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On-time vaccination coverage in premature infants in Ontario, 2002-2009
Kumanan Wilson1, Steven Hawken, Kirsten Holdt Henningsen
1Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON. kwilson@ohri.ca
Insights
Premature infants, especially those extremely premature, show lower on-time vaccination rates. Hospitalization status significantly impacts these vaccination schedules for vulnerable infants.
Area of Science:
- Pediatrics
- Public Health
- Immunization
Background:
- Premature infants face higher risks from vaccine-preventable diseases.
- Routine childhood vaccinations are recommended at the same chronological age for all infants, with specific exceptions.
Purpose of the Study:
- To compare on-time vaccination levels in premature infants versus full-term infants.
- To identify disparities in timely immunization for different categories of premature births.
Main Methods:
- Utilized linked health administrative databases in Ontario.
- Compared on-time vaccination rates at 2, 4, and 6 months for term, near-term, very premature, and extremely premature infants.
- Analyzed data with and without exclusion of hospitalized infants.
Main Results:
- Excluding hospitalized infants, vaccination rates were similar across all groups (within 3%).
- Including hospitalized infants revealed significantly lower on-time vaccination rates for extremely premature infants at 2 and 4 months.
- Very premature infants also showed lower on-time rates at 2 months when hospitalization was considered.
Conclusions:
- Hospitalization status is a critical factor influencing on-time vaccination for premature infants.
- There is a need to verify if vaccinations are administered during hospitalization for scheduled infant immunization.
Objective:
Premature children are at increased risk of complications from vaccine-preventable diseases and should be vaccinated with the routinely recommended childhood vaccines at the same chronological age as full-term infants with the exception of the hepatitis B vaccine for infants of HBsAg-positive mothers. We sought to compare on-time vaccination levels in premature children for recommended vaccinations to levels in children born at term.
Methods:
Using linked health administrative databases, we compared the proportion of term (37+ wks), near term (33-36 wks), very premature (28-32 wks) and extremely premature (≤27 wks) children who received at least one vaccination during the 2-, 4- and 6-month vaccination visits within the recommended time period in the province of Ontario.
Results:
When we excluded children who were hospitalized at any time during the vaccination window, we identified that vaccination rates were within 3% of each other in the 4 categories examined. However, when we included infants who may have been hospitalized at any point during the on-time window, we observed substantially lower rates in the extremely premature children at 2 and 4 months and in the very premature children at 2 months.
Conclusion:
Our study identifies the need to confirm whether vaccinations are given while premature children are in hospital during the time of their scheduled vaccinations.
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