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     Measles, Mumps and Rubella
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Initial Report on Public Health
Immunization Coverage of Measles, Mumps and Rubella
Narrative

The immunization coverage for measles, mumps and rubella indicator estimates the proportion of school children aged 7 years who are known to be complete for age for vaccination against measles, mumps and rubella.

Several vaccines are currently provided through the publicly funded immunization program to reduce the incidence of vaccine preventable diseases. 113 Publicly funded vaccines are provided for routine immunization, the immunization of high-risk persons, and the control of disease outbreaks. The measles virus is highly contagious and can result in respiratory complications and death in extreme cases; 114 mumps can cause sterility and subfertility in adult males; 115 and the rubella virus is a respiratory disease that causes rash and fever. If contracted by a pregnant woman, the rubella virus can have devastating consequences on the developing fetus. 116

The combined measles, mumps and rubella (MMR) vaccine became available in 1975. It is administered to Ontario children on or after their first birthday and again at age 18 months as part of the Publicly Funded Immunization Schedules. Under the Immunization of School Pupils Act (ISPA), all school pupils must have documented receipt of two doses of measles and one dose each of mumps and rubella by 7 years of age for school attendance, unless a valid exemption is provided. 117 Children receive this immunization primarily through primary care physicians or through public health unit clinics.

Public health units are required to assess the immunization status of all school pupils and attendees of licensed day nurseries on a yearly basis to determine their immunization status and in the case of school pupils, the medical officer of health may issue suspension orders to school principals, where required, to remove non-immunized children from school. The process also provides important information to public health units regarding vulnerable children and populations in order to target these groups for immunization and to plan for potential outbreaks of disease. Public health units also provide recommendations to parents to immunize infants and children whose immunization is not up to date to ensure that both day nursery attendees and school pupils are appropriately immunized.

Having up to date MMR immunization at age 7 contributes to the timely and effective detection and identification of children and priority populations facing barriers to immunization who may be susceptible to vaccine preventable diseases, and their associated risk factors, as well as to any emerging immunization trends. It relates to the public’s awareness of the importance of immunization across the lifespan and the achievement of target coverage rates for provincially-funded immunizations.

At the end of the 2007-2008 school year 84.9% of school children in Ontario age 7 years were known to be complete for age for vaccination against measles, mumps and rubella. Based on 36 public health units in Ontario, the highest coverage was 97.8% and the lowest coverage was 20.7% of school children age 7 years known to be complete for age for vaccination against measles, mumps and rubella.

Indicator Definition

Definition:

The immunization coverage for measles, mumps and rubella indicator estimates the proportion of school children age 7 years who are known to be complete for age for vaccination against measles, mumps and rubella.

Data Source(s):

Numerator: Immunization Record Information System, 36 locally maintained databases shared with the Public Health Division, Ministry of Health and Long-Term Care
Denominator: Immunization Record Information System, 36 locally maintained databases shared with the Public Health Division, Ministry of Health and Long-Term Care

Formula:

Number of school children age seven years who are known by the health unit to be complete for age for vaccination against measles, mumps and rubella (2007/2008 school year)

Number of children enrolled in school (2007/2008 school year)
 
 
x 100

Notes:

  • Data as complete on June 30, 2008 (2007/2008 school year) for 7 year olds (birth year 2000)
  • Data was extracted from IRIS, August 2008 to January 2009
  • Vaccination information is collected only for children attending schools that public health units have screened
  • Some children/students may not be eligible for a vaccine due to medical contraindication. This information may be collected and recorded in IRIS. However, ineligible children are not excluded from the denominator of vaccine coverage calculations since not all IRIS vaccine coverage reports summarize this information
  • Children/students with exemptions (medical, philosophical, conscience or religious) or with no information are treated as incomplete

113 Ministry of Health and Long-Term Care. Publicly funded immunization schedules for Ontario - January 2009 [Internet]. Toronto, ON: Queen’s Printer for Ontario; 2009. Retrieved April 23, 2009 from: http://www.health.gov.on.ca/english/providers/program/immun/pdf/schedule.pdf.
114 Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis. 2004;189 (Suppl 1):S4-16.
115 Masarani M, Wazait H, Dinneen M. Mumps orchitis. J R Soc Med. 2006;99(11):573-5.
116 Anonymous. Rubella (German measles) in pregnancy. Paediatr Child Health. 2007 Nov;12(9):798-802.
117 Immunization of School Pupils Act, R.S.O. 1990, c. I.1. Retrieved April 23, 2009 from: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90i01_e.htm.

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