TY - JOUR AU - Caron-Poulin, Laurence AU - Rotondo, Jenny AU - Cutler, Jennifer AU - Desai, Shalini AU - Squires, Susan PY - 2017/05/02 Y2 - 2024/03/29 TI - Burden and deaths associated with vaccine preventable diseases in Canada, 2010-2014 JF - Online Journal of Public Health Informatics JA - OJPHI VL - 9 IS - 1 SE - Communicable Disease Surveillance Use Cases for Human, Animal, and Zoonotic Diseases DO - 10.5210/ojphi.v9i1.7676 UR - https://ojphi.org/ojs/index.php/ojphi/article/view/7676 SP - AB - <div style="left: 86.4px; top: 327.128px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.08175);" data-canvas-width="61.227199999999996">Objective</div><div style="left: 100.8px; top: 341.481px; font-size: 13.6px; font-family: serif; transform: scaleX(0.986403);" data-canvas-width="362.9962399999997">To describe the recent trends in the burden of disease and mortality</div><div style="left: 86.4px; top: 357.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00127);" data-canvas-width="291.57040000000006">associated with vaccine preventable diseases (VPDs).</div><div style="left: 86.4px; top: 387.928px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.11862);" data-canvas-width="79.3288">Introduction</div><div style="left: 100.8px; top: 402.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.11306);" data-canvas-width="368.68239999999975">Vaccination is one of the most successful public health</div><div style="left: 86.4px; top: 418.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02678);" data-canvas-width="378.45536000000004">interventions. Despite this, there are a variety of reasons that VPDs</div><div style="left: 86.4px; top: 434.281px; font-size: 13.6px; font-family: serif; transform: scaleX(0.974312);" data-canvas-width="379.7541600000002">continue to be seen in developed countries such as Canada. This</div><div style="left: 86.4px; top: 450.281px; font-size: 13.6px; font-family: serif; transform: scaleX(0.981613);" data-canvas-width="380.03159999999997">analysis describes the recent trends in the burden of disease and</div><div style="left: 86.4px; top: 466.281px; font-size: 13.6px; font-family: serif; transform: scaleX(0.975918);" data-canvas-width="377.32248">mortality associated with VPDs for which publicly funded vaccination</div><div style="left: 86.4px; top: 482.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01285);" data-canvas-width="378.25000000000006">programs for infants or children are implemented across the country</div><div style="left: 86.4px; top: 498.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00135);" data-canvas-width="293.828">and for which national surveillance data are available.</div><div style="left: 86.4px; top: 528.728px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.07381);" data-canvas-width="55.9096">Methods</div><div style="left: 100.8px; top: 543.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00129);" data-canvas-width="365.70400000000006">Surveillance data on VPDs were obtained from the Canadian</div><div style="left: 86.4px; top: 559.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03569);" data-canvas-width="378.5777599999999">Notifiable Disease Surveillance System. Population and death data</div><div style="left: 86.4px; top: 575.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.989492);" data-canvas-width="377.3591999999997">were obtained from Statistics Canada. Death data were only available</div><div style="left: 86.4px; top: 591.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00587);" data-canvas-width="380.6395199999997">to 2012. In total, 11 VPDs have been included in the analyses</div><div style="left: 86.4px; top: 607.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03727);" data-canvas-width="379.10544">namely tetanus, diphtheria, pertussis, polio, haemophilus influenza</div><div style="left: 86.4px; top: 623.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02356);" data-canvas-width="378.7518399999996">(Hi), measles, mumps, rubella, congenital rubella syndrome (CRS),</div><div style="left: 86.4px; top: 639.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02957);" data-canvas-width="380.9740799999999">invasive meningococcal disease (IMD), invasive pneumococcal</div><div style="left: 86.4px; top: 655.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01211);" data-canvas-width="378.30984000000007">disease (IPD). Exclusion of non-vaccine preventable serotypes from</div><div style="left: 86.4px; top: 671.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.988312);" data-canvas-width="377.3211199999998">either data source was not possible. Analyses included incidence rate,</div><div style="left: 86.4px; top: 687.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00175);" data-canvas-width="216.44400000000007">proportion, mortality rate and risk ratio.</div><div style="left: 86.4px; top: 717.528px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.0848);" data-canvas-width="49.123200000000004">Results</div><div style="left: 100.8px; top: 731.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03396);" data-canvas-width="364.33311999999967">Surveillance data indicate that from 2010 to 2014, an average of</div><div style="left: 86.4px; top: 747.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.992762);" data-canvas-width="377.41496">6,020 cases of VPDs were reported annually, representing an average</div><div style="left: 86.4px; top: 763.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.963594);" data-canvas-width="379.2224">annual crude incidence rate of 17.3 cases per 100,000 population.</div><div style="left: 86.4px; top: 779.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00226);" data-canvas-width="377.83519999999993">VPDs accounting for the largest proportion of reported cases include</div><div style="left: 86.4px; top: 795.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.981593);" data-canvas-width="377.1116799999997">IPD (54.4%) and pertussis (29.6%). Age groups most affected include</div><div style="left: 86.4px; top: 811.