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Vaccination status of infants discharged from a neonatal intensive care unit
S Meleth1, L S Dahlgren, R Sankaran
1Department of Pediatrics, University of Saskatchewan, Saskatoon.
Insights
Infant vaccination rates after neonatal intensive care unit (NICU) discharge are suboptimal. Non-native infants show higher vaccination completion, while urban native children are at higher risk for incomplete immunization.
Area of Science:
- Pediatrics
- Public Health
- Neonatal Care
Background:
- Neonatal intensive care unit (NICU) graduates require ongoing health supervision.
- Vaccination is crucial for preventing infant infectious diseases.
- Understanding vaccination rates in vulnerable infant populations is essential.
Purpose of the Study:
- To determine the vaccination coverage among infants discharged from a NICU.
- To identify factors influencing vaccination rates in this high-risk population.
- To assess the impact of ethnic background and residence on immunization status.
Main Methods:
- A cross-sectional survey was conducted among 395 infants discharged from the NICU.
- Data were collected when infants were 12 to 18 months old.
- Key variables included vaccination status, ethnic background, and place of residence.
Main Results:
- Only 56.6% of infants completed their full vaccination series.
- Non-native ethnic background was a significant predictor of completed vaccinations (OR 5.40).
- Urban residence was inversely associated with completed vaccinations after controlling for ethnicity (OR 0.34).
Conclusions:
- Vaccination rates among NICU graduates are not optimal.
- Urban native children are identified as a high-risk group for incomplete immunizations.
- Targeted interventions are needed to improve vaccination coverage, particularly for native children.
Objective:
To determine the vaccination rate among infants discharged from a neonatal intensive care unit (NICU) and factors affecting that rate.
Design:
Cross-sectional survey conducted when the children were 12 to 18 months of age.
Setting:
NICU at the Royal University Hospital, Saskatoon, Sask.
Participants:
All 395 infants discharged from the NICU between Jan. 1 and June 30, 1992.
Main Outcome Measures:
Vaccination rate, ethnic background (native or non-native), place of residence (urban or rural), health status (number of days spent in the NICU), reasons for delay in or incomplete vaccinations (those involving parents' responsibility, infant illness or contraindications).
Results:
Of the 395 infants, 20 (5.0%) had died and incomplete information was available for 30 (7.6%). Complete data were available for 345 (87.3%). Of the infants for whom data were available, 8 (2.3%) had never been vaccinated and 142 (41.2%) had a delayed vaccination schedule or had not completed their scheduled vaccinations. Only 195 (56.6%) of the infants had received a full vaccination series. Non-native ethnic background was a predictor of completed vaccinations (odds ratio [OR] 5.40, 95% confidence interval [CI] 3.05 to 9.52). In a univariate model, urban area of residence was not a significant predictor of vaccination status, but when ethnic background was controlled for in a multivariate logistic regression analysis, urban area of residence was found to be inversely associated with completed vaccinations (OR 0.34, 95% CI 0.15 to 0.79). The number of days the child had spent in the NICU was not a significant predictor of vaccination status.
Conclusion:
The vaccination rate of infants discharged from the NICU is not optimal. Urban native children appears to be at risk of not being vaccinated. Non-native infants are five times more likely than native infants to have completed all of their scheduled vaccinations. Methods to improve the rate of completed vaccinations, especially for native children, must be sought and tested.