Up-to-date immunization coverage rates among 2-year olds in Saskatchewan First Nations communities

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1 Up-to-date immunization coverage rates among 2-year olds in Saskatchewan First Nations communities Presented by: Michelle Allard-Johnson BScN, RN Regional Immunization Coordinator First Nations Inuit Health Branch-Saskatchewan

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5 Current State Paper based records system Large Reserves, served by one Health Centre Transient populations Many challenges and competing priorities for the Nurses Determinants of Health 5

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7 Methods Up-to-date (UTD) coverage by 24 months using the National Standards for Immunization Coverage Assessment Recommendations from the Canadian Immunization Registry Network (CIRN) Antigens included are: Diphtheria Tetanus Polio Haemophilus Influenzae Type B Mumps Measles Rubella Pneumococcal conjugate Meningococcal conjugate Varicella Hepatitis-A 7

8 Methods The purpose was to estimate the change in the UTD vaccine coverage rates among 2 year-olds in the Saskatchewan First Nations communities between 2006 and Data compiled by individual communities using individual client records (paperbased) to electronic format and shared with FNIHB Therefore, the UTD coverage is an under estimate because clients immunized off-reserve may not always be recorded in the community client record. Also, most communities are not part of the provincial Panorama system. Analysis included descriptive statistics and simple linear regression analysis. Residual diagnostic conducted and no issues with model fitness 95% confidence intervals for point estimates of UTD coverage calculated using Fisher s Exact Method Analysis conducted using SAS TM EG 5.1 and Microsoft Excel 2010

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10 Definitions: SPECIFIED AGE DEFINITIONS population = total number of eligible children (ie 2 year olds) born between January 1 and December 31 of the given year. ANTIGEN Some antigens may have more than one option for up to date criteria, depending on whether the child is on time with immunizations or on a delayed schedule - children are either be counted as being on time with immunizations or on a delayed schedule (not both). VACCINE SPECIFIC CRITERIA DTaP-IPV: 4 doses Hib: 1, 2, 3 or 4 doses For children on time with immunizations, four doses received as per the routine immunization schedule are considered up to date. For children on a delayed schedule, the number of doses required depends upon the age at which a child presents for immunizations. Pneu C 13: 2, 3 or 4 doses For children on time with immunizations, three doses (or four for medically high risk children) received as per the routine immunization schedule are considered up to date. For children on a delayed schedule, two, three or four doses may be up to date depending both on the time the series was started, the age at which the child presents as well as when it was completed for both healthy and medically high risk children. Men C: 1 dose MMR: 2 doses Hep A: 2 doses Var: 1 or 2 doses depending on date of birth 10

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12 Vaccine coverage (%) Results Between 2006 and 2015, the up-to-date vaccine coverages among 2-year-olds in the Saskatchewan First Nations communities have, on average, increased 1.7% per year. 100% Figure 1. Up-to-date vaccine* coverage, Saskatchewan First Nations communities, 2006 to % 80% 70% 60% 50% 40% 30% 20% 10% 0% Year SK FN CIC goal *DTaP-IPV, H Influenza type b, MMR, HepA, Pneumo-C, Men-C, Var

13 Results Up-to-date vaccine coverage among 2-year-olds, Saskatchewan First Nations on-reserve communities among select vaccines in SK FN on-reserve Year 2015 SK Province* Vaccine and dosage % (95% CI) % (95% CI) Pertussis (4 doses) 80.4% (±2.2) 75.0% (±0.7) Meningococcal (1 dose) 94.5% (±1.4) 88.1% (±0.5) Measles (2 doses) 84.5% (±2.0) 74.6% (±0.8) *Source: Saskatchewan Ministry of Health. Childhood Immunization: Coverage Statistics for 2- and 7-year-old children. Quarterly Report: December May 2016: Regina, Saskatchewan.

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15 Lessons Learned Communication Community engagement Immunization Champions Creating events in combination with other programs Making services available outside of regular working hours Make interventions Community specific

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17 Acknowledgements OUR NURSES!!! Community Health Nurses and Home Care Nurses Community Health Representatives and Health Centre Staff Nurse Managers Health Directors Community Leaders Community Members

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19 Other contributers Nolan Claude; Ryan Leadbetter; Mustafa Andkhoie; Germain Bukassa Kazadi; Deborah Kupchanko; Dr. Ibrahim Khan

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