Saskatoon Health Region 2015 Immunization

Early Childhood Immunization

About the Data One Page Summary

Definition:

Coverage means percent of the population receiving the recommended number of doses for this age group. Coverage percentages are recorded at the same time each year and remain static for reporting purposes (in spite of mobility of immunized and unimmunized persons moving in and out of the area in subsequent years).

Disparity refers to difference between two areas or two sub-populations. Immunization disparity can be expressed as a ratio by comparing the top socio-economic quintile to the bottom socio-economic quintile (see Calculation).

Deprivation index is an index or compilation of indicators to measure deprivation across Canada at a small area level. The method was developed by the Institute National de Sante Publique du Quebec. Factor scores for material and social components of deprivation were determined for each dissemination area (DA) with a population of 400 to 700 persons per DA. For each measure of deprivation, the DAs have been ranked from the most to the least deprived, then broken down into quintiles, each of which contains approximately 20% of the total population. Quintile 1 represents the least deprived population, while quintile 5 represents the most deprived.

Equity is the principle of and commitment to incorporating social justice into health by reducing health inequalities. It implies that all people can reach their full health potential and should not be disadvantaged from attaining it because of their race, ethnicity, religion, gender, [sexual orientation], age, [disability], social class, [where they live], socioeconomic status or other socially determined circumstances. Health inequity occurs in the absence of health equity.

Geographic areas refer to Rural Planning Zones (RPZ), a designated area comprised of rural municipalities and towns/villages. The population base of each zone is roughly equivalent at about 15,000 each. Selected indicators are also shown by urban Saskatoon geography or neighbourhood.

Up to date means having received the recommended number of doses at a given age of the individual. All coverage percentages are considered up to date unless otherwise indicated. The number of vaccines doses is indicated in parenthesis. For the number of recommended doses for each vaccine by age see Saskatchewan Immunization Manual (chapter 5: Schedules) http://www.health.gov.sk.ca/immunization-manual

Calculations:

Percentage is the numerator (all persons receiving the recommended number of doses) divided by the denominator (all eligible persons receiving the recommended number of doses). All denominators are active clients entered into the Saskatchewan Immunization Management System (SIMS). References to coverage rates mean coverage percentage.

Coverage of neighbourhoods with under 20 individuals in the selected age group is not reported.

Immunization disparity ratio is calculated by dividing the two year old MMR coverage rate in the top socio-economic quintile by the coverage rate in the bottom socio-economic quintile in Saskatoon. A disparity ratio of one means the coverage rates are equal in the top and bottom quintiles. A ratio greater than one means that there is a lower coverage in low income areas, and indicates a greater disparity.

Source:

Saskatchewan Immunization Management System, SIMS. For more information see http://www.shin.sk.ca/accounts/Documents/SIMS%20JSAP.pdf (accessed May 2014)

Limitations:

Children immunized in First Nations clinics may not be updated in SIMS and this may lead to an underestimation of coverage percentages in some geographic areas. This underestimation is believed to be small. Children with postal code mapped to the Provincial Social Services building are excluded to prevent these children from being included in the Central Business Area neighbourhood. Disparities in neighbourhood coverage percentages may not be statistically significant. Confidence intervals are not presented here.

Reference:

Saskatchewan Ministry of Health. Covered population report. Saskatchewan Ministry of Health 2013 [cited 2014 Mar 11]; Available from: URL: http://www.health.gov.sk.ca/population-stats

Whitehead M, Dahlgren G. Concepts and principles for tackling social inequities in health: Levelling up part 1. Geneva: World Health Organization 2006. [cited 2014 May 14];Available from: URL: http://nccdh.ca/resources/entry/concepts-and-principles-for-tackling-social-inequities-in-health

Done by Two - complete immunization requires 5 visits over a child's first 2 years. 20% of two-year-olds in our Region are not Done by Two. Two year old measles coverage varies by geographic area.

School Age Immunization

About the Data One Page Summary

Definition:

Coverage means percent of the population receiving the recommended number of doses for this age group. Coverage percentages are recorded at the same time each year and remain static for reporting purposes (in spite of mobility of immunized and unimmunized persons moving in and out of the area in subsequent years). Human Papilloma virus vaccination (HPV), a new vaccine program in which “catch up “ is added over several years, is an exception to this rule as and is updated annually for all years. Where data is not displayed for a given year the data has not been collected or the vaccine/program is new.

Geographic areas refer to Rural Planning Zones (RPZ), a designated area comprised of rural municipalities and towns/villages. The population base of each zone is roughly equivalent at about 15,000 each. Selected indicators are also shown by urban Saskatoon geography or neighbourhood.

Up to date means having received the recommended number of doses at a given age of the individual. All coverage percentages are considered up to date unless otherwise indicated. The number of vaccines doses is indicated in parenthesis. *Seven year old pertussis coverage is 4 or 5 doses depending on the age when the third dose is given. For the number of recommended doses for each vaccine by age see Saskatchewan Immunization Manual (chapter 5: Schedules) http://www.health.gov.sk.ca/immunization-manual

Calculation:

Percentage is the numerator (all persons receiving the recommended number of doses) divided by the denominator (all eligible persons receiving the recommended number of doses). All denominators are active clients entered in into SIMS (Saskatchewan Immunization Management System). References to coverage rates mean coverage percentage.

Coverage of neighbourhoods with under 20 individuals in the selected age group is not reported.

Source:

Saskatchewan Immunization Management System (SIMS). For more information see http://www.shin.sk.ca/accounts/Documents/SIMS%20JSAP.pdf .

