Abstract
Introduction
British Columbia (BC) implemented a universal infant hepatitis B (HB) immunization program in 2001. The study objective was to evaluate HB immunization coverage among the first six-month cohort of eligible infants in the province outside of the Vancouver-Richmond health region and to assess parent/guardian behavioural and attitudinal determinants of HB immunization.
Methods
A cross-sectional survey of HB immunization was conducted using a random sample of eligible infants born between 1 January-30 June 2001. HB immunization coverage data were obtained from the provincial Public Health Information System, and through a telephone survey of 487 of eligible infants’ parents/guardians that was conducted between October 2002-January 2003. At this time, parents/guardians were also asked about behaviours and attitudes towards immunization, based on the Immunization Health Belief Model Scale.
Results
HB immunization coverage with at least one dose of HB vaccine was 89% and uptake of 3 doses of HB vaccine was 78%. HB immunization was significantly associated (p<0.001) with a recommendation for HB immunization from a health care professional. The main reason for non-HB immunization was parental concern about side effects.
Discussion
Seventy-eight percent of infants completed the 3-dose HB vaccination schedule. Parental behaviour regarding HB immunization of their children was strongly influenced by a supportive recommendation from either a nurse or doctor.
MeSH terms: Hepatitis B; immunization; program evaluation; health behavior
résumé
Introduction
En 2001, la Colombie-Britannique a mis en place un programme d’immunisation infantile contre l’hépatite B (HB). L’objectif de cette étude était d’évaluer la couverture vaccinale d’une cohorte d’enfants britanno-colombiens résidant à l’extérieur de la région sanitaire de Vancouver-Richmond et admissibles à la vaccination lors des six premiers mois du programme. L’étude évaluait aussi les déterminants reliés à l’attitude et au comportement des parents ou tuteurs vis-à-vis l’immunisation contre l’HB.
Méthode
Nous avons mené une étude transversale auprès d’un échantillon aléatoire d’enfants nés entre le 1er janvier et le 30 juin 2001. Les données concernant la couverture vaccinale ont été obtenues en consultant le système d’information de la santé publique de la Colombie-Britannique (PHIS) et en menant un sondage téléphonique entre les mois d’octobre 2002 et de janvier 2003 auprès des parents ou tuteurs de 487 enfants admissibles. Pour le sondage, nous avons interrogé les parents ou tuteurs, en utilisant l’échelle du document «Immunization Health Belief Model», au sujet de leurs attitudes et comportements à l’égard de la vaccination.
Résultats
La couverture vaccinale incluant au moins une dose du vaccin contre l’HB était de 89 %, et celle incluant trois doses du vaccin était de 78 %. L’immunisation contre l’HB était significativement associée (p<0,001) à la recommandation d’un professionnel de la santé. La crainte des effets secondaires indésirables était la principale raison évoquée par les parents pour refuser de faire vacciner leur enfant.
Discussion
Soixante-dix-huit p. cent des enfants ont reçu les trois doses de vaccin nécessaires pour être protégés contre l’HB. Les conseils et recommandations d’un médecin ou d’une infirmière ont fortement influencé le comportement des parents concernant l’immunisation de leurs enfants contre l’HB.
Footnotes
Acknowledgements: Karen Jacobsen, Theresa Fuller, and the research team of Westcoast Clinical Research, Inc. for conducting telephone interviews, and Lisan Kwindt, BC Centre for Disease Control, for data entry.
Source of support: This study was sponsored by an unrestricted grant-in-aid from Merck-Frosst Canada Ltd.
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