Vaccination during pregnancy : Understanding the data
The current tab presents information on the importance of vaccination during pregnancy, introduces the data sources used to build this dashboard, and offers useful explanations and definitions of the terminology used throughout this publication.
- Last updated: 2024-09-16
The purpose of this dashboard is to provide detailed data on vaccination during pregnancy. The data presented here can be used to complement existing knowledge on vaccination during pregnancy and/or to generate new ideas for further research.
Please note: The Public Health Agency of Canada (PHAC) recognizes that not all people giving birth will identify as women or mothers.
The writing in this publication uses the term ‘pregnant individual' to describe the parent gestating the fetus.
The term “biological mother” refers to the person who is postpartum and should be considered to also apply to those individuals who do not specifically identify as female gender but have given birth.
Finally, PHAC acknowledges the dynamic nature of language. It is likely that language deemed to be suitable in one context may not translate across others, and over the coming years will likely change and evolve with respect to appropriate representation.
On this page
Importance of vaccination during pregnancy
Vaccination during pregnancy is an important preventive health measure that protects both pregnant individuals and their developing babies from serious infections. Through vaccination, pregnant individuals develop protective antibodies that are passed on to their developing babies through the placenta. The transferred antibodies provide some protection to newborns during their initial months of life when they are not yet eligible for vaccination.
In Canada, the National Advisory Committee on Immunization (NACI) recommends that all pregnant individuals receive vaccination against pertussis (whooping cough) and influenza (flu) during each of their pregnancies. These recommendations are reaffirmed by the Society of Obstetricians and Gynaecologists of Canada (SOGC). Both vaccines are currently offered at no cost to pregnant individuals in all provinces and territories.
Data sources
The Survey on Vaccination during Pregnancy
The Survey on Vaccination during Pregnancy (SVP)—the primary data source used to build this dashboard—is a large, national survey of individuals who had recently given birth. The survey collects data on pertussis and influenza vaccination during pregnancy and also delves into respondents' knowledge, attitudes, and beliefs regarding these vaccinations.
The SVP was first conducted in 2019 and then again in 2021.
Table 1. Summary of survey characteristics
| Survey characteristics | 2019 SVP | 2021 SVP |
|---|---|---|
| Target population | Biological mothers of 0–6 month-olds, who gave birth between September 2, 2018 and March 1, 2019 | Biological mothers of 0–6 month-olds, who gave birth between September 1, 2020 and March 1, 2021 |
| Sampling frame | List of applicants to the Canada Child Benefit (CCB) | List of applicants to the Canada Child Benefit (CCB) |
| Populations not included | Biological mothers living on First Nations reserves and those who are institutionalized | Biological mothers living on First Nations reserves and those who are institutionalized |
| Period of data collection | December 2019 to March 2020 | January 2022 to April 2022 |
| Data collection tool | Electronic questionnaire or telephone interview | Electronic questionnaire or telephone interview |
Table 2. Targeted sample size, response rate (%), and final sample size Footnote1 by province and territory
| Province or territory | 2019 SVP | 2021 SVP | ||||
|---|---|---|---|---|---|---|
| Targeted sample size | Response rate (%) | Final sample size Footnote1 | Targeted sample size | Response rate (%) | Final sample size Footnote1 | |
| Newfoundland and Labrador | 750 | 57.8 | 420 | 586 | 49.1 | 284 |
| Prince Edward Island | 551 | 59.4 | 313 | 436 | 51.2 | 217 |
| Nova Scotia | 831 | 58.6 | 474 | 647 | 51.4 | 325 |
| New Brunswick | 814 | 58.2 | 465 | 631 | 52.1 | 318 |
| Quebec | 945 | 67.1 | 610 | 620 | 57.6 | 344 |
| Ontario | 978 | 60.4 | 554 | 691 | 49.5 | 331 |
| Manitoba | 879 | 55.4 | 452 | 716 | 53.6 | 365 |
| Saskatchewan | 873 | 56.1 | 468 | 703 | 51.2 | 347 |
| Alberta | 925 | 65.7 | 581 | 629 | 49.9 | 302 |
| British Columbia | 919 | 60.4 | 528 | 681 | 50.7 | 325 |
| Yukon Territory | 133 | 65.3 | 81 | 156 | 59.7 | 86 |
| Northwest Territories | 237 | 42.6 | 95 | 258 | 38.3 | 94 |
| Nunavut | 261 | 30.9 | 50 | 27 | 47.4 | 9 |
| Canada | 9,096 | 58.9 | 5,091 | 6,781 | 51.3 | 3,347 |
- Footnote 1
-
Final sample size=(Targeted sample size*Response rate) – out of scope respondents
Both the 2019 and 2021 SVP included a sufficient number of respondents to derive national- and provincial/territorial-level estimates; however, the number of participants from Nunavut was insufficient during both survey cycles to allow for the reporting of reliable and accurate estimates for the territory. Participants from Nunavut were, however, included in the calculation of national-level estimates.
