Dataset Information

Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort.

ABSTRACT: Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determinants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status was available at age two years. Incomplete vaccination was defined as ≥ 1 missing dose of recommended vaccines. Potential determinants of incomplete vaccination were identified by using logistic regression, taking into account attrition and missing data. Of the 5,740 (31.3%) children analyzed, 46.5% (95% confidence interval [CI] 44.7-48.0) were incompletely vaccinated. Factors independently associated with incomplete vaccination were having older siblings (adjusted odds ratio 1.18, 95% CI [1.03-1.34] and 1.28 [1.06-1.54] for one and ≥ 2 siblings, respectively, vs. 0), residing in an isolated area (1.92 [1.36-2.75] vs. an urban area), parents not following health recommendations or using alternative medicines (1.81 [1.41-2.34] and 1.23 [1.04-1.46], respectively, vs. parents confident in institutions and following heath recommendations), not being visited by a maternal and child protection service nurse during the child's first two months (1.19 [1.03-1.38] vs. ≥ 1 visit), and being followed by a general practitioner (2.87 [2.52-3.26] vs. a pediatrician).

Conclusions

Incomplete vaccination was highly prevalent in the studied pediatric population and was associated with several socio-demographic, parental, and healthcare service characteristics. These findings may help in designing targeted corrective actions.

What is known

• Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries. • The partial understanding of the determinants of incomplete vaccination precludes the design of effective targeted corrective actions.

What is new

• High prevalence of incomplete vaccination at age two years in France. • Incomplete vaccination was independently associated with several socio-demographic, parental, and healthcare service characteristics.

SUBMITTER: Jacques M

PROVIDER: S-EPMC9768772 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort.

Jacques Marianne M Lorton Fleur F Dufourg Marie-Noëlle MN Bois Corinne C Launay Elise E Siméon Thierry T Raude Jocelyn J Guen Christèle Gras-Le CG Lévy-Brühl Daniel D Charles Marie-Aline MA Chalumeau Martin M Scherdel Pauline P

European journal of pediatrics 20221221 3

Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determinants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status wa ...[more]

PMID: 36542162

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Project description:BackgroundDelayed vaccination increases the time infants are at risk for acquiring vaccine-preventable diseases. Factors associated with incomplete vaccination are relatively well characterized in resource-limited settings; however, few studies have assessed immunization timeliness.MethodsWe conducted a prospective cohort study examining Diphtheria-Tetanus-Pertussis (DTP) vaccination timing among newborns enrolled in a Neonatal Vitamin A supplementation trial (NEOVITA) conducted in urban Dar es Salaam (n = 11,189) and rural Morogoro Region (n = 19,767), Tanzania. We used log-binomial models to assess the relationship of demographic, socioeconomic, healthcare access, and birth characteristics with late or incomplete DTP1 and DTP3 immunization.ResultsThe proportion of infants with either delayed or incomplete vaccination was similar in Dar es Salaam (DTP1 11.5% and DTP3 16.0%) and Morogoro (DTP1 9.2% and DTP3 17.3%); however, the determinants of delayed or incomplete vaccination as well as their magnitude of association differed by setting. Both maternal and paternal education were more strongly associated with vaccination status in rural Morogoro region as compared to Dar es Salaam (p-values for heterogeneity < 0.05). Infants in Morogoro who had fathers and mothers with no education had 36% (95% CI: 22-52%) and 22% (95% CI: 10-34%) increased risk of delayed or incomplete DTP3 vaccination as compared to those with primary school education, respectively. In Dar es Salaam, mothers who attended their first antenatal care (ANC) visit in the 3rd trimester had 1.55 (95% CI: 1.36-1.78) times the risk of delayed or not received vaccination as compared to those with a 2nd trimester booking, while there was no relationship in Morogoro. In rural Morogoro, infants born at home had 17% (95% CI: 8-27%) increased risk for delayed or no receipt of DTP3 vaccination. In both settings, younger maternal age and poorer households were at increased risk for delayed or incomplete vaccination.ConclusionWe found some risk factors for delayed and incomplete vaccination were shared between urban and rural Tanzania; however, we found several context-specific risk factors as well as determinants that differed in their magnitude of risk between contexts. Immunization programs should be tailored to address context-specific barriers and enablers to improve timely and complete vaccination.