Limitations:

Children immunized in First Nations clinics may not be updated in SIMS and this may lead to an underestimation of coverage percentages in some geographic areas. This underestimation is believed to be small. Children with postal code mapped to the Provincial Social Services building are excluded to prevent these children from being included in the Central Business Area neighbourhood. Disparities in neighbourhood coverage percentages may not be statistically significant. Confidence intervals are not presented here.

91% of children entering school in our Region are immunized against measles. HPV vaccination for thirteen-year-old females has increased.

Seniors and Medically at Risk

About the Data One Page Summary

Definition:

Coverage means percent of the population receiving the recommended number of doses for this age group. Coverage percentages are recorded at the same time each year and remain static for reporting purposes (in spite of mobility of immunized and unimmunized persons moving in and out of the area in subsequent years).

Medically at risk individuals have medical conditions that put them at risk of complications of disease. Risk varies by disease and condition. For a description of the specific medical conditions eligible for cost-free vaccination see the Saskatchewan Immunization Manual http://www.health.gov.sk.ca/sim-chapter7.

Up to date means having received the recommended number of doses at a given age of the individual. All coverage percentages are considered up to date unless otherwise indicated. The number of vaccines doses is indicated in parenthesis.

Calculation:

Percentage is the numerator (all persons receiving the recommended number of doses) divided by the denominator (all eligible persons receiving the recommended number of doses). All denominators are covered populations for the specific age group. References to coverage rates mean coverage percentage. The denominator for the medically at-risk group is estimated to be 8.3 % of the covered population of the age group described (see reference).

Source:

For pneumococcal 23 vaccine Saskatchewan Immunization Management System (SIMS). For more information see http://www.shin.sk.ca/accounts/Documents/SIMS%20JSAP.pdf. For influenza vaccine data, Saskatoon Health Region, Population & Public Health. For Covered Population, Saskatchewan Ministry of Health.

Limitations:

The denominator for medically at risk adults is an estimate, while the numerator is a count of doses administered to individuals who have identified a medical risk. If the true denominator is larger than 8.3% of the covered population of the specified age group this would result in an underestimate of the true coverage for medically at risk persons. Some persons who received pneumoccal conjugate or the vaccine that covers 7 or 13 subtypes of pneumococcal vaccine will have some protection but are not considered “protected” in this analysis.

References:

European Centre for Disease Prevention and Control. Guidance: Priority Risk Groups for Influenza Vaccination 2008 [cited 2014 May 14]; Available from:URL: http://www.ecdc.europa.eu/en/publications/Publications/0808_GUI_Priority_Risk_Groups_for_Influenza_Vaccination.pdf

54% of our Region's medically at-risk adults 18 to 6 years old have not been vaccinated against pneumococcal disease. 44% of seniors in the community did not hav a flu shot in 2014.

Influenza Immunization

About the Data One Page Summary

Definition:

Coverage means percent of the population receiving the recommended number of doses for this age group. Coverage percentages are recorded at the same time each year and remain static for reporting purposes (in spite of mobility of immunized and unimmunized persons moving in and out of the area in subsequent years).

Medically at risk individuals have medical conditions that put them at risk of complications of disease. Risk varies by disease and condition. For a description of the specific medical conditions eligible for cost-free vaccination see the Saskatchewan Immunization Manual http://www.health.gov.sk.ca/sim-chapter7.

Up to date means having received the recommended number of doses at a given age of the individual. All coverage percentages are considered up to date unless otherwise indicated. The number of vaccines doses is indicated in parenthesis.

Calculation:

Percentage is the numerator (all persons receiving the recommended number of doses) divided by the denominator (all eligible persons receiving the recommended number of doses). All childhood denominators are SIMS registered populations. All adult age denominators are covered populations for the specific age group. References to coverage rates mean coverage percentage.

The denominator for the medically at-risk group is estimated to be 8.3 % of the covered population of the age group described (see reference).

The influenza coverage percentage of Saskatoon Health Region employees from 2013 includes physicians and Saskatoon Cancer Agency employees, in addition to immunizations delivered by Occupational Health and Safety (OH+S), that include SHR operated and affiliated long term care facilities. Coverage of long term care facilities is also reported separately. General population coverage percentage includes immunizations recorded by OH & S, Population and Public Health, Physician, SIMS and Third Party nursing services.

The denominator for pregnant women is the annual number of births, however only women who are pregnant during the 9 month flu season are eligible for vaccination. The estimate for coverage of this risk group may be underestimated.

Source:

For childhood immunization, Saskatchewan Immunization Management System (SIMS). For more information see http://www.shin.sk.ca/accounts/Documents/SIMS%20JSAP.pdf. For adult immunization Saskatoon Health Region, Population & Public Health. For employee immunization Saskatoon Health Region Occupational Health & Safety. For Covered Population, Saskatchewan Ministry of Health.

Limitations:

General population coverage percentage includes immunizations recorded by OH & S, Population and Public Health, Physician, SIMS and Third Party nursing services. Some double counting may occur, which would tend to overestimate the total coverage percent.

Reference:

European Centre for Disease Prevention and Control. Guidance: Priority Risk Groups for Influenza Vaccination 2008 [cited 2014 May 14]; Available from:URL: http://www.ecdc.europa.eu/en/publications/Publications/0808_GUI_Priority_Risk_Groups_for_Influenza_Vaccination.pdf

Influenza immunization is low among at-risk adults and pregnant women in our Region.