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Martínez-Marcos M, Reñé-Reñé A, Zabaleta-Del-Olmo E, Guiriguet C, Gómez-Durán EL, Cabezas-Peña C. Measles, mumps, and rubella vaccination coverage: an ecological study of primary health care and socio-economic factors in Catalonia, Spain. J Public Health Policy 2024; 45:299-318. [PMID: 38664542 DOI: 10.1057/s41271-024-00484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 06/16/2024]
Abstract
This study examined the association of socio-economic factors and the structure of primary care centres (PCCs) with measles, mumps, and rubella (MMR) vaccination coverage among the 8-year-old population in Catalonia, Spain. We conducted an ecological study to retrospectively assess the MMR vaccination-recorded status of children born in 2012, using public health data extracted in December 2020. For each of 300 PCCs serving 70,498 children, we calculated vaccination coverage rates from electronic health records and linked these rates to a composite deprivation index corresponding to the territory served by each PCC. We identified a relationship between unfavourable socio-economic factors and higher recorded vaccination coverage. On average, directly managed PCCs had higher vaccination coverage rates than indirectly managed PCCs. Greater utilisation of primary care services by the population was also associated with higher vaccination coverage rates. Further research is needed to generate knowledge valuable for informing more equitable child-vaccination service delivery models.
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Affiliation(s)
- Montse Martínez-Marcos
- Preventive Medicine Service, Sub-directorate General for Health Promotion, Secretariat of Public Health, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Anna Reñé-Reñé
- Central Vaccine Registry Management Team, Institut Català de la Salut, Girona, Spain
| | - Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.
- Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain.
| | - Carolina Guiriguet
- Sistema d'Informació dels Serveis d'Atenció Primària (SISAP), Healthcare Management, Information Systems Directorate, Institut Català de la Salut, Barcelona, Spain
- Gotic Primary Care Centre, Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
| | | | - Carmen Cabezas-Peña
- Sub-directorate General for Health Promotion, Secretariat of Public Health, Department of Health, Generalitat de Catalunya, Barcelona, Spain
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Díaz-García RS, Sánchez-Gómez A, López-Zambrano MA, Esteban-Vasallo MD, Cañellas Llabrés S, Gutiérrez Rodríguez MÁ, Lasheras Carbajo MD. Vaccination against influenza: Coverage and adherence in children under 15 years with high-risk medical conditions in the Community of Madrid. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2023; 98:3-11. [PMID: 36496313 DOI: 10.1016/j.anpede.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Vaccination against influenza is indicated in children at risk of complications or severe disease. The objective of this study was to describe the percentage of children aged less than 15 years with risk conditions vaccinated against influenza in the Community of Madrid, and to analyze the factors associated with adherence to vaccination throughout 3 vaccination campaigns. MATERIALS AND METHODS Population-based cross-sectional observational study of children aged 6 months to 14 years with conditions that indicated influenza vaccination at the beginning of the 2018-2019 campaign. Electronic population registers were used. We described the percentage of children vaccinated in 3 consecutive campaigns, and assessed the association of adherence to vaccination with demographic and socioeconomic variables and risk conditions using bivariate and multivariate analysis. RESULTS The vaccination coverage was 15.6% in the 2018-2019 campaign. The adherence to vaccination was 65.9%. The variables associated with greater adherence were age greater than 2 years, especially in the 6-10 years group (aOR = 1.63; 95% CI, 1.43-1.85) and presenting more than one risk condition, especially 3 or more diseases (aOR = 1.80; 95% CI, 1.00-3.26). Diabetes mellitus was the disease associated most strongly with adherence (aOR = 2.15; 95% CI, 1.74-2.65). Adherence was lower in the immigrant population (aOR = 0.43; 95% CI, 0.36-0.51). We found no association between vaccination adherence and sex or socioeconomic status. CONCLUSIONS Vaccination coverage and adherence were suboptimal. Adherence to vaccination against influenza is associated with demographic and clinical conditions. Strategies need to be established to increase vaccination in children, with greater involvement of professionals and education of parents.