The SVP is a self-report-based survey that relies on recall. Such surveys are prone to recall bias (i.e., not remembering or misremembering past events or experience), social desirability bias (i.e., when respondents conceal their true opinion on a subject in order to make themselves look good to others) and non-response bias (i.e., when those who agree to participate in a survey are different in certain characteristics than those who choose not to participate). If present, these biases may lead to over- or under-estimation of vaccination coverage and other measures estimated using survey data.
Another limitation of the SVP is that biological mothers living on-reserve and those who are institutionalized are excluded from the survey. Although not an exclusion criterion per se, individuals who speak neither one of the official languages cannot participate as the survey is only available in English and French.
For more detailed information on the survey methodology, please visit Statistics Canada.
World Health Organization (WHO) Immunization Data Portal
The WHO Immunization Data Portal allows users to interact, visualize, and download international immunization data. Results can be visualized and downloaded by WHO region, globally, or by country. Data topics available on the portal include: vaccine-preventable disease reported cases and incidence, vaccination coverage, immunization program indicators, vaccine introductions, vaccine schedules, and other immunization related topics.
WHO member states (countries) report vaccination coverage data annually through the WHO/UNICEF Joint Reporting Form (JRF). These data are made available annually, in mid-July, and updated thereafter as country data are received.
For the purpose of this dashboard, international data on vaccination coverage against pertussis and influenza in pregnancy were downloaded from the WHO Immunization Data Portal. Only data submitted by countries often benchmarked against Canada in healthcare comparisons (i.e., the United Stated of America, the United Kingdom, Australia, Germany, France, Sweden, the Kingdom of the Netherlands, and New Zealand) were considered for inclusion in this dashboard.
The data on pertussis and influenza vaccination coverage in pregnancy that Canada submitted to the WHO during the two most recent reporting cycles were collected through the SVP.
Immunization data available through the WHO Immunization Data Portal may have some limitations. The description of the denominator of the target group (in this case, pregnant individuals) in the reporting countries may vary. Therefore, differences in official vaccination coverage estimates observed between countries may be, at least to some extent, the result of methodological differences. Additionally, differences between the reporting countries’ data sources such as administrative systems and/or surveys may impact the reported coverage estimates.
Notes on the estimates
The estimates (percentages) derived using data from the SVP are all weighted estimates. This means that survey sampling weights, adjusted for age and geographic region, were applied to the calculations to ensure that the derived estimates are representative of the Canadian population of individuals who had recently given birth.
The term 'significant' is often used throughout this publication when discussing changes in vaccination coverage estimates over time. The term refers to statistical significance which means that any differences in estimates between two time points are likely not due to chance, but are true differences caused by something other than chance.
The small black bars visible on some of the charts represent the confidence intervals around the estimates. Confidence intervals (CIs) are one way to relay information about how "good" an estimate is. The wider the confidence interval for a particular estimate, the more caution is required when using the estimate.
Definitions
- Pertussis (whooping cough)
- Pertussis is a contagious bacterial infection of the lungs and airways. It causes serious coughing fits that can lead to choking or vomiting. Without treatment, pertussis can last for weeks or months, and can cause brain damage or even death. Pertussis is particularly serious and most dangerous in infants and young children who are not yet eligible for vaccination or are unvaccinated or under-vaccinated.
- Influenza (flu)
- Influenza is a contagious viral respiratory infection. While most people recover from influenza within a week, severe illness can occur. Some groups, including pregnant individuals, are at a greater risk of influenza-related complications. In Canada, influenza is ranked among the top 10 leading causes of death.
- Canadian Index of Multiple Deprivation
- