Taking a closer look: an examination of measles, mumps, and rubella immunization uptake in Saskatoon.

BACKGROUND Immunization is one of the most successful public health initiatives in Canada, yet continuous monitoring of coverage rates is essential to ensure high uptake for sustained success. The purpose of this study was to utilize newly available data from the Saskatchewan Immunization Management System (SIMS) to examine city and neighbourhood uptake of the Measles, Mumps and Rubella vaccine and identify potential factors that contribute to low immunization uptake in Saskatoon. METHODS The study examined records for 10,287 two year olds between 1999 and 2002 using an ecological study design. The first step consisted of simple rate calculations to determine the total, complete, up-to-date and not up-to-date immunization rates for the city of Saskatoon and in each residential neighbourhood. Quantitative neighbourhood-level data were then used to determine if neighbourhood variables could significantly contribute to the variation in immunization coverage. RESULTS The findings revealed MMR/MR immunization rates were relatively stable between 1999 and 2002. However, significant disparities were found at the neighbourhood level, with areas of social and economic disadvantage having lower rates of total, complete, and up-to-date immunization uptake compared to areas of greater social and economic wealth. Multivariate linear regression revealed 80.6% of variation in up-to-date immunization uptake in Saskatoon could be explained by the proportion of single mothers and vehicles per capita in the neighbourhood. CONCLUSION Significant inequities in immunization uptake exist on the neighbourhood level in Saskatoon. These findings are supported by the literature and may indicate the presence of real or perceived barriers to immunization in some Saskatoon neighbourhoods.