Childhood National Immunization Coverage Survey (CNICS)

Detailed information for 2021

Status:

Active

Frequency:

Every 2 years

Record number:

5185

The purpose of the Childhood National Immunization Coverage Survey is to collect information on national immunization coverage for vaccines administered to children and pregnant women.

Data release - To be determined

Description

The purpose of the Childhood National Immunization Coverage Survey (CNICS) is to collect information on national immunization coverage for vaccines administered to children and pregnant women. The survey is intended to

- determine whether children and pregnant women are vaccinated in accordance with recommended immunization schedules for publicly funded vaccines
- provide the World Health Organization and the Pan American Health Organization with estimates of national vaccine coverage for childhood vaccines such as those against measles, diphtheria, pertussis, tetanus and polio
- provide information on parental and guardian knowledge and beliefs about vaccines.

Reference period: Varies

Collection period: Winter 2021 to spring 2022

Subjects

  • Children and youth
  • Health

Data sources and methodology

Target population

The target population for this survey is children and youth aged 2, 7, 14 and 17 years old, and women who have given birth between September 1, 2020, and March 1, 2021, living in the 10 provinces and three territories. It excludes those residing on First Nations reserves and those living in institutions.

Instrument design

The survey content of the 2011 CNICS was developed in collaboration with the Public Health Agency of Canada. It was tested by Statistics Canada's Questionnaire Design Resource Centre (QDRC) in one-on-one interviews in participants' homes prior to collection. There were no significant content changes in 2013 and 2015. New survey content was developed in 2017 and tested by the QDRC in one-on-one interviews in testing facilities in Vancouver, Montreal and Ottawa. New survey content was also developed in 2019 when the survey moved to an electronic questionnaire and was tested by the QDRC in one-on-one interviews in Montreal and Ottawa.

For the 2021 cycle, a few questions were added to the questionnaire and were tested in one-on-one virtual interviews conducted by Statistics Canada's Centre for Social Data Integration and Development and the QDRC.

Data collection for the CNICS is composed of multiple components.

For respondents with children aged 2, 7, 14 or 17 years old, the first component of the survey is an electronic questionnaire or a computer-assisted telephone interview (CATI). For this component, the person most knowledgeable (PMK) about the child's immunizations provides information about vaccines the child has received and answers questions on their knowledge and beliefs about immunization. For the second component, respondents are asked to complete and return by mail a form that provides consent for Statistics Canada to contact their child's health care provider to obtain their child's vaccine history. The receipt of the consent form triggers the third component, the Immunization Record Request form. This is a mail-out mail-back questionnaire sent to the child's health care provider, who fills out and returns the form with the child's detailed immunization history. The data from the health care provider are used to enhance the PMK-reported data.

The 2021 CNICS includes a module for women who have recently given birth. Biological mothers are asked questions about vaccines they were offered and received during their recent pregnancy, in addition to questions about their knowledge and beliefs regarding immunization. This component of the survey is conducted via an electronic questionnaire or CATI, and Statistics Canada does not contact health care providers for these respondents.

The COVID-19 pandemic has highlighted the need for up-to-date data on childhood immunization coverage. A module on immunization during the COVID-19 pandemic was added to the 2021 CNICS questionnaire.

The 2021 CNICS asks respondents for permission to access their child's vaccination record from regional, provincial and territorial immunization registries. Where available, the linked data will be used to evaluate the potential to integrate immunization registry data into future cycles of the survey. To access this information, Statistics Canada must enter into data sharing and data acquisition agreements with each individual jurisdiction. Linkage will only be undertaken for consenting respondents.

Statistics Canada has data sharing and data acquisition agreements in place with Prince Edward Island and Manitoba for the 2021 survey cycle and has completed an assessment of the registry coverage for these provinces. Parents and guardians living in these two provinces will be given the opportunity to skip the detailed questions about vaccination, providing they agree to share their child's identifiers with the respective provincial immunization registry. When consent is provided, registry immunization data will be used instead of parent or guardian or health care provider data. Women in these provinces who have recently given birth will also be asked whether they consent to Statistics Canada linking to provincial registry immunization data to assess registry coverage for this population. For the 2021 CNICS, these respondents need to respond to the detailed vaccine questions.

Sampling

This is a sample survey with a cross-sectional design.

The main objective of the 2021 CNICS is to produce national, provincial and territorial estimates of immunization coverage for women who gave birth between September 1, 2020, and March 1, 2021, and for children aged 2 years old, and national estimates of immunization coverage for children and youth aged 7, 14 and 17 years old. The sampling frame is stratified by age and by province or territory to ensure that the sample is representative while remaining efficient. It was determined that a sample of 19,494 units would yield the desired accuracy.

Data sources

Data collection for this reference period: 2022-01-10 to 2022-06-17

Responding to this survey is voluntary.

Data are collected directly from the PMK for children and youth aged 2, 7, 14 and 17 years old, and from the biological mother for children younger than 1 year old.

Data are collected using an electronic questionnaire and CATI.

With consent, data are also collected from the selected child's immunization provider (e.g., physician, nurse or clinic). The data collected from the health care provider are combined with the immunization data collected from the parent or guardian.

Immunization data are also obtained from regional, provincial and territorial immunization registries when the CNICS respondent has given consent to link to and access the child's vaccination record or, in the case of women who have recently given birth, to link to and access their own vaccination record. This step happens only for jurisdictions with which Statistics Canada has concluded data sharing and data acquisition agreements.

View the Questionnaire(s) and reporting guide(s) .

Error detection

The metadata will be provided upon release.

Imputation

The metadata will be provided upon release.

Estimation

The metadata will be provided upon release.

Quality evaluation

The metadata will be provided upon release.

Disclosure control

Statistics Canada is prohibited by law from releasing any data which would divulge information obtained under the Statistics Act that relates to any identifiable person, business, or organization without the prior knowledge or the consent in writing of that person, business, or organization. Various confidentiality rules are applied to all data that are released or published to prevent the publication or disclosure of any information deemed confidential. If necessary, data are suppressed to prevent direct or residual disclosure of identifiable data.

To keep the data confidential, some modifications are performed on the collected data. For example, the survey questionnaire asks for the country of origin of the child and parents; however, only the continent of origin is available in the microdata file.

Revisions and seasonal adjustment

This methodology does not apply to this survey program.

Data accuracy

The metadata will be provided upon release.

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