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Affiliation(s)
- Rosa S Díaz-García
- Servicio de Prevención de la Enfermedad, Subdirección General de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain; Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Amaya Sánchez-Gómez
- Servicio de Prevención de la Enfermedad, Subdirección General de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - María Alejandra López-Zambrano
- Servicio de Prevención de la Enfermedad, Subdirección General de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - María Dolores Esteban-Vasallo
- Servicio de Informes de Salud y Estudios, Subdirección General de Vigilancia en Salud Pública, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - Soledad Cañellas Llabrés
- Servicio de Prevención de la Enfermedad, Subdirección General de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - María Ángeles Gutiérrez Rodríguez
- Servicio de Prevención de la Enfermedad, Subdirección General de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| | - María Dolores Lasheras Carbajo
- Servicio de Prevención de la Enfermedad, Subdirección General de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
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Díaz-García RS, Sánchez-Gómez A, López-Zambrano MA, Esteban-Vasallo MD, Cañellas Llabrés S, Gutiérrez Rodríguez MÁ, Lasheras Carbajo MD. Cobertura y adherencia a la vacunación frente a la gripe en menores de 15 años con condiciones de riesgo en la Comunidad de Madrid. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Tabacchi G, Costantino C, Napoli G, Marchese V, Cracchiolo M, Casuccio A, Vitale F. Determinants of European parents' decision on the vaccination of their children against measles, mumps and rubella: A systematic review and meta-analysis. Hum Vaccin Immunother 2016; 12:1909-23. [PMID: 27163657 PMCID: PMC4964810 DOI: 10.1080/21645515.2016.1151990] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Low measles, mumps and rubella (MMR) immunization levels in European children highlight the importance of identifying determinants of parental vaccine uptake to implement policies for increasing vaccine compliance. The aim of this paper is to identify the main factors associated with partial and full MMR vaccination uptake in European parents, and combine the different studies to obtain overall quantitative measures. This activity is included within the ESCULAPIO project, funded by the Italian Ministry of Health. ORs and CIs were extracted, sources of heterogeneity explored and publication bias assessed. Forty-five papers were retrieved for the qualitative study, 26 of which were included in the meta-analysis. The following factors were associated with lower MMR vaccine uptake: misleading knowledge, beliefs and perceptions on vaccines (OR 0.57, CI 0.37-0.87); negative attitudes and behaviors toward vaccination (OR 0.71, CI 0.52-0.98); demographic characteristics, such as different ethnicity in Southern populations (OR 0.44, CI 0.31-0.61), higher child's age (OR 0.80, CI 0.76-0.85); low socio-economic status (OR 0.64, CI 0.51-0.80), especially low income (OR 0.39, CI 0.25-0.60) and education (OR 0.64, CI 0.48-0.84), high number of children (OR 0.54, CI 0.42-0.69), irregular marital status (OR 0.80, CI 0.66-0.96). The factors explaining heterogeneity were country location, administration modality, collection setting and responses reported on MMR alone or in combination. Findings from this study suggest policy makers to focus communication strategies on providing better knowledge, correct beliefs and perceptions on vaccines, and improving attitudes and behaviors in parents; and to target policies to people of ethnic minority from Southern Europe, low educated and deprived, with higher number of children and non-married marital status.
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Affiliation(s)
- Garden Tabacchi
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Claudio Costantino
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Giuseppe Napoli
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Valentina Marchese
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Manuela Cracchiolo
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Alessandra Casuccio
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
| | - Francesco Vitale
- a Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro ", University of Palermo , Palermo , Italy
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Barata RB, Pereira SM. Desigualdades sociais e cobertura vacinal na cidade de Salvador, Bahia. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2013; 16:266-77. [DOI: 10.1590/s1415-790x2013000200004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 05/23/2012] [Indexed: 11/22/2022] Open
Abstract
Objetivo: Estimar as coberturas vacinais alcançadas em crianças nascidas na cidade de Salvador, analisando essas coberturas por condições socioeconômicas. Método: Foi realizado um inquérito domiciliar sobre cobertura vacinal, na cidade de Salvador, capital do Estado da Bahia, Nordeste do Brasil, sendo incluídas crianças nascidas em 2005, que no momento do estudo apresentavam 18 a 36 meses de idade. Foi realizada amostragem por conglomerados em múltiplas etapas. Os setores censitários foram estratificados utilizando-se dados do censo demográfico realizado em 2000. Foram coletados dados socioeconômicos dos domicílios. O tamanho da amostra foi definido a partir de metodologia específica para inquéritos de cobertura vacinal. O questionário foi aplicado tomando por base as informações constantes na caderneta de vacinação. Foi estimada a cobertura vacinal nos diversos estratos considerando o plano complexo de amostragem, ponderando as observações segundo a fração amostral, as perdas e o efeito do desenho. Resultados: Observou-se desigualdade socioeconômica nos diversos estratos, com um gradiente diretamente proporcional entre cobertura vacinal e nível socioeconômico. As diferenças mostram-se estatisticamente significantes entre os estratos D e E comparado ao estrato A. Em relação ao esquema completo, as crianças residentes nos estratos D e E apresentam cobertura significantemente menor que aquelas residentes no estrato B. Para vacinas não incluídas no esquema básico, as diferenças são muito acentuadas, sendo inferior a 3% nos estratos D e E. Conclusões: A cobertura vacinal pelo esquema completo ao final dos 18 meses de idade, com doses válidas, foi insatisfatória e foram observadas heterogeneidades entre os estratos socioeconômicos com pior cobertura nos grupos mais pobres.
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Stronegger WJ, Freidl W. A hierarchical analysis of social determinants of measles vaccination coverage in Austrian schoolchildren. Eur J Public Health 2009; 20:354-9. [PMID: 19948778 DOI: 10.1093/eurpub/ckp188] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Numerous socio-economic and demographic factors have been identified as being associated with low vaccination coverage in children. However, the complex interrelation between these factors is not fully understood. We focused our study on the less well-established associations of familial resources for child care with vaccination coverage and their interrelationship with socio-demographic factors. METHODS This cross-sectional study (n = 2386) focuses on parental social status and on resources for child care as determinants of measles vaccination coverage of schoolchildren aged 6-13 years in Styria, Austria. In order to reveal the relationships among these factors, an analysis based on a conceptual hierarchical model was performed. The so-called graphical modelling approach was used for the multivariate analysis of the hierarchically structured determinants. RESULTS The findings indicate that vaccination coverage is directly associated with a large number of children in the family (P < 0.0001) and directly as well as indirectly associated with a low level of education of the father (P < 0.001). All other included child-care resources are only indirectly associated with a low coverage, whereby the number of children acts as main mediating factor. CONCLUSIONS The results suggest that vaccination programmes should mainly focus on families with many children or parents of low educational level and not on the whole population.
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Affiliation(s)
- Willibald J Stronegger
- Institute of Social Medicine and Epidemiology Medical University of Graz, Universitätsstrasse 6/I, Graz, Austria.
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