Evidence map›Paper›PMID 35078822›Full record

ArticleCMAJ open

Routine childhood vaccination rates in an academic family health team before and during the first wave of the COVID-19 pandemic: a pre-post analysis of a retrospective chart review.

Anson Dong, Christopher Meaney, Gurbani Sandhu, Nelia De Oliveira, Suzanne Singh, Natalie Morson, Milena Forte

Open access · diamondAbstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Anson DongRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont. anson.dong@ualberta.ca.
Christopher MeaneyRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont.
Gurbani SandhuRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont.
Nelia De OliveiraRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont.
Suzanne SinghRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont.
Natalie MorsonRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont.
Milena ForteRay D. Wolfe Department of Family Medicine (Dong, Sandhu, De Oliveira, Singh, Morson, Forte), Sinai Health; Department of Family and Community Medicine (Dong, Sandhu, Meaney, Singh, Morson), University of Toronto; Department of Family and Community Medicine (Forte), University of Toronto, Toronto, Ont.
University of Toronto · CASinai Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere has been concern about declining routine vaccination rates during the COVID-19 pandemic. We evaluated the impact of the COVID-19 pandemic on early childhood vaccination rates at 2 sites of an academic family health team in the Greater Toronto Area, Ontario, serving both an urban and suburban patient population.

methodsWe conducted a pre-post analysis of vaccination records from Jan. 1, 2018, to Nov. 30, 2020, for a cohort of children born between Jan. 1, 2018, and Aug. 31, 2020, from the electronic medical record (EMR) of the Mount Sinai Academic Family Health Team (including an urban academic site in Toronto and a suburban community site in Vaughan, Ontario). We estimated the proportion of children receiving timely, delayed or no vaccination for 10 publicly funded vaccines in the Ontario immunization schedule for the pre-COVID-19 (Jan. 1, 2018, to Mar. 16, 2020) and COVID-19 (Mar. 17 to Nov. 30, 2020) pandemic periods. We determined timeliness in accordance with the recommended age of administration, with a 28-day window; we considered vaccines administered after this window to be delayed. We estimated the median time to vaccination for each vaccine and present cumulative incidence curves.

resultsThe patient population was balanced between boys (52.4%) and girls (47.6%), with an average age of 18.5 months and representation across low-, middle- and high-income groups. Of the 506 children in our cohort, 422 were up to date with vaccinations (83.4%) by the end of the study period. Comparatively, 308 (83.2%) of the 370 eligible patients were up to date for all required vaccinations by the end of the pre-COVID-19 period. Among children younger than 12 months, vaccination rates were similar in the pre-COVID-19 and COVID-19 pandemic periods. Lower rates of timely vaccination for children between 12 and 18 months of age were amplified during the pandemic. Cumulative incidence curves were suggestive of a decrease in the timeliness of vaccinations in the COVID-19 period for the vaccines administered at 12, 15 and 18 months, compared with the pre-COVID-19 period.

interpretationOur local findings suggest a deterioration in the uptake of routine childhood vaccines in children aged 12 to 18 months in the first year of the COVID-19 pandemic. Further study is needed to determine the extent of the vaccination gap in children across Canada, including the impact of subsequent waves of the COVID-19 pandemic.

Indexed as

Child, PreschoolCOVID-19COVID-19 VaccinesElectronic Health RecordsFamily HealthHumansInfantOutcome Assessment, Health CarePublic Health SurveillanceRetrospective StudiesSARS-CoV-2VaccinationVaccination CoverageCOVID-19 Vaccines

Identifiers

PMID35078822
PMCPMC8920592
OpenAlexW4210616157

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.