Vaccine coverage for kindergarteners: Factors associated with school and area variation in Vancouver, British Columbia

Abstract

IntroductionWe investigated the extent to which school-specific kindergarten vaccination up-to-date status prevalence differs by public and private school types, student demographic composition, and geographic location across schools in Vancouver, and four adjacent British Columbia communities, during 2013–14. MethodsSchool-specific kindergarten coverage for seven vaccinations plus up-to-date status were merged with data on school type and student sociodemographic composition for 219 schools within 9 Local Health Areas (LHAs). ResultsIn adjusted Tobit regression models, private non-religious (versus public) schools were associated with lower up-to-date status (b=−9.51 percentage points). Student enrollment was positively associated with higher coverage, while greater number of English Language Learners (ELL), students speaking English at home, and Aboriginal students were each negatively associated with up-to-date coverage. The most socioeconomically disadvantaged and advantaged LHAs had the lowest coverage. ConclusionOur findings identify lower coverage among some types of private schools and in affluent and disadvantaged communities—and corroborate documented US coverage patterns. Future studies need to investigate school and community factors that may contribute to such patterns, in order to identify potential mechanisms and design appropriate interventions to increase vaccine coverage.