Increased disparity in routine infant vaccination during COVID-19
Notice bibliographique
Résumé
Abstract Background COVID-19 restrictions and its impact on healthcare resources have reduced routine infant vaccine uptake, although some report that this effect was short-lived. These prior studies mostly described entire populations, but disparities in uptake may have changed during the pandemic due to differential access to healthcare. Objectives We aimed to examine disparities in the reduction in routine infant vaccine uptake during the COVID-19 pandemic in Manitoba, Canada. Methods We assessed vaccine uptake for routine infant vaccines for a pre-pandemic and pandemic subcohort. We assessed how the reduction in vaccine uptake differed by gender, neighborhood income quintile and region of residence. For each evaluation age, we limited the pandemic subcohort to children reaching this milestone age on/before November 30, 2021. Results Vaccine uptake was about 5-10% lower during the pandemic. The groups most vulnerable to COVID-19 saw the largest reductions in vaccine uptake, with an ongoing downward trend throughout the pandemic. Children in the lowest income neighborhoods saw a 17% reduction in diphtheria, tetanus, and acellular pertussis dose 4 uptake at 24 months, 4.4-fold that of high-income neighborhoods, and an 11% reduction in measles, mumps, rubella (MMR) vaccine uptake at 24 months, 5.6-fold that of high-income neighborhoods. The largest reductions were for low-income Northern residents and smallest for high-income Winnipeg residents, e.g. 16-fold larger for MMR at 24 months (79:94 pre-pandemic to 65:93 during the pandemic). Conclusions While privileged children have similar high vaccine uptake as before the pandemic, children in populations hardest hit by COVID-19 continue seeing concerning reductions in routine infant vaccination. It is imperative that infant vaccination rates are increased, especially in communities with lower socioeconomic status, as a failure to do so could lead to persistent rebound epidemics in the most vulnerable populations. Synopsis Study question How did COVID-19 and its restrictions affect routine infant vaccine uptake? What’s already known We know that vaccine uptake in infants decreased during the pandemic. We do not know whether this affected everyone equally or whether the pandemic worsened existing disparities in vaccine uptake. What this study adds Although vaccine uptake was not affected in wealthy urban neighborhoods, the reduction in uptake was largest, and continued on a downward trend, for groups with the lowest baseline vaccine uptake. Only two-thirds of children, instead of the 4/5th before the pandemic, in the remote, predominantly Indigenous Northern region received a measles vaccine by their second birthday.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».