MEASLES CONTAINING VACCINE COVERAGE AMONG ADOLESCENTS IN SWITZERLAND: DO SCHOOL VACCINATION PROGRAMS MATTER?

Transcription

1 MEASLES CONTAINING VACCINE COVERAGE AMONG ADOLESCENTS IN SWITZERLAND: DO SCHOOL VACCINATION PROGRAMS MATTER? P. Lang*, F. Valeri+, U. Piller*, L. Held*, C. Hatz* * ISPM, Zürich & +ISPM, Bern Swiss Public Health Conference 2012 Lausanne, 30. August Seite 1

2 Overview Methods SNVCS database Results Measles containing vaccine (MCV) coverage, Factors affecting MMR vaccine coverage Conclusions Seite 2

3 The Swiss National Vaccination Coverage Survey (SNVCS) Funded by the FOPH and the Health Departments in the Cantons To determine vaccination coverage for children living in Switzerland in all 26 Cantons Target population: 2, 8 and 16 years of age Period of data collection: , , School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 3

4 Methodology 3-year rolling cycle Sampling depends on sampling frame: Cluster sampling vs. Simple random sampling Contact municipalities / office of registration for information on selected families Families are contacted directly: 2X per mail, 1X per telephone (5-6 attempts) Exceptions: BS, JU, VD- school health nurses School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 4

5 Participation for the adolescents in the SNVCS for the 3 survey periods Cantons Sample Participation Cantonal Range n n % % School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 5

6 Coverage Institut für Sozial- und Präventivmedizin MCV coverage (%) for the 16 year old adolescents for the 3 survey periods % 90% 80% 70% 60% 50% 40% 30% 20% 10% % 1 dos e 2 dos es School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 6

7 100% MCV coverage (%) at 2 doses for the 16 year old adolescents in the Cantons, Germ an-speaking canto Latin-speaking cantons 90% 84% 80% 88% 70% 60% 50% 40% BS SG GL GR AG SH LU TG UR ZH ZG SO AR NW BE SZ BL OW AI GE FR VS VD NE TI CH School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 7

8 MCV coverage (%) for the 16 year old adolescents by year of birth, y = x R 2 = Birth cohort School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 8

9 Summary of cantonal school vaccination policy in regards to whether vaccination is provided in the schools during and vaccinates in the schools does NOT vaccinate in the schools OCCASIONALLY vaccinates in the schools ONLY checks and vaccinates in the practice Germ anspeak ing AR/BS/AG/SH/SZ/NW/GL/ TG/SO/AI/GR/UR/ZG SG-S/BE-S/ZH-S (10) /LU/BL (8) ZH-L/SG-L/BE-L (3) OW Frenchspeak ing VD/NE-S/JU/VS (4) NE-L/GE FR Ita lianspeak ing TI TG: belonged to occassionally vaccinate in the schools in School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 9

10 Summary of cantonal school vaccination policy in regards to having nurses involved in reviewing MMR-vaccination records in the schools during and Nurses invo lved Nurses not involved Germ anspeak ing BS/AG/SZ/NW/SG-S/BE- S/ZH-S (7 TG/AI/GR/ZG/LU/BL/AR/GL /OW/UR/SO/SH/BE-L/ZH- L/SG-L/ (15) Frenchspeak ing VD/JU/VS/GE/NE-S (5) FR/ NE-L Ita lianspeak ing TI School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 10

11 Factors influencing being UTD for MMR vaccination at 2 doses for the 16 Y, (1) Logistic regression: Univariate analysis Year of birth Linguistic region Nationality Gender School vaccination program Multivariate analysis Adusted for all 5 factors in the univariate analysis Using variable canton as a random variable School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 11

12 Factors influencing being UTD for MMR vaccination at 2 doses for the 16 Y, (2) variable N Coverage univariate analysis odds ratio (95% CI multivariate analys odds ratio (95% CI year of birth NA 1.21 ( ) 1.21 ( ) linguistic region Germ an-speaking % French-spea king % 1.17 ( ) 0.91 ( ) Italian-spea king % 0.87 ( ) 0.85 ( ) R om ansch-speaking 75 73% 0.72 ( ) 0.61 ( ) nationality Swiss % No rthern Europe % 1.35 ( ) 1.22 ( ) Eastern Europe % 0.94 ( ) 0.76 ( ) So uthern Europe % 2.08 ( ) 1.82 ( ) R em aining countries % 0.89 ( ) 0.62 ( ) sex fem ale % m ale % 0.88 ( ) 0.88 ( ) School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 12

13 Factors influencing being UTD for MMR vaccination at 2 doses for the 16 Y, (3) variable N Coverage univariate analysis odds ratio (95% CI multivariate analys odds ratio (95% CI school vaccination program (0) no school vax program % 0.48 ( ) 0.45 ( ) (1) yes, but does not vax % (2) ye s, but occass. vax % 1.21 ( ) 1.28 ( ) (3) ye s, does vax % 1.54 ( ) 0.99 ( ) (4) school nurse is not involved % (5) school nurse is involved % 1.57 ( ) 1.35 ( ) not included in analysis: : JU,VD, NW; : JU School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 13

14 MMR vaccine coverage (%) for the 16 Y according to the different school vaccination programs in 4 cantons, detailled by linguistic regions, Canton linguistic region school vax program school nurses involved n MMR vaccine coverage FR D uncle ar no % FR F uncle ar no % VS D vax ye s % VS F vax ye s % NE-L F no va x no % NE-S F vax ye s % ZH-L D uncle ar no % ZH-S D vax ye s % School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 14

15 Conclusions MCV coverage at 2 doses for the adolescents is increasing. MMR vaccine coverage for adolescents is influenced by nationality, year of birth, gender and school vaccination program. The higher MMR vaccine coverage in the Frenchspeaking region compared to the German-speaking region is most likely due to the different preventive measures implemented School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 15

16 Acknowledgements Swiss Federal Office of Public Health Chief Medical Officers and their Staff School Health Services School Doctors, School Nurses, Lungenliga Nurses Municipalities / Offices of Data Protection Families of selected children School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 16

17 Thank you for your attention! School vaccination programs and MMR vaccine coverage, Ph. Lang Seite 17