The impact of physician bonuses, enhanced fees, and feedback on childhood immunization coverage rates.

Maintaining high vaccine coverage (VC) for pediatric vaccinations is crucial to ensure herd immunity, reducing the risk of vaccine-preventable diseases (VPD). The Italian vaccination Law (n. 119/2017) reinforced mandates for polio, diphtheria, tetanus, and hepatitis B, extending the mandate to pertussis, Haemophilus influenzae type b, chickenpox, measles, mumps, and rubella, for children up to 16 years of age. We analyzed the national temporal trends of childhood immunization rates from 2014 to 2019 to evaluate the impact of the mandatory reinforcement law set in 2017 as a sustainable public health strategy in Italy. In a 3-year period, 9 of the 10 compulsory vaccinations reached the threshold of 95% and VC for chicken pox increased up to 90.5%, significantly. During the same period, the recommended vaccinations (against meningococcus B and C, pneumococcus, and rotavirus) also recorded a significant increase in VC trends. In conclusion, although the reinforcement of compulsory vaccination generated a wide public debate that was amplified by traditional and social media, the 3-year evaluation highlights positive results.

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Effect of a pay for performance schemes on improvement of the childhood immunization coverage rates: A literature review

Pediatric Dimensions ◽

10.15761/pd.1000175 ◽

2018 ◽

Vol 3 (3) ◽

Author(s):

Giorgia Rotundo ◽

Marianna Mauro ◽

Monica Giancotti

Keyword(s):

Literature Review ◽

Pay For Performance ◽

Immunization Coverage ◽

Childhood Immunization ◽

Coverage Rates

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Effect of vaccine reminder and tracker bracelets on routine childhood immunization coverage and timeliness in urban Pakistan: protocol for a randomized controlled trial

BMC Public Health ◽

10.1186/s12889-019-7667-3 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Danya Arif Siddiqi ◽

Mehr Munir ◽

Mubarak Taighoon Shah ◽

Aamir Javed Khan ◽

Subhash Chandir

Keyword(s):

Randomized Controlled Trial ◽

Low Cost ◽

Controlled Trial ◽

Immunization Coverage ◽

Control Group ◽

Due Dates ◽

Childhood Immunization ◽

Randomized Controlled ◽

Routine Childhood ◽

The Impact

Abstract Background Inability to track children’s vaccination history coupled with parents’ lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. Traditional Reminder/Recall (RR) interventions such as paper-based immunization cards or mHealth based platforms do not yield optimal results in resource-constrained settings. There is thus a need for a low-cost intervention that can simultaneously stimulate demand and track immunization history to help reduce drop-outs and improve immunization coverage and timeliness. The objective of this study is to evaluate the impact of low-cost vaccine reminder and tracker bracelets for improving routine childhood immunization coverage and timeliness in Pakistani children under 2 years of age. Methods The study is an individually randomized, three-arm parallel Randomized Controlled Trial with two intervention groups and one control group. Infants in the two intervention groups will be given two different types of silicone bracelets at the time of recruitment, while infants in the control group will not receive any intervention. The two types of bracelets consist of symbols and/or numbers to denote the EPI vaccination schedule and each time the child will come for vaccination, the study staff will perforate a hole in the appropriate symbol to denote vaccine administration. Therefore, by looking at the bracelet, caregivers will be able to see how many vaccines have been received. Our primary outcome measure is the increase in coverage and timeliness of Pentavalent-3/PCV-3/Polio-3 and Measles-1 vaccine in the intervention versus control groups. A total of 1446 participants will be recruited from 4 Expanded Program on Immunization (EPI) centers in Landhi Town, Karachi. Each enrolled child will be followed up till the Measles-1 vaccine is administered, or till eleven months have elapsed since enrolment. Discussion Participant recruitment commenced on July 19, 2017, and was completed on October 10, 2017. Proposed duration of the study is 18 months and expected end date is December 1, 2018. This study constitutes one of the first attempts to rigorously evaluate an innovative, low-cost vaccine reminder bracelet. Trial registration ClinicalTrials.gov NCT03310762. Retrospectively Registered on October 16, 2017.

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Role of Maternal Education and Vaccination Coverage: Evidence From Pakistan Demographic and Health Survey

Asia Pacific Journal of Public Health ◽

10.1177/1010539519889765 ◽

2019 ◽

Vol 31 (8) ◽

pp. 679-688 ◽

Cited By ~ 2

Author(s):

Atta Muhammad Asif ◽

Muhammad Akbar ◽

Muhammad Ramzan Tahir ◽

Irshad Ahmad Arshad

Keyword(s):

Health Survey ◽

Maternal Education ◽

Negative Impact ◽

Immunization Coverage ◽

Demographic And Health Survey ◽

Lower Percentage ◽

Childhood Immunization ◽

Wealth Status ◽

Substantial Impact ◽

The Impact

The aim of this study was to examine the impact of maternal education on child immunization uptake in Pakistan, both at individual and community levels. Pakistan Demographic and Health Survey data were used for analysis. Multilevel logistic regression was used to access the individual- and community-level factors associated with childhood immunization coverage. Out of 6765 children 2659 (39.3%) were fully immunized. Parents education, access to media, and wealth status have positive while ethnicity and working status of mother have a negative impact on the immunization uptake. In the community with a high percentage of educated mothers, the odds of immunized children were high (odds ratio = 1.43, 95% confidence interval = 1.14-1.80) as compared with communities with lower percentage of educated mothers. Moreover, significant variation was found in the likelihood of full immunization across communities. Both community- and individual-level factors have substantial impact on children immunization status. There is a need of improvement in maternal education, poverty alleviation, and removal of rural-urban disparities.

