Gaps in childhood immunizations and preventive care visits during the COVID-19 pandemic: a population-based cohort study of children in Ontario and Manitoba, Canada, 2016-2021

被引:2
作者
Evans, Andrea [1 ,2 ,3 ]
Mahar, Alyson L. L. [4 ,5 ]
Deb, Bhumika [3 ]
Boblitz, Alexa [3 ]
Brownell, Marni [4 ,5 ,6 ]
Guttmann, Astrid [3 ,7 ,8 ,9 ,10 ,11 ]
Stukel, Therese A. A. [3 ,10 ]
Cohen, Eyal [3 ,7 ,8 ,9 ,10 ,11 ]
Sarkar, Joykrishna [5 ]
Eze, Nkiruka [5 ]
Katz, Alan [4 ,5 ,12 ]
Raveendran, Tharani [8 ]
Saunders, Natasha [3 ,7 ,8 ,9 ,10 ,11 ]
机构
[1] Childrens Hosp Eastern Ontario, Ottawa, ON, Canada
[2] Univ Ottawa, Dept Pediat, Ottawa, ON, Canada
[3] ICES, Toronto, ON, Canada
[4] Univ Manitoba, Dept Community Hlth Sci, Winnipeg, MB, Canada
[5] Manitoba Ctr Hlth Policy, Winnipeg, MB, Canada
[6] Childrens Hosp Res Inst Manitoba, Winnipeg, MB, Canada
[7] Hosp Sick Children, Toronto, ON, Canada
[8] SickKids Res Inst, Child Hlth Evaluat Sci, Toronto, ON, Canada
[9] Univ Toronto, Temerty Fac Med, Dept Pediat, Toronto, ON, Canada
[10] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[11] Univ Toronto, Edwin SH Leong Ctr Hlth Children, Toronto, ON, Canada
[12] Univ Manitoba, Dept Family Med, Winnipeg, MB, Canada
来源
CANADIAN JOURNAL OF PUBLIC HEALTH-REVUE CANADIENNE DE SANTE PUBLIQUE | 2023年 / 114卷 / 05期
基金
加拿大健康研究院;
关键词
COVID-19; Immunization coverage; Health systems; Pediatrics; Primary care; Preventive care; Family medicine; Cohort study; Well-child care; INFANT;
D O I
10.17269/s41997-023-00797-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
ObjectiveWe aimed to estimate the changes to the delivery of routine immunizations and well-child visits through the pandemic.MethodsUsing linked administrative health data in Ontario and Manitoba, Canada (1 September 2016 to 30 September 2021), infants <12 months old (N=291,917 Ontario, N=33,994 Manitoba) and children between 12 and 24 months old (N=293,523 Ontario, N=33,001 Manitoba) exposed and unexposed to the COVID-19 pandemic were compared on rates of receipt of recommended a) vaccinations and b) well-child visits after adjusting for sociodemographic measures. In Ontario, vaccinations were captured using physician billings database, and in Manitoba they were captured in a centralized vaccination registry.ResultsExposed Ontario infants were slightly more likely to receive all vaccinations according to billing data (62.5% exposed vs. 61.6% unexposed; adjusted Relative Rate (aRR) 1.01 [95% confidence interval (CI) 1.00-1.02]) whereas exposed Manitoba infants were less likely to receive all vaccines (73.5% exposed vs. 79.2% unexposed; aRR 0.93 [95% CI 0.92-0.94]). Among children exposed to the pandemic, total vaccination receipt was modestly decreased compared to unexposed (Ontario aRR 0.98 [95% CI 0.97-0.99]; Manitoba aRR 0.93 [95% CI 0.91-0.94]). Pandemic-exposed infants were less likely to complete all recommended well-child visits in Ontario (33.0% exposed, 48.8% unexposed; aRR 0.67 [95% CI 0.68-0.69]) and Manitoba (55.0% exposed, 70.7% unexposed; aRR 0.78 [95% CI 0.77-0.79]). A similar relationship was observed for rates of completed well-child visits among children in Ontario (aRR 0.78 [95% CI 0.77-0.79]) and Manitoba (aRR 0.79 [95% CI 0.77-0.80]).ConclusionThrough the first 18 months of the pandemic, routine vaccines were delivered to children < 2 years old at close to pre-pandemic rates. There was a high proportion of incomplete well-child visits, indicating that developmental surveillance catch-up is crucial.
引用
收藏
页码:774 / 786
页数:13
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