Project description:In nations like Ethiopia, vaccination rates are low despite being one of the most effective public health treatments to protect infants from common infectious diseases that can be prevented by immunization. In Worebabo District, the reasons of the underutilization of vaccination programs are poorly understood. Therefore, this study aimed to identify determinants of incomplete childhood vaccination in the study setting. Community based unmatched case-control study was carried out among 441 mothers of children aged 12-23 months old (147 cases and 294 controls) in Worebabo District, Ethiopia from March 1-April 30, 2020. Using a multistage sampling process, mothers were chosen. Health professionals were trained to collect data using a pre-tested standardized questionnaire. Data entered into Epi Info version 7.2 and put through statistical analysis in SPSS version 23. Binary logistic regression was performed to determine the odds ratio with a 95%CL. A p-value of under 0.05 was estimated statistically significant. The study found that older moms (>35 years old) were more likely than younger mothers to fail to properly immunize their children (AOR = 2.4, 95% CI: 1.09, 5.28). In addition, mothers with incomplete vaccinations had lower knowledge of the benefits of vaccination (AOR = 2.02, 95% CI: 1.20, 3.39), Negative attitudes towards immunization (AOR = 4.9, 95% CI: 2.82, 8.49), less access to prenatal care (AOR = 3.68, 95% CI: 1.58, 8.54), home delivery (AOR = 5.47, 95% CI: 2.58)., 11.58), absent home visits (AOR = 3.56, 95% CI: 1.69, 7.48), and longer time to reach vaccination site (>1 h) (AOR = 10.07)., 95% CI: 1.75, 57.79) were found associated with mother incomplete vaccination of the child. Mothers being older age, less access to antenatal care services, place of home delivery, longer time to reach vaccination site, negative attitude and poor knowledge towards the benefit of vaccination were associated with mothers' incomplete vaccination of the child. Therefore, health professionals should inform and counsel mothers about the advantages of childhood immunization as well as the consequences of incomplete or not vaccination of children at the time of the facility visit and by community health workers during the routine home visit.

Project description:Excessive screen time in infancy and childhood has been associated with consequences on children's development and health. International guidelines call for no screen time before age 2 years, whereas in France, the most prominent guidelines recommend no screen before age 3 years. However, data are lacking on parental adherence to the no-screen guideline for toddlers and factors of adherence in France. Using data from the French nationwide Elfe birth cohort, we estimated adherence to the no-screen guideline at age 2 years and examined related factors, including sociodemographic characteristics, parental leisure activities and screen time. In 2011, 18,329 newborns and their parents were enrolled in 349 randomly selected maternity units across mainland France. At age 2 years, screen exposure of 13,117 toddlers was reported by parents in phone interviews. Data on sociodemographic characteristics, parental leisure activities and screen time were collected from both parents. Three patterns of parental leisure activities were derived by principal component analysis: literate (e.g.,reading), screen-based, and physical/artistic activities. Multivariable logistic regression models were used to examine the associations of sociodemographic characteristics, parental leisure activities and parental screen time with adherence to the no-screen guideline for toddlers. Overall, 1809/13,117 (13.5%) families adhered to the no-screen guideline for toddlers. Adherence was reduced with maternal age < 40 years, low parental education, single-parent household and parental migration status. After adjusting for sociodemographic characteristics, adherence to the guideline was positively associated with a parental literate activity pattern (mothers: odds ratio [95% confidence interval]: 1.15 [1.08, 1.22]); fathers: 1.15 [1.07, 1.23]) and negatively with a screen-based activity pattern (mothers: 0.73 [0.69, 0.77]; fathers: 0.81 [0.76, 0.87]). With each additional hour of parental screen time, mothers and fathers were less likely to adhere to the guideline (mothers: adjusted odds ratio 0.80 [0.77, 0.83]; fathers: 0.88 [0.85, 0.91]). Adherence to the no-screen guideline for toddlers in France was low. Parental leisure activities and parental screen time are major factors of adherence to the no-screen guideline and could be considered in targeted public health interventions.

Dataset Information

Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort.

Conclusions

What is known

What is new

Publications

Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort.

Similar Datasets

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