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The impact of computer-generated messages on childhood immunization coverage

American Journal of Preventive Medicine ◽

10.1016/s0749-3797(00)00178-1 ◽

2000 ◽

Vol 19 (1) ◽

pp. 68-70 ◽

Cited By ~ 11

Author(s):

Eugene F Dini ◽

Robert W Linkins ◽

Jennifer Sigafoos

Keyword(s):

Immunization Coverage ◽

Childhood Immunization ◽

The Impact

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Impact of the COVID-19 pandemic on routine immunization coverage in children under 2 years old in Ontario, Canada: A retrospective cohort study

10.1101/2021.10.28.21265578 ◽

2021 ◽

Author(s):

Catherine Ji ◽

Pierre-Philippe Piche-Renaud ◽

Jemisha Apajee ◽

Ellen Stephenson ◽

Milena Forte ◽

...

Keyword(s):

Cohort Study ◽

Early Period ◽

Immunization Coverage ◽

Educational Interventions ◽

Research Network ◽

Childhood Immunization ◽

Mmr Vaccine ◽

Vaccine Preventable Diseases ◽

Practice Based Research ◽

Coverage Rates

Background: The COVID-19 pandemic has caused a disruption in childhood immunization coverage around the world. This study aimed to determine the change in immunization coverage for children under 2 years old in Ontario, Canada, comparing time periods pre-pandemic to during the pandemic. Methods: We conducted an observational retrospective open cohort study, using primary care electronic medical record data from the University of Toronto Practice-Based Research Network (UTOPIAN) database, from January 2019 to December 2020. Children under 2 years old who had at least 2 visits recorded in UTOPIAN were included. We measured up-to-date (UTD) immunization coverage rates, overall and by type of vaccine (DTaP-IPV-Hib, Pneu-C-13, Rot, Men-C-C, MMR, Var), and on-time immunization coverage rates by age milestone (2, 4, 6, 12, 15 and 18 months). We compared average coverage rates over 3 periods of time: January 2019-March 2020 (T1); March-July 2020 (T2); and August-December 2020 (T3). Results: 12,313 children were included. Overall UTD coverage for all children was 71.0% in T1, dropped by 5.7% (95% CI: -6.2, -5.1) in T2, slightly increased in T3 but remained lower than in T1. MMR vaccine UTD coverage slightly decreased in T2 and T3 by approximately 2%. The largest decreases were seen at ages 15-month and 18-month old, with drops in on-time coverage of 14.7% (95% CI: -18.7, -10.6) and 16.4% (95% CI: -20.0, -12.8) respectively during T2. When stratified by sociodemographic characteristics, no specific subgroup of children was found to have been differentially impacted by the pandemic. Conclusion: Childhood immunization coverage rates for children under 2 years in Ontario decreased significantly during the early period of the COVID-19 pandemic and only partially recovered during the rest of 2020. Public health and educational interventions for providers and parents are needed to ensure adequate catch-up of delayed/missed immunizations to prevent potential outbreaks of vaccine-preventable diseases.

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Effect of vaccine reminder and tracker bracelets on routine childhood immunization coverage and timeliness in urban Pakistan: a randomized controlled trial

10.21203/rs.3.rs-19517/v1 ◽

2020 ◽

Author(s):

Danya Arif Siddiqi ◽

Rozina Feroz Ali ◽

Mehr Munir ◽

Mubarak Taighoon Shah ◽

Aamir J Khan ◽

...

Keyword(s):

Multivariate Analysis ◽

Low Cost ◽

Controlled Trial ◽

Immunization Coverage ◽

Control Group ◽

Practical Implementation ◽

Due Dates ◽

Childhood Immunization ◽

Adjusted Risk ◽

The Impact

Abstract Background Inability to track children’s vaccination history coupled with parents’ lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. We evaluated the impact of two types of silicon immunization reminder bracelets for children in improving immunization coverage and timeliness of Pentavalent-3 and the Measles-1 vaccines. Methods Children < 3 months were enrolled in either of the 2 intervention groups (Alma Sana Bracelet Group and Star Bracelet Group) or the Control group. Children in the intervention groups were provided the 2 different bracelets at the time of recruitment. Each time the child visited the immunization center, a hole was perforated in the silicon bracelet to denote vaccine administration. Each child was followed up till administration of Measles-1 vaccine or till 12 months of age (if they did not come to the center for vaccination). Data was analyzed using the intention-to-treat population between groups. The unadjusted and adjusted Risk Ratios (RR) and 95% confidence interval (CI) for Pentavalent-3 and Measles-1 coverage at 12 months of age were estimated through bivariate and multivariate analysis. Time-to-Pentavalent-3 and Measles-1 immunization curves were calculated using the Kaplan–Meier method. Results A total of 1,446 children were enrolled in the study between July 19, 2017 and October 10, 2017. Baseline characteristics among the three groups were similar. Up-to-date coverage for the Pentavalent-3 /Measles-1 vaccine at 12 months of age was 84.6%/72.0%, 85.4%/70.5% and 83.0%/68.5% in Alma Sana Bracelet group, Star Bracelet group and Control group respectively but the differences were not statistically significant. In the multivariate analysis, neither the Alma Sana bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06), (adjusted RR: 1.05; 95% CI: 0.97-1.13) nor the Star bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06) (adjusted RR: 1.03; 95% CI: 0.95-1.11) was significantly associated with Pentavalent-3 vaccination or Measles-1 vaccination. Conclusion Although we did not observe any significant impact of the bracelets on improved immunization coverage and timeliness, our findings add to the existing literature on innovative, low cost reminders for health and make several suggestions for enhancing practical implementation of these tools.

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