Standardized Reporting on Vaccination (STARVAX):About STARVAX

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Purpose

STARVAX (Standardized Reporting on Vaccination) is operated by the Public Health Agency of Canada and its provincial and territorial partners through the Canadian Immunization Registries and Coverage (CIRC) Network. STARVAX provides timely and accurate vaccination coverage rates. Vaccination coverage is the percentage of a population vaccinated against a disease.

Background

STARVAX is based on the Canadian COVID-19 Vaccination Coverage Surveillance System (CCVCSS). CCVCSS efficiently measured coverage during the COVID-19 vaccine campaign. It used reports from provinces and territories to estimate coverage. Data came from immunization registries or information systems.

Components

STARVAX consists of 2 components: routine childhood vaccination and seasonal vaccination against respiratory infections.

Routine childhood vaccination coverage

STARVAX childhood vaccination coverage reports capture routine childhood vaccinations at the milestone ages of 1, 2, 7, 14 and 17. The first of these reports were received by PHAC in February 2023.

Coverage is broken down by:

• age
• sex
• vaccine type
• last dose rank (how close they are to the final dose in a vaccine series) or up-to-date status (whether they have received all recommend doses of a vaccines)

The name of the last vaccine product may also be collected depending on the type of vaccine.

Respiratory virus vaccination coverage

The respiratory virus report is a new STARVAX component that started in 2024. It replaced the former Canadian COVID-19 Vaccination Coverage Surveillance System (CCVCSS). The report captures COVID-19 and influenza vaccination for all age groups.

Coverage is broken down by:

• age group
• sex
• last vaccine product
• month of last dose

How STARVAX works

Each year, participating provinces and territories use their immunization data to create standardized reports. These reports detail the total number of people vaccinated in the past year. More frequent reports may be submitted as needed to PHAC. For example, reports may be submitted during disease outbreaks that lead to more immunization.

Report numbers can be combined and compared because of similar:

• definitions
• inclusion and exclusion criteria
• reference dates

To calculate vaccination coverage, PHAC divides the report numbers by estimates of population size. Population estimates come from Statistics Canada or territorial bureaus of statistics.

Types of vaccinations recorded

Provinces and territories report vaccinations only if their registries have complete data. Data is complete if all providers in the region are obliged to report or enter vaccinations into the registry. Across Canada, all vaccines administered by public health nurses are entered. Whether other providers (such as medical doctors and pharmacists) report vaccines varies by region.

All provinces and territories participating in STARVAX report on:

• vaccines administered at school
  • This includes vaccines like human papillomavirus (HPV), tetanus, diphtheria and acellular pertussis (Tdap)
  • School-based vaccination is usually done by public health nurses who are obliged to enter vaccinations in registries, so registries contain complete data
• COVID-19 vaccinations
  • In all provinces and territories, all vaccine providers are obliged to report or enter COVID-19 vaccinations

Limitations of STARVAX

STARVAX vaccination coverage estimates may be affected by data completeness and population movement.

• Underestimation may occur when vaccinations are not fully captured in immunization registries or when records for individuals who moved between jurisdictions or immigrated to Canada are missing.
• Overestimation may occur if individuals who have moved out of a province or territory, or who have died, are still included in the counts.

The impact of these limitations increases as the time between vaccination and the reference date increases. As a result:

• Seasonal vaccination estimates (based on vaccinations given in the four months before the reference date) are minimally affected
• Routine childhood vaccination estimates with shorter intervals (e.g., MMR at age 2) are in theory more reliable than those with longer intervals (e.g., DTaP or MMR at age 7)