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.993951);" data-canvas-width="377.63528">children less than 1 year of age (92.6 cases per 100,000) and children</div><div style="left: 86.4px; top: 827.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03021);" data-canvas-width="378.6375999999999">between 1 and 4 years of age (36.0 cases per 100,000). Age groups</div><div style="left: 86.4px; top: 843.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02333);" data-canvas-width="378.47711999999996">least affected include adults between 20 and 24 years old (6.9 cases</div><div style="left: 86.4px; top: 859.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01461);" data-canvas-width="378.2295999999997">per 100,000 population) and between 25 and 29 years old (7.3 cases</div><div style="left: 86.4px; top: 875.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00258);" data-canvas-width="345.58959999999985">per 100,000 population). Age groups affected differed by VPD.</div><div style="left: 100.8px; top: 891.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.978464);" data-canvas-width="365.14640000000014">Death data indicate that from 2010 to 2012, VPDs accounting</div><div style="left: 86.4px; top: 907.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.0005);" data-canvas-width="380.2750399999997">for the largest proportion of deaths across all ages include IPD</div><div style="left: 86.4px; top: 923.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.963519);" data-canvas-width="379.38559999999984">(58.2%), Hi (16.3%) and IMD (15.3%). Youth aged 19 years and</div><div style="left: 86.4px; top: 939.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.984557);" data-canvas-width="377.4135999999997">under accounted for 26.1% of VPDs deaths (mortality rate of 0.17 per</div><div style="left: 86.4px; top: 955.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.991629);" data-canvas-width="377.49655999999993">100,000 population). Children less than one year old have the highest</div><div style="left: 86.4px; top: 971.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.949004);" data-canvas-width="378.82663999999994">mortality rate due to VPDs (2.0 per 100,000 population) and were</div><div style="left: 86.4px; top: 987.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.959209);" data-canvas-width="376.72952">26.9 times more likely to die from VPDs compared to children between</div><div style="left: 86.4px; top: 1003.88px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01563);" data-canvas-width="378.2377599999999">1 and 19 years of age. Adults aged 20 years and older accounted for</div><div style="left: 86.4px; top: 1019.88px; font-size: 13.6px; font-family: serif; transform: scaleX(0.985248);" data-canvas-width="377.3007199999995">73.9% of VPD deaths (mortality rate of 0.14 per 100,000 population).</div><div style="left: 86.4px; top: 1035.88px; font-size: 13.6px; font-family: serif; transform: scaleX(1.0527);" data-canvas-width="378.9027999999998">A high mortality rate was also seen in adults 60 year old and over</div><div style="left: 86.4px; top: 1051.88px; font-size: 13.6px; font-family: serif; transform: scaleX(0.992844);" data-canvas-width="377.56183999999996">(0.3 per 100,000 population); adults 60 years old and over were more</div><div style="left: 86.4px; top: 1067.88px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01129);" data-canvas-width="378.0868">2.6 times more likely to die from VPDs compared to adults between</div><div style="left: 86.4px; top: 1083.88px; font-size: 13.6px; font-family: serif; transform: scaleX(1.0009);" data-canvas-width="109.9152">20 and 59 years old.</div><div style="left: 86.4px; top: 1114.33px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.10338);" data-canvas-width="81.6136">Conclusions</div><div style="left: 100.8px; top: 1128.68px; font-size: 13.6px; font-family: serif; transform: scaleX(0.993023);" data-canvas-width="365.6808799999999">The results of routine Canadian surveillance data suggest that</div><div style="left: 86.4px; top: 1144.68px; font-size: 13.6px; font-family: serif; transform: scaleX(0.99718);" data-canvas-width="379.92551999999995">despite high vaccine coverage rates generally seen in developed</div><div style="left: 86.4px; top: 1160.68px; font-size: 13.6px; font-family: serif; transform: scaleX(0.957444);" data-canvas-width="378.9721599999995">countries such as Canada, a possible preventable burden of illness</div><div style="left: 489.6px; top: 325.481px; font-size: 13.6px; font-family: serif; transform: scaleX(0.980207);" data-canvas-width="379.8956">due to VPDs still occurs across all age groups. Consideration of</div><div style="left: 489.6px; top: 341.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00471);" data-canvas-width="377.93856">VPDs as a whole allows a real appreciation of the burden and deaths</div><div style="left: 489.6px; top: 357.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01474);" data-canvas-width="378.27720000000005">associated with VPDs in general. The analysis has shown that while</div><div style="left: 489.6px; top: 373.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00376);" data-canvas-width="380.24239999999986">the incidence rates are highest among children 4 years old and</div><div style="left: 489.6px; top: 389.481px; font-size: 13.6px; font-family: serif; transform: scaleX(0.970836);" data-canvas-width="379.3216799999999">younger, mortality due to VPDs continues to occur and primarily</div><div style="left: 489.6px; top: 405.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02259);" data-canvas-width="378.4267999999999">affects infants and elderly. Due to the asymptomatic nature of some</div><div style="left: 489.6px; top: 421.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02461);" data-canvas-width="378.73008">VPDs and data limitations, reported cases are likely underestimates</div><div style="left: 489.6px; top: 437.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00113);" data-canvas-width="100.4632">of the true burden.</div> ER -