Factors Associated with Up-to-Date Measles Vaccination Among 2-Year-Old Children in Canada: An Analysis of the 2021 Childhood National Immunization Coverage Survey.

Background/Objectives: Ongoing measles outbreaks in Canada and worldwide, largely among unvaccinated individuals, emphasize the importance of examining predictors of measles vaccination. This study aims to report on factors associated with up-to-date measles vaccination among 2-year-olds in Canada. Methods: We used national cross-sectional data from the 2021 childhood National Immunization Coverage Survey (cNICS), which was conducted among 2-year-old Canadian children between 10 January 2022 and 14 July 2022. We examined proportions of vaccinated children by sociodemographic characteristics and conducted multivariable logistic regression analysis to determine factors associated with up-to-date measles vaccination coverage, defined as receiving at least one dose of a measles-containing vaccine by 2 years of age. Results: Among 3118 two-year-olds, 91.6% (95% CI: 89.9-93.1) were up-to-date with their measles vaccines. Lower odds of being up-to-date among 2-year-olds was associated with a household income of less than $60,000 (aOR = 0.35, 95% CI: 0.16-0.75; p < 0.05), experiencing pandemic-related obstacles or delays to vaccination (aOR = 0.23, 95% CI: 0.12-0.43, p < 0.05) and parents being more vaccine-hesitant (aOR = 0.49, 95% CI: 0.26-0.94, p < 0.05). Conclusions: Lower household income, experiencing pandemic-related obstacles, and parental hesitancy contribute to being not up-to-date on measles vaccination among children in Canada. These results support developing targeted programs and communication efforts to help increase measles vaccination coverage in Canada.