Tags

Type your tag names separated by a space and hit enter

Clinic accessibility and clinic-level predictors of the geographic variation in 2009 pandemic influenza vaccine coverage in Montreal, Canada.
Influenza Other Respir Viruses. 2014 May; 8(3):317-28.IO

Abstract

BACKGROUND

Nineteen mass vaccination clinics were established in Montreal, Canada, as part of the 2009 influenza A/H1N1p vaccination campaign. Although approximately 50% of the population was vaccinated, there was a considerable variation in clinic performance and community vaccine coverage.

OBJECTIVE

To identify community- and clinic-level predictors of vaccine uptake, while accounting for the accessibility of clinics from the community of residence.

METHODS

All records of influenza A/H1N1p vaccinations administered in Montreal were obtained from a vaccine registry. Multivariable regression models, specifically Bayesian gravity models, were used to assess the relationship between vaccination rates and clinic accessibility, clinic-level factors, and community-level factors.

RESULTS

Relative risks compare the vaccination rates at the variable's upper quartile to the lower quartile. All else being equal, clinics in areas with high violent crime rates, high residential density, and high levels of material deprivation tended to perform poorly (adjusted relative risk [ARR]: 0·917, 95% CI [credible interval]: 0·915, 0·918; ARR: 0·663, 95% CI: 0·660, 0·666, ARR: 0·649, 95% CI: 0·645, 0·654, respectively). Even after controlling for accessibility and clinic-level predictors, communities with a greater proportion of new immigrants and families living below the poverty level tended to have lower rates (ARR: 0·936, 95% CI: 0·913, 0·959; ARR: 0·918, 95% CI: 0·893, 0·946, respectively), while communities with a higher proportion speaking English or French tended to have higher rates (ARR: 1·034, 95% CI: 1·012, 1·059).

CONCLUSION

In planning future mass vaccination campaigns, the gravity model could be used to compare expected vaccine uptake for different clinic location strategies.

Authors+Show Affiliations

Surveillance Lab, McGill Clinical and Health Informatics, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Children's Hospital Informatics Program, Children's Hospital Boston, Boston, MA, USA; Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24382000

Citation

Charland, Katia M., et al. "Clinic Accessibility and Clinic-level Predictors of the Geographic Variation in 2009 Pandemic Influenza Vaccine Coverage in Montreal, Canada." Influenza and Other Respiratory Viruses, vol. 8, no. 3, 2014, pp. 317-28.
Charland KM, de Montigny L, Brownstein JS, et al. Clinic accessibility and clinic-level predictors of the geographic variation in 2009 pandemic influenza vaccine coverage in Montreal, Canada. Influenza Other Respir Viruses. 2014;8(3):317-28.
Charland, K. M., de Montigny, L., Brownstein, J. S., & Buckeridge, D. L. (2014). Clinic accessibility and clinic-level predictors of the geographic variation in 2009 pandemic influenza vaccine coverage in Montreal, Canada. Influenza and Other Respiratory Viruses, 8(3), 317-28. https://doi.org/10.1111/irv.12227
Charland KM, et al. Clinic Accessibility and Clinic-level Predictors of the Geographic Variation in 2009 Pandemic Influenza Vaccine Coverage in Montreal, Canada. Influenza Other Respir Viruses. 2014;8(3):317-28. PubMed PMID: 24382000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinic accessibility and clinic-level predictors of the geographic variation in 2009 pandemic influenza vaccine coverage in Montreal, Canada. AU - Charland,Katia M, AU - de Montigny,Luc, AU - Brownstein,John S, AU - Buckeridge,David L, Y1 - 2014/01/02/ PY - 2013/12/01/accepted PY - 2014/1/3/entrez PY - 2014/1/3/pubmed PY - 2014/12/15/medline KW - Influenza vaccine KW - mass vaccination KW - public health SP - 317 EP - 28 JF - Influenza and other respiratory viruses JO - Influenza Other Respir Viruses VL - 8 IS - 3 N2 - BACKGROUND: Nineteen mass vaccination clinics were established in Montreal, Canada, as part of the 2009 influenza A/H1N1p vaccination campaign. Although approximately 50% of the population was vaccinated, there was a considerable variation in clinic performance and community vaccine coverage. OBJECTIVE: To identify community- and clinic-level predictors of vaccine uptake, while accounting for the accessibility of clinics from the community of residence. METHODS: All records of influenza A/H1N1p vaccinations administered in Montreal were obtained from a vaccine registry. Multivariable regression models, specifically Bayesian gravity models, were used to assess the relationship between vaccination rates and clinic accessibility, clinic-level factors, and community-level factors. RESULTS: Relative risks compare the vaccination rates at the variable's upper quartile to the lower quartile. All else being equal, clinics in areas with high violent crime rates, high residential density, and high levels of material deprivation tended to perform poorly (adjusted relative risk [ARR]: 0·917, 95% CI [credible interval]: 0·915, 0·918; ARR: 0·663, 95% CI: 0·660, 0·666, ARR: 0·649, 95% CI: 0·645, 0·654, respectively). Even after controlling for accessibility and clinic-level predictors, communities with a greater proportion of new immigrants and families living below the poverty level tended to have lower rates (ARR: 0·936, 95% CI: 0·913, 0·959; ARR: 0·918, 95% CI: 0·893, 0·946, respectively), while communities with a higher proportion speaking English or French tended to have higher rates (ARR: 1·034, 95% CI: 1·012, 1·059). CONCLUSION: In planning future mass vaccination campaigns, the gravity model could be used to compare expected vaccine uptake for different clinic location strategies. SN - 1750-2659 UR - https://www.unboundmedicine.com/medline/citation/24382000/Clinic_accessibility_and_clinic_level_predictors_of_the_geographic_variation_in_2009_pandemic_influenza_vaccine_coverage_in_Montreal_Canada_ L2 - https://doi.org/10.1111/irv.12227 DB - PRIME DP - Unbound Medicine ER -