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Text Equivalent - National Standards for Immunization Coverage Assessment: Recommendations from the Canadian Immunization Registry Network

Figure 1 – Assessment of  “up-to-date” status by immunization events

This figure displays an example of how “up-to date” status is determined by immunization events. The time scale shown displays yearly intervals since the birthdate of a child born on March 15th, 2004. Each box along the time scale displays a single dose; which includes the antigens given and the age at which the immunization was delivered. The antigens given include diphtheria-tetanus-pertussis (DTaP), polio (IPV), Haemophilus influenza type b (Hib) at 3, 3.5,6, and 27 months of age, pneumococcal (PCV-7) at 3, 3.5, and12 months of age, and measles-mumps-rubella (MMR), varicella (Var), pneumococcal (PCV-7), and meningococcal (MenC) at 12 months of age. In this example, the child would be eligible for immunization coverage assessment within the year of interest 2006 indicated by the reporting period box. This child received all recommended doses of each antigen, however the second dose of DTaP-IPV-Hib and PCV-7 at 3.5 months of age are invalid (e.g. given too early) and the fourth dose of DTaP-IPV-Hib is late (e.g. received after 2nd birthday). The 2nd birthday is indicated by the “24 mos” box. Therefore this child would not be counted as “up-to-date” for PCV-7 and the DTaP-IPV-Hib series of antigens.

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Figure 2 – Assessment of “on-time” status by immunization events

This figure displays an example of how “on-time” status is determined by immunization events. The time scale shown displays yearly intervals since the birthdate of a child born on March 15th, 2004. Each box along the time scale displays a single dose; which includes the antigens given and the age at which the immunization was delivered. The antigens given include diphtheria-tetanus-pertussis (DTaP), polio (IPV), Haemophilus influenza type b (Hib) at 2, 4, 9 and 18 months of age, pneumococcal (PCV-7) at 2, 4, and 12 months of age, and measles-mumps-rubella (MMR), varicella (Var), and meningococcal (MenC) at 12 months of age. In this example, this child would be eligible for immunization coverage assessment within the year of interest 2006 indicated by the reporting period box. All required doses of each antigen are received before the child’s 2nd birthday. However, they are not all received at the correct time and with correct intervals between doses. The third dose of DTaP-IPV Hib, PCV-7 given at 9 months of age is only “on-time” if administered between 28 days from the second dose to the end of the 6th month of life (e.g. by 3 months from 2nd dose). In this example the third dose was late; therefore this child would not be considered “on-time” for the DTaP-IPV-Hib series of antigens.

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Registry Data

This is a formula used to calculate “up-to-date” immunization coverage in a given population. The first formula is used when registry data is the source of information. It is measured by taking the number of children with active records in registry who have completed the routine childhood immunization schedule by 1st (or 2nd) birthday in a province, divided by the total number of children with active records in the provincial registry who turn 1 or 2 within the year of interest, times 100

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Survey Data

The second fomula is used when survey data is the source of information. It is measured by taking the number of children in the survey sample who have completed the routine childhood immunization schedule by 1st (or 2nd) birthday, divided by the total number of children whose parents have responded to the survey, times 100.

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