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Childhood immunisation: factors associated with failure to complete the recommended schedule by two years of age
J N Hanna1, J E Wakefield, C J Doolan
1Tropical Centre for Disease Control, Cairns.
Insights
Childhood immunisation rates in North Queensland childcare facilities were low, with only 60.3% of children fully vaccinated by age two. Late vaccine starters and lack of a parent-held record were key barriers to timely immunisation.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Childhood immunisation is critical for preventing vaccine-preventable diseases.
- Suboptimal immunisation coverage poses a risk for disease outbreaks in childcare settings.
- Understanding factors influencing immunisation status is essential for targeted interventions.
Purpose of the Study:
- To assess the immunisation status of preschool children in North Queensland.
- To identify factors associated with incomplete immunisation by two years of age.
Main Methods:
- A random sample of 613 preschool children from childcare facilities in Cairns and Mulgrave Shire was surveyed.
- Immunisation records were assessed to determine vaccination status by two years of age.
- Statistical analysis, including odds ratios, was used to identify associated factors.
Main Results:
- Only 60.3% of children were fully immunised by two years of age.
- Children starting immunisation late (after three months) had significantly lower completion rates (OR 10.3).
- Children lacking a parent-held immunisation record were less likely to be up-to-date (OR 2.8).
Conclusions:
- Immunisation coverage in North Queensland is inadequate to prevent disease outbreaks.
- Interventions targeting late starters and promoting parent-held records are crucial.
- Innovative strategies are needed to improve vaccine uptake and achieve herd immunity.
Abstract:
This study aimed to determine the immunisation status of preschool-aged children attending formal child-care facilities in north Queensland, and to examine factors associated with failure to be completely immunised by two years of age. Child-care centres and kindergartens within the Cairns City and Mulgrave Shire local government boundaries were selected randomly with probability proportional to size, and 613 children (median age of 47.0 months) were selected randomly from the facilities. Only 60.3 per cent (95 per cent confidence interval (CI) 56.3 to 64.3) of the children were fully immunised by two years of age. Children who had not received any vaccines by three months of age (that is, 'late starters') were less likely to be fully up-to-date at two years of age than children who started on time (odds ratio (OR) 10.3; CI 5.2 to 20.9). Children without a parent-held immunisation record were less likely to be up-to-date at two years of age than those children with a parent-held immunisation record (OR 2.8; CI 1.9 to 4.0). With follow-up of late-starters, and with the simultaneous administration of overdue vaccines with vaccines given in the second year of life, the percentage of children up-to-date at 24 months of age could have increased from 60.3 per cent to 82.3 per cent (CI 79.1 to 85.5). The immunisation coverage rates were inadequate to prevent outbreaks of vaccine-preventable diseases. Innovative strategies will be required if the vaccine coverage rates are to be improved. The parent-held immunisation record is of fundamental importance to all these strategies.