Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children: A record linkage cohort study

Parveen Fathima, Heather F. Gidding, Thomas L. Snelling, Peter B. McIntyre, Christopher C. Blyth, Sarah Sheridan, Bette Liu, Nicholas de Klerk, Hannah C. Moore

Research output: Contribution to journalArticle

Abstract

Objectives: Rotavirus vaccines (RV), included in Australia's National Immunisation Program from mid-July 2007, are unique in strict time limits for administration. Here, we report on timeliness of RV uptake, compare cumulative RV coverage to age 12 months with DTPa, and assess factors associated with receipt of RV among Aboriginal and non-Aboriginal children. Methods: Birth records for 681,456 children born in two Australian states in 2007–2012 were probabilistically linked to national immunisation records. We assessed on-time coverage (defined as receipt of vaccine dose between 4 days prior to scheduled date and the recommended upper limit) for RV and compared this to diphtheria-tetanus-pertussis (DTPa) vaccine. Logistic regression modelling was used to assess independent determinants of receipt of RV. Results: Compared to non-Aboriginal infants, on-time RV coverage was lower for all doses among Aboriginal infants. Post the upper age limit of RV dose2, DTPa dose2 coverage increased by 9–16% to ≥90%, whereas RV coverage remained around 77% (Aboriginal) and 85% (non-Aboriginal). Compared to first-born children, the adjusted odds of receiving ≥1 RV dose if born to a mother with ≥3 previous births was 0.30 (95%CI: 0.27–0.34) among Aboriginal, and 0.53 (95%CI: 0.51–0.55) among non-Aboriginal children. Prematurity (<33 weeks), low birthweight (<1500 g), maternal age <20 years, maternal smoking during pregnancy and living in a disadvantaged area were independently associated with decreased vaccine uptake. Conclusions: Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher. Although specific programs targeting groups at risk of delayed vaccination might improve RV coverage, relaxation of upper age restrictions is most readily implementable, and its overall risk-benefit should be evaluated.

Original languageEnglish
Pages (from-to)5835-5843
Number of pages9
JournalVaccine
Volume37
Issue number39
DOIs
Publication statusPublished - 16 Sep 2019

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Rotavirus Vaccines
Rotavirus
cohort studies
linkage (genetics)
Cohort Studies
vaccines
uptake mechanisms
Vaccines
infants
Mothers
Diphtheria-Tetanus-Pertussis Vaccine
Birth Certificates
Immunization Programs
immunization
dosage
Maternal Age
Vulnerable Populations
premature birth
whooping cough
Immunization

Cite this

@article{68770917dd5c41f98e4e0e1f36b325f3,
title = "Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children: A record linkage cohort study",
abstract = "Objectives: Rotavirus vaccines (RV), included in Australia's National Immunisation Program from mid-July 2007, are unique in strict time limits for administration. Here, we report on timeliness of RV uptake, compare cumulative RV coverage to age 12 months with DTPa, and assess factors associated with receipt of RV among Aboriginal and non-Aboriginal children. Methods: Birth records for 681,456 children born in two Australian states in 2007–2012 were probabilistically linked to national immunisation records. We assessed on-time coverage (defined as receipt of vaccine dose between 4 days prior to scheduled date and the recommended upper limit) for RV and compared this to diphtheria-tetanus-pertussis (DTPa) vaccine. Logistic regression modelling was used to assess independent determinants of receipt of RV. Results: Compared to non-Aboriginal infants, on-time RV coverage was lower for all doses among Aboriginal infants. Post the upper age limit of RV dose2, DTPa dose2 coverage increased by 9–16{\%} to ≥90{\%}, whereas RV coverage remained around 77{\%} (Aboriginal) and 85{\%} (non-Aboriginal). Compared to first-born children, the adjusted odds of receiving ≥1 RV dose if born to a mother with ≥3 previous births was 0.30 (95{\%}CI: 0.27–0.34) among Aboriginal, and 0.53 (95{\%}CI: 0.51–0.55) among non-Aboriginal children. Prematurity (<33 weeks), low birthweight (<1500 g), maternal age <20 years, maternal smoking during pregnancy and living in a disadvantaged area were independently associated with decreased vaccine uptake. Conclusions: Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher. Although specific programs targeting groups at risk of delayed vaccination might improve RV coverage, relaxation of upper age restrictions is most readily implementable, and its overall risk-benefit should be evaluated.",
keywords = "DTPa vaccine, Record-linkage, Rotavirus vaccine, Timeliness, Vaccine coverage",
author = "Parveen Fathima and Gidding, {Heather F.} and Snelling, {Thomas L.} and McIntyre, {Peter B.} and Blyth, {Christopher C.} and Sarah Sheridan and Bette Liu and {de Klerk}, Nicholas and Moore, {Hannah C.}",
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Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children : A record linkage cohort study. / Fathima, Parveen; Gidding, Heather F.; Snelling, Thomas L.; McIntyre, Peter B.; Blyth, Christopher C.; Sheridan, Sarah; Liu, Bette; de Klerk, Nicholas; Moore, Hannah C.

In: Vaccine, Vol. 37, No. 39, 16.09.2019, p. 5835-5843.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children

T2 - A record linkage cohort study

AU - Fathima, Parveen

AU - Gidding, Heather F.

AU - Snelling, Thomas L.

AU - McIntyre, Peter B.

AU - Blyth, Christopher C.

AU - Sheridan, Sarah

AU - Liu, Bette

AU - de Klerk, Nicholas

AU - Moore, Hannah C.

PY - 2019/9/16

Y1 - 2019/9/16

N2 - Objectives: Rotavirus vaccines (RV), included in Australia's National Immunisation Program from mid-July 2007, are unique in strict time limits for administration. Here, we report on timeliness of RV uptake, compare cumulative RV coverage to age 12 months with DTPa, and assess factors associated with receipt of RV among Aboriginal and non-Aboriginal children. Methods: Birth records for 681,456 children born in two Australian states in 2007–2012 were probabilistically linked to national immunisation records. We assessed on-time coverage (defined as receipt of vaccine dose between 4 days prior to scheduled date and the recommended upper limit) for RV and compared this to diphtheria-tetanus-pertussis (DTPa) vaccine. Logistic regression modelling was used to assess independent determinants of receipt of RV. Results: Compared to non-Aboriginal infants, on-time RV coverage was lower for all doses among Aboriginal infants. Post the upper age limit of RV dose2, DTPa dose2 coverage increased by 9–16% to ≥90%, whereas RV coverage remained around 77% (Aboriginal) and 85% (non-Aboriginal). Compared to first-born children, the adjusted odds of receiving ≥1 RV dose if born to a mother with ≥3 previous births was 0.30 (95%CI: 0.27–0.34) among Aboriginal, and 0.53 (95%CI: 0.51–0.55) among non-Aboriginal children. Prematurity (<33 weeks), low birthweight (<1500 g), maternal age <20 years, maternal smoking during pregnancy and living in a disadvantaged area were independently associated with decreased vaccine uptake. Conclusions: Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher. Although specific programs targeting groups at risk of delayed vaccination might improve RV coverage, relaxation of upper age restrictions is most readily implementable, and its overall risk-benefit should be evaluated.

AB - Objectives: Rotavirus vaccines (RV), included in Australia's National Immunisation Program from mid-July 2007, are unique in strict time limits for administration. Here, we report on timeliness of RV uptake, compare cumulative RV coverage to age 12 months with DTPa, and assess factors associated with receipt of RV among Aboriginal and non-Aboriginal children. Methods: Birth records for 681,456 children born in two Australian states in 2007–2012 were probabilistically linked to national immunisation records. We assessed on-time coverage (defined as receipt of vaccine dose between 4 days prior to scheduled date and the recommended upper limit) for RV and compared this to diphtheria-tetanus-pertussis (DTPa) vaccine. Logistic regression modelling was used to assess independent determinants of receipt of RV. Results: Compared to non-Aboriginal infants, on-time RV coverage was lower for all doses among Aboriginal infants. Post the upper age limit of RV dose2, DTPa dose2 coverage increased by 9–16% to ≥90%, whereas RV coverage remained around 77% (Aboriginal) and 85% (non-Aboriginal). Compared to first-born children, the adjusted odds of receiving ≥1 RV dose if born to a mother with ≥3 previous births was 0.30 (95%CI: 0.27–0.34) among Aboriginal, and 0.53 (95%CI: 0.51–0.55) among non-Aboriginal children. Prematurity (<33 weeks), low birthweight (<1500 g), maternal age <20 years, maternal smoking during pregnancy and living in a disadvantaged area were independently associated with decreased vaccine uptake. Conclusions: Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher. Although specific programs targeting groups at risk of delayed vaccination might improve RV coverage, relaxation of upper age restrictions is most readily implementable, and its overall risk-benefit should be evaluated.

KW - DTPa vaccine

KW - Record-linkage

KW - Rotavirus vaccine

KW - Timeliness

KW - Vaccine coverage

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U2 - 10.1016/j.vaccine.2019.08.013

DO - 10.1016/j.vaccine.2019.08.013

M3 - Article

VL - 37

SP - 5835

EP - 5843

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 39

ER -