫情的长期影响，并实施有效的补种干预措施，以提高疫苗接种覆盖率并预防疫苗可预防疾病的暴发。
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