Abstract
BackgroundVaccine coverage (VC) at a given age is a widely-used indicator for measuring the performance of vaccination programs. However, there is increasing data suggesting that measuring delays in administering vaccines complements the measure of VC. Providing feedback to vaccinators is recognized as an effective strategy for improving vaccine coverage, but its implementation has not been widely documented in Canada. The objective of this study was to evaluate the feasibility of providing personalized feedback to vaccinators and its impact on vaccination delays (VD).MethodsIn April and May 2008, a one-hour personalized feedback session was provided to health professionals in vaccinating medical clinics in the Quebec City region. VD for vaccines administered at two and twelve months of age were presented. Data from the regional vaccination registry were analysed for participating clinics. Two 12-month periods before and after the intervention were compared, namely from April 1st, 2007 to March 31st, 2008 and from June 1st, 2008 to May 31st, 2009.ResultsTen medical clinics out of the twelve approached (83%), representing more than 2500 vaccinated children, participated in the project. Preparing and conducting the feedback involved 20 hours of work and expenses of $1000 per clinic. Based on a delay of one month, 94% of first doses of DTaP-Polio-Hib and 77% of meningococcal vaccine doses respected the vaccination schedule both before and after the intervention. Following the feedback, respect of the vaccination schedule increased for vaccines planned at 12 months for the four clinics that had modified their vaccination practices related to multiple injections (depending on the clinic, VD decreased by 24.4%, 32.0%, 40.2% and 44.6% respectively, p < 0.001 for all comparisons).ConclusionsThe present study shows that it is feasible to provide personalized feedback to vaccinating clinics. While it may have encouraged positive changes in practice concerning multiple injections, this intervention on its own did not impact vaccination delays of the clinics visited. It is possible that feedback integrated into other types of effective interventions and sustained over time may have more impact on VD.
Highlights
Vaccine coverage (VC) at a given age is a widely-used indicator for measuring the performance of vaccination programs
Participants The twelve medical clinics that had administered the largest number of doses of DTaP-Polio-Hib vaccine in 2007 in the Quebec City region were approached to participate in the feedback project
It was noted that four clinics changed their practices concerning multiple injections
Summary
Vaccine coverage (VC) at a given age is a widely-used indicator for measuring the performance of vaccination programs. There is increasing data suggesting that measuring delays in age-appropriate vaccination complements the Across Canada, a consensus has been reached on the definition of VD, namely one month after the due date on the vaccination schedule [11] This definition is in line with the principal studies on the subject [4,6,12,13,14,15]. Since 2006, the Quebec Ministry of Health and Social Services has compiled VD noted in Health and Social Service Centres (Centres de santé et de services sociaux or CSSS) based on a delay of one week following the recommended age [16] This tracking of VD is not carried out in private medical clinics, which administer about half of the vaccines for infants in the province of Quebec [3,17]
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