CPHA Canvax

Project Title: Identification of under-immunized districts in Manitoba through mapping of vaccine uptake, and development of local intervention strategies to increase vaccine uptake in children living in these districts
Funding Recipient: Manitoba Health, Seniors and Active Living
Project Contact: Richard Baydack – Director (Richard.Baydack@gov.mb.ca)
Project Period: April 1st, 2017 – March 31st, 2020


About the Project

Within Manitoba, for various reasons, immunization coverage rates differ by district/region.  While these pockets of under/un-immunized are often not evident at the regional health authority level, they can be identified by analyzing data at the geographic district level.  Accordingly, this project will map areas of under and unimmunized populations, and identify causes of low vaccine uptake in order to tailor local intervention strategies to increase immunization coverage rates. 

This project is an expansion of a pilot project that mapped immunization coverage rates for measles in children below seven years of age in one of Manitoba’s health regions. It will provide tools that could be used for the identification of areas with under/un-immunized populations, by using ArcGIS, a mapping program that allows for analytics, to map data from Manitoba’s immunization registry. This allows health information to be geographically displayed and analysed in a variety of ways. This will also help to identify the district specific causes of low vaccine uptake, and develop and tailor local intervention strategies to increase immunization coverage rates in these areas. In addition to measles, this project will map immunization coverage rates for pertussis, human papillomavirus, and rotavirus in children at select ages in the five health regions of Manitoba.

Objectives 

  • Map the vaccination rates for selected ages for four antigens (human papillomavirus, measles, pertussis and rotavirus) for the five health regions in Manitoba.
  • Identify potential causes of low vaccine uptake in children in districts with low vaccine uptake. 
  • Develop, tailor and implement local intervention strategies that address region and/or district specific causes of low vaccine uptake.
  • Evaluate the impacts of local intervention strategies on vaccine uptake

Outcomes

  • Short Term: GIS-generated maps of vaccine uptake in children at select ages will be created, identifying geographic districts with lower immunization rates within health regions.
  • Medium Term: Identification, development and implementation of region- and/or district-specific intervention strategies that are tailored with behavioural, environmental, and social contexts to increase vaccine uptake in the identified districts with lowest vaccine uptake. 
  • Long Term: GIS-generated maps will be created to assess the impacts of local intervention strategies on vaccine uptake and there will be an increase in vaccine uptake in underimmunized geographic districts, in line with provincial averages.

The challenge that the project addresses

Evidence has shown that areas with lower vaccine uptake, which were not evident at the regional health authority level, could be identified by analyzing data at the geographic district (10,000 population unit) level. Unlike the pilot project that covered only measles in children seven years of age in Interlake-Eastern Regional Health Authority, the expansion of the project will include mapping of immunization coverage rates for pertussis, human papillomavirus, and rotavirus at select ages by geographic district in the five health regions of Manitoba. Evaluating coverage rates for these four vaccines allows us to assess immunization rates in four different age groups, based on Manitoba’s Routine Immunization Schedule for these vaccines. In addition, it allows us to assess two recent changes to Manitoba’s publicly funded immunization program: the additions of rotavirus vaccine in 2014, and HPV vaccine for boys beginning in September 2016. By shifting the discussion to local district level, local intervention strategies can be developed, tailored and implemented, as opposed to “one size fits all” solutions at the RHA or provincial level. This project can then serve as a base for comparing immunization rates in future years.

About Manitoba Health, Seniors and Active Living 

Manitoba Health Healthy Living and Seniors (MHSAL) is uniquely positioned to execute vaccine acceptance and uptake initiatives efficiently and effectively. Relevant knowledge rests both within MHSAL’s Communicable Disease Control (CDC) Unit specifically and across Public Health and Primary Care Divisions generally. MHSAL’s depth of knowledge, skills, interest and experience extends far beyond a single individual and includes a diverse group of epidemiologists, geospatial analysis experts, public health nursing, senior public health managers, primary care providers, immunization coordinators, registry experts, policy analysts and others who work closely day to day to deliver existing immunization programs.