Two Birds With One Stone: Estimating Population Vaccination Coverage From a Test-negative Vaccine Effectiveness Case-control Study.
Vaccination program evaluation includes assessment of vaccine uptake and direct vaccine effectiveness (VE). Often examined separately, we propose a design to estimate rotavirus vaccination coverage using controls from a rotavirus VE test-negative case-control study and to examine coverage following implementation of the Quebec, Canada, rotavirus vaccination program. We present our assumptions for using these data as a proxy for coverage in the general population, explore effects of diagnostic accuracy on coverage estimates via simulations, and validate estimates with an external source. We found 79.0% (95% confidence interval, 74.3%, 83.0%) ≥2-dose rotavirus coverage among participants eligible for publicly funded vaccination. No differences were detected between study and external coverage estimates. Simulations revealed minimal bias in estimates with high diagnostic sensitivity and specificity. We conclude that controls from a VE case-control study may be a valuable resource of coverage information when reasonable assumptions can be made for estimate generalizability; high rotavirus coverage demonstrates success of the Quebec program.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University.
Margaret K
MK
Doll
Department of Epidemiology, Biostatistics and Occupational Health, McGill University.
Kathryn T
KT
Morrison
Department of Epidemiology, Biostatistics and Occupational Health, McGill University.
David L
DL
Buckeridge
Department of Epidemiology, Biostatistics and Occupational Health, McGill University.|Department of Pediatrics, Division of Infectious Diseases, The Montreal Children's Hospital.|Vaccine Study Centre, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Caroline
C
Quach
D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D015397:Program Evaluation; D011792:Quebec / Q000453:epidemiology; D015203:Reproducibility of Results; D012401:Rotavirus / Q000235:genetics / Q000276:immunology; D012400:Rotavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000276:immunology; D012680:Sensitivity and Specificity; D014611:Vaccination / Q000706:statistics & numerical data*; D000073887:Vaccination Coverage / Q000706:statistics & numerical data*
D022243:Rotavirus Vaccines
case-control; rotavirus; test-negative; vaccine coverage