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ICES study finds few children getting flu vaccine


Since 2000, every Ontario resident has been entitled to free influenza vaccination under the provincial government’s universal influenza immunization program (UIIP). But a study out of the Institute for Clinical Evaluative Sciences (ICES) has found most children aged 6- to 23-months and older with chronic medical conditions are not getting vaccinated. The figures for children vaccinated are far less than the targeted 70 per cent for high risk groups. Children under two years of age are hospitalized due to influenza at a similar rate to the elderly and so are considered a high risk group, as are children with chronic medical conditions.

The study surveyed the caregivers of 4,854 children between the ages of 6-months and 11-years-old over the phone during the 2006-2007 influenza season and found:

  • For children with medical conditions placing them at higher risk for complications from influenza, only 1 in 3 (30.8 per cent) get flu shots according to the recommended dosing schedule.
  • Only 1 in 10 (10.2 per cent) infants aged 6-months to 2-years-old received the right number of flu shots.
  • These rates are lower than the target of 70 per cent for high-risk groups.
  • The rate of flu shots in Ontario infants was lower than other provinces despite Ontario’s universal program making flu shots free for the entire population aged 6-months and older.
  • An improvement in Ontario rates could be achieved by increasing efforts to promote awareness of the benefits of flu shots to families and their doctors.
  • It is important to develop a system to routinely measure and monitor flu shots so efforts can be targeted specifically to groups with low coverage, like infants.

Flu shots are not universally effective but have been shown to reduce the burden of influenza in individuals and communities. All provinces in Canada provide free flu shots to these high risk groups, whereas Ontario has expanded the program to include everybody.

“This study shows that just making flu shots freely and easily available to the entire population may not be enough for reaching certain high risk groups,” says Dr. Jeff Kwong, one of the authors of the study. “Educating the public and vaccine providers about vaccinating young children and those with medical conditions against influenza is important in order to reach those who are most vulnerable.”

Author affiliations: ICES (Maaten, Guttmann, Kwong); Durham Region Health Department and York Region Community and Health Services (Moran); Division of Paediatric Medicine, The Hospital for Sick Children (Guttmann) Departments of Paediatrics and Health Policy, Management and Evaluation, UofT (Guttmann); Institute for Social Research, York University (Northrup); Department of Family and Community Medicine and Dalla Lana School of Public Health, UofT (Kwong), Toronto.

The study “Influenza vaccination rates in Ontario children: implications for universal childhood vaccination policy” is in the April 14, 2009 issue (volume 27, number 17) of Vaccine.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.



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