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MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study

BACKGROUND: Refugee children may be under-immunised against common vaccine-preventable diseases due to a myriad of factors related to their migration journey. METHODS: This retrospective cohort study explored the rates and determinants of enrolment on the National Immunisation Register (NIR) and mea...

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Autores principales: Charania, Nadia A., Paynter, Janine, Turner, Nikki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969282/
https://www.ncbi.nlm.nih.gov/pubmed/36860307
http://dx.doi.org/10.1016/j.lanwpc.2023.100709
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author Charania, Nadia A.
Paynter, Janine
Turner, Nikki
author_facet Charania, Nadia A.
Paynter, Janine
Turner, Nikki
author_sort Charania, Nadia A.
collection PubMed
description BACKGROUND: Refugee children may be under-immunised against common vaccine-preventable diseases due to a myriad of factors related to their migration journey. METHODS: This retrospective cohort study explored the rates and determinants of enrolment on the National Immunisation Register (NIR) and measles, mumps and rubella (MMR) coverage among refugee children up to 18 years old who resettled in Aotearoa New Zealand (NZ) from 2006 to 2013. Univariate and multivariable logistic regression were conducted to determine associations. FINDINGS: Of the cohort (N = 2796), two thirds of the children (69%) were enrolled on the NIR. Among this sub-cohort (n = 1926), less than one third (30%) were age-appropriately vaccinated with MMR. MMR coverage was highest among younger children and improved over time. Logistic modelling revealed that visa category, year of arrival, and age group were significant factors that influenced NIR enrolment and MMR vaccine uptake. Those arriving via asylum seeking, family reunification and humanitarian pathways were less likely to be enrolled and vaccinated compared to refugees who entered under the national quota programme. More recent arrivals and younger children were more likely to be enrolled and vaccinated compared to children who arrived in NZ longer ago and were older. INTERPRETATION: Resettled refugee children have suboptimal NIR enrolment and MMR coverage rates which varied significantly by visa category, highlighting the need for immunisation services to better engage with all refugee families. These findings suggest that broad structural factors related to policy and immunisation service delivery may influence the differentials seen. FUNDING: 10.13039/501100001505Health Research Council of New Zealand (18/586).
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spelling pubmed-99692822023-02-28 MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study Charania, Nadia A. Paynter, Janine Turner, Nikki Lancet Reg Health West Pac Articles BACKGROUND: Refugee children may be under-immunised against common vaccine-preventable diseases due to a myriad of factors related to their migration journey. METHODS: This retrospective cohort study explored the rates and determinants of enrolment on the National Immunisation Register (NIR) and measles, mumps and rubella (MMR) coverage among refugee children up to 18 years old who resettled in Aotearoa New Zealand (NZ) from 2006 to 2013. Univariate and multivariable logistic regression were conducted to determine associations. FINDINGS: Of the cohort (N = 2796), two thirds of the children (69%) were enrolled on the NIR. Among this sub-cohort (n = 1926), less than one third (30%) were age-appropriately vaccinated with MMR. MMR coverage was highest among younger children and improved over time. Logistic modelling revealed that visa category, year of arrival, and age group were significant factors that influenced NIR enrolment and MMR vaccine uptake. Those arriving via asylum seeking, family reunification and humanitarian pathways were less likely to be enrolled and vaccinated compared to refugees who entered under the national quota programme. More recent arrivals and younger children were more likely to be enrolled and vaccinated compared to children who arrived in NZ longer ago and were older. INTERPRETATION: Resettled refugee children have suboptimal NIR enrolment and MMR coverage rates which varied significantly by visa category, highlighting the need for immunisation services to better engage with all refugee families. These findings suggest that broad structural factors related to policy and immunisation service delivery may influence the differentials seen. FUNDING: 10.13039/501100001505Health Research Council of New Zealand (18/586). Elsevier 2023-02-18 /pmc/articles/PMC9969282/ /pubmed/36860307 http://dx.doi.org/10.1016/j.lanwpc.2023.100709 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Articles
Charania, Nadia A.
Paynter, Janine
Turner, Nikki
MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study
title MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study
title_full MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study
title_fullStr MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study
title_full_unstemmed MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study
title_short MMR vaccine coverage and associated factors among overseas-born refugee children resettled in Aotearoa New Zealand: a national retrospective cohort study
title_sort mmr vaccine coverage and associated factors among overseas-born refugee children resettled in aotearoa new zealand: a national retrospective cohort study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969282/
https://www.ncbi.nlm.nih.gov/pubmed/36860307
http://dx.doi.org/10.1016/j.lanwpc.2023.100709
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