OBJECTIVES:In June 2015, Alberta, Canada instituted a universal publicly funded rotavirus vaccination programme (Rotarix, RV1), with vaccine doses scheduled for 2 and 4 months of age. Vaccination was restricted so that infants were only allowed to receive first dose between 6 and 20 weeks of age, and second dose before eight calendar months of age. We assessed the coverage and schedule non-compliance of rotavirus vaccination for babies born between June 2015 and August 2016, that is, since the inception of the publicly funded rotavirus vaccination programme, and determined factors associated with rotavirus vaccine uptake. DESIGN:Retrospective cohort study using linked administrative health data. SETTING:Alberta, Canada. PARTICIPANTS:Cohort of 66 689 children. PRIMARY AND SECONDARY OUTCOME MEASURES: (1) First and second dose rotavirus vaccination coverage, (2) percent of children non-compliant with recommended vaccine schedule and (3) adjusted ORs for factors associated with vaccination status. RESULTS:For the 66 689 children included in the study, coverage levels for one-dose and two-dose rotavirus vaccination were 87% and 83%, respectively. In comparison, two-dose diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine coverage was 92%, despite having the same dosing schedule. Schedule non-compliance during the publicly funded programme was very low. We observed socioeconomic disparities in the uptake of the vaccine, with income, location of residence and number of children in the household all contributing to the odds of a child being vaccinated with rotavirus. CONCLUSIONS:Compliance to the recommended rotavirus schedule was very high, suggesting that even with the restrictive rotavirus vaccine schedule, the vaccine can be delivered on-time. However, rotavirus vaccine coverage remained lower than DTaP, a similarly scheduled childhood vaccination. We also observed socioeconomic disparities in vaccine uptake. These findings raise concerns about rotavirus protection in the groups at highest risk for gastrointestinal illness, including low-income and rural populations.

译文

目标:2015年6月,加拿大艾伯塔省实施了一项由公众资助的通用轮状病毒疫苗接种计划(Rotarix,RV1),疫苗接种计划在2个月和4个月龄时进行。疫苗接种受到限制,因此仅允许婴儿在6至20周龄之间接受第一剂,在八个日历月龄之前接受第二剂。我们评估了2015年6月至2016年8月(即自政府资助的轮状病毒疫苗接种计划启动以来)出生的轮状病毒疫苗接种的覆盖率和时间表,并确定了与轮状病毒疫苗摄入相关的因素。
设计:使用链接的行政健康数据进行回顾性队列研究。
地点:加拿大艾伯塔省。
参加人数:66 689名儿童。主要和次要措施:(1)第一和第二次轮状病毒疫苗接种覆盖率;(2)不符合建议的疫苗接种计划的儿童百分比;(3)针对与疫苗接种状态相关的因素进行调整的OR。
结果:对于纳入研究的66至689名儿童,一剂和两剂轮状病毒疫苗的接种率分别为87%和83%。相比之下,尽管有相同的给药时间表,但两剂白喉-破伤风-百日咳-百日咳-polio-嗜血杆菌流感疫苗的覆盖率为92%。公共资助计划期间的时间表违规率非常低。我们观察到了疫苗接种的社会经济差异,收入,居住地点和家庭中儿童的人数均增加了儿童接种轮状病毒疫苗的几率。
结论:对推荐的轮状病毒时间表的依从性很高,这表明即使使用限制性轮状病毒疫苗时间表,也可以按时交付疫苗。但是,轮状病毒疫苗的覆盖率仍然低于DTaP,后者是类似的儿童期接种疫苗。我们还观察到了疫苗摄入方面的社会经济差异。这些发现引起了人们对轮状病毒保护的关注,这些人群包括低收入人群和农村人群,其在胃肠道疾病风险最高的人群中受到保护。

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