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Two Birds With One Stone: Estimating Population Vaccination Coverage From a Test-negative Vaccine Effectiveness
Margaret K Doll1, Kathryn T Morrison1, David L Buckeridge1
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University.
Summary
Evaluating rotavirus vaccination coverage is crucial. This study found high rotavirus vaccine coverage in Quebec using controls from a vaccine effectiveness study, demonstrating program success.
Area of Science:
- Immunization and Public Health
- Epidemiology
- Vaccine Program Evaluation
Background:
- Vaccination program evaluation typically assesses vaccine uptake and vaccine effectiveness (VE) separately.
- Estimating vaccination coverage often requires dedicated population surveys.
- Rotavirus vaccination programs aim to reduce disease burden, necessitating accurate coverage assessment.
Purpose of the Study:
- To propose and evaluate a method for estimating rotavirus vaccination coverage using control group data from a rotavirus VE test-negative case-control study.
- To assess rotavirus vaccination coverage following the implementation of the Quebec, Canada, rotavirus vaccination program.
- To explore the impact of diagnostic accuracy on coverage estimates and validate findings with external data.
Main Methods:
- Utilized control participants from a rotavirus VE test-negative case-control study as a proxy for population coverage.
- Conducted simulations to assess the effect of diagnostic sensitivity and specificity on coverage estimates.
- Validated the derived coverage estimates against an independent external data source.
Main Results:
- Estimated rotavirus vaccination coverage of 79.0% (95% CI, 74.3%-83.0%) for at least two doses among eligible participants.
- Found no significant differences between coverage estimates derived from the study controls and external estimates.
- Simulations indicated minimal bias in coverage estimates when diagnostic sensitivity and specificity were high.
Conclusions:
- Controls from VE case-control studies can serve as a valuable resource for estimating vaccination coverage, provided appropriate assumptions for generalizability are met.
- The high rotavirus coverage observed indicates the successful implementation and impact of the Quebec vaccination program.
- This methodology offers a cost-effective approach to supplement traditional coverage assessment methods.
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