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Immunization Coverage of Albertan Children in Care of the Government Open Access


Other title
Children in Care
Type of item
Degree grantor
University of Alberta
Author or creator
Hermann, Jennifer Sarah
Supervisor and department
MacDonald, Shannon (Faculty of Nursing)
Olson, Joanne (Faculty of Nursing)
Examining committee member and department
Kunyk, Diane (Faculty of Nursing)
Simmonds, Kimberley (School of Public Health)
Faculty of Nursing

Date accepted
Graduation date
2017-11:Fall 2017
Master of Nursing
Degree level
Background: Children in care of the child welfare system (‘children in care’) are a vulnerable population who access preventive health services less than children not in care. Objective: To assess immunization coverage of a cohort children who have been in care in Canada and compare it to children who have never been in care. Methods: Three population-based administrative datasets were linked to assess immunization coverage for children at age two (N=44 206) and seven (N=42 241) for diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (DTaP-IPV-Hib), meningococcal, and measles, mumps, rubella (MMR) vaccines. A child was considered to be in care if they spent any time in care before the age of assessment. Logistic regression was used to compare immunization status. Results: Immunization coverage for children in care at age two ranged from 54.3% (DTaP-IPV-Hib) to 81.4% (MMR) compared to those not in care which ranged from 74.2% (DTaP-IPV-Hib) to 87.4% (MMR). Coverage for children in care at age seven was 53.1% (DTaP-IPV) and 65.3% (MMR) compared to those not in care 76.6% (DTaP-IPV) and 83.4% (MMR). For both ages, the odds of being under vaccinated were higher for children in care for all vaccines (e.g. DTaP-IPV-Hib odds ratio [OR]: 2.43; 95% confidence interval [CI]: 1.72-3.44). For children not in care that live in households with competing demands (e.g. highly mobile lifestyle), their coverage was lower (e.g. 63.1% for DTaP-IPV-Hib) than those not in care without such demands (e.g. 76.4% for DTaP-IPV-Hib) but higher than children in care. Among the three groups, children in care had the highest odds of being under vaccinated (e.g. DTaP-IPV-Hib, OR: 2.72; 95% CI: 1.93-3.86). Conclusion: Children in care have lower immunization coverage than children not in care. Policies and practices should be examined to ensure optimal access to vaccination for these children.
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