Abstract
Objective: Our objective was to determine the effectiveness of an intervention, the Immunization Reminders Project, in terms of a) improving vaccination coverage rates for measles, mumps and rubella (MMR) among 2-year-olds and b) ameliorating geographical disparities in early childhood immunization coverage.
Target Population: All 14-month-old and 20-month-old children in Saskatoon Health Region who were overdue for their immunizations.
Setting: Saskatoon Health Region (SHR).
Intervention: The intervention involved calling the parents/caregivers of the children in the target population with a reminder about immunizations. After five telephone calls and if the parent/caregiver could not be reached, a letter was mailed to the last known address. If there was no response to the letter, a reminder home visit was attempted for families residing in the low-income neighbourhoods in Saskatoon. Since January 2009, all reminders for families not residing in the low-income neighbourhoods in Saskatoon are made through mailed letters.
Outcomes: After the introduction of the Immunization Reminders Project, coverage rates among 2-year-olds for MMR increased significantly overall and in most geographical areas examined. Disparities between geographical subgroups appeared to be declining, but not significantly.
Conclusion: A universal approach to early childhood immunization can likely contribute to increases in coverage rates, but there is still room for improvement in SHR. These findings have prompted additional practice and policy changes.
Key words: Immunization, child, intervention studies
Résumé
Objectif: Déterminer l’efficacité d’un projet appelé Immunization Reminders pour ce qui est: a) d’améliorer les taux de couverture vaccinale de la rougeole, de la rubéole et des oreillons (RRO) chez les enfants de 2 ans et b) de réduire les disparités géographiques dans la couverture vaccinale des jeunes enfants.
Population cible: Les enfants de 14 mois et de 20 mois de la Région sanitaire de Saskatoon qui n’avaient pas encore reçu leurs vaccins.
Lieu: La Région sanitaire de Saskatoon (RSS).
Intervention: L’intervention a consisté à téléphoner aux parents/aidants des enfants de la population cible pour leur rappeler que leurs enfants avaient besoin d’être vaccinés. Si l’on n’arrivait pas à joindre le parent/l’aidant après cinq appels, on postait une lettre à la dernière adresse connue. Si l’on ne recevait pas de réponse à la lettre, on essayait de faire une visite au domicile des familles habitant les quartiers à faible revenu de Saskatoon. Depuis janvier 2009, tous les rappels aux familles n’habitant pas dans les quartiers à faible revenu de Saskatoon se font par la poste.
Résultats: Après le lancement du projet Immunization Reminders, les taux de couverture du vaccin RRO chez les enfants de 2 ans ont significativement augmenté dans l’ensemble et dans la plupart des zones géographiques examinées. Les disparités entre les sous-groupes géographiques ont semblé diminuer, mais pas de façon significative.
Conclusion: Une approche universelle à la vaccination des jeunes enfants peut probablement contribuer à accroître les taux de couverture, mais il y a encore matière à amélioration dans la RSS. Les constatations de l’étude ont entraîné des changements dans les pratiques et dans les politiques.
Mots clés: immunisation, enfant, études d’intervention
Footnotes
Acknowledgements: This research was funded through a Canadian Institutes of Health Research grant. The authors wish to thank Dr. Ross Findlater, Karen Grauer and Sarah Sundquist for their contributions to this study, as well as all the Public Health Services and Saskatoon Tribal Council staff who assisted with the intervention.
Conflict of Interest: None to declare.
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