Skip to main content
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2015 Sep 1;106(6):e355–e361. doi: 10.17269/CJPH.106.4981

Applications of geographic information systems in public health: A geospatial approach to analyzing MMR immunization uptake in Alberta

Kristin M Eccles 14,, Stefania Bertazzon 14
PMCID: PMC6972108  PMID: 26680425

Abstract

Objective: This study evaluates the temporal, spatial, and spatio-temporal variation of immunization rates for measles, mumps and rubella (MMR) immunization in the province of Alberta. The study uses yearly immunization rate data for Health Zones and Local Geographic Areas (2004–2012), which were obtained from Alberta Health’s Interactive Health Data Application (IHDA).

Methods: Spatial analyses include a global spatial analysis, Moran’s I, and local indicators of spatial association (LISA) analysis - Getis and Ord’s G* - to identify clusters of high or low immunization rates. Spatial methods are then applied to a time series analysis to examine how the immunization rates change over time in conjunction with space.

Results: Mapped results indicate decreasing immunization rates over time for the majority of the province where most local geographic areas (LGAs) fall short of the 95% herd immunity threshold. Clusters of high immunization rates in the metropolitan centres, and clusters of low immunization rates in the southern and northern region of the province exist spatially and spatio-temporally. Over time, the high rate clusters are decreasing in size and the low rate clusters are increasing.

Conclusion: This research provides a localized geographic approach to assessing MMR immunization rates in Alberta. Findings from this research can be used to target public health interventions to specific areas that exhibit the lowest immunization rates. These results can also be used for hypothesis generation in future research on barriers to immunization uptake.

Key Words: Immunizations, MMR, public health, GIS, spatial analysis

Mots Clés: immunisations, vaccinations, ROR, santé publique, SIG, analyse spatiale

Footnotes

Conflict of Interest: None to declare.

References

  • 1.Shane A, Hiebert J, Sherrard L, Deehan H. Inside this issue: Measles in Canada. Can Commun Dis Rep. 2014;40:12. doi: 10.14745/ccdr.v40i12a01. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Matkin A, Simmonds K, Suttorp V. Measles-containing vaccination rates in southern Alberta. Can Commun Dis Rep. 2014;40:12. doi: 10.14745/ccdr.v40i12a03. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Diekema DS. American Academy of Pediatrics Committee on Bioethics. Responding to parental refusals of immunization of children. Pediatrics. 2005;115(5):1428–31. doi: 10.1542/peds.2005-0316. [DOI] [PubMed] [Google Scholar]
  • 4.Omer SB, Salmon DA, Orenstein WA, deHart MP, Halsey N. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N Engl J Med. 2009;360(19):1981–88. doi: 10.1056/NEJMsa0806477. [DOI] [PubMed] [Google Scholar]
  • 5.Fox JP, Elveback L, Scott W, Gatewood L, Ackerman E. Herd immunity: Basic concept and relevance to public health immunization practices. In: Schneider D, Lilienfeld DE, editors. Public Health: The Development of a Discipline, Vol 2, Twentieth-Century Challenges. New Brunswick, NJ: Rutgers University Press; 2011. [Google Scholar]
  • 6.PHAC. Canadian Immunization Guide. 2015. [Google Scholar]
  • 7.Omer SB, Enger KS, Moulton LH, Halsey NA, Stokley S, Salmon DA. Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis. Am J Epidemiol. 2008;168(12):1389–96. doi: 10.1093/aje/kwn263. [DOI] [PubMed] [Google Scholar]
  • 8.Getis A. A history of the concept of spatial autocorrelation: A geographer’s perspective. Geogr Anal. 2008;40(3):297–309. doi: 10.1111/j.1538-4632.2008.00727.x. [DOI] [Google Scholar]
  • 9.Government of Alberta. Alberta Health and Wellness, Surveillance & Assessment Branch Interactive Health Data Application - Immunization Coverage Rates. 2010. [Google Scholar]
  • 10.Government of Alberta. Alberta Health, Surveillance & Assessment Branch Interactive Health Data Application - Immunization Coverage Rate. 2015. [Google Scholar]
  • 11.IHDA. Data Methods. 2012. [Google Scholar]
  • 12.Tobler WR. A computer movie simulating urban growth in the Detroit region. Econ Geogr. 1970;46:234–40. doi: 10.2307/143141. [DOI] [Google Scholar]
  • 13.Crighton EJ, Elliott SJ, Kanaroglou P, Moineddin R, Upshur REG. Spatiotemporal analysis of pneumonia and influenza hospitalizations in Ontario, Canada. Geospat Health. 2008;2(2):191–202. doi: 10.4081/gh.2008.243. [DOI] [PubMed] [Google Scholar]
  • 14.Anselin L. Local indicators of spatial association—LISA. Geogr Anal. 1995;27(2):93–115. doi: 10.1111/j.1538-4632.1995.tb00338.x. [DOI] [Google Scholar]
  • 15.Getis A, Aldstadt J. Constructing the spatial weights matrix using a local statistic. In: Anselin L, Ray SJ, editors. Perspectives on Spatial Data Analysis. Berlin, Heidelberg: Springer; 2010. pp. 147–63. [Google Scholar]
  • 16.Alberta Health. Alberta Immunization Strategy 2007-2017. 2007. [Google Scholar]
  • 17.Kulig JC, Meyer CJ, Hill SA, Handley CE, Lichtenberger SM, Myck SL. Refusals and delay of immunization within Southwest Alberta. Understanding alternative beliefs and religious perspectives. Can J Public Health. 2002;93:109–12. doi: 10.1007/BF03404549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Kershaw T, Suttorp V, Simmonds K, St Jean T. Outbreak of measles in a nonimmunizing population, Alberta 2013. Can Commun Dis Rep. 2014;40(12):243. doi: 10.14745/ccdr.v40i12a04. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Openshaw S. The modifiable areal unit problem. Geo Abstracts University of East Anglia. 1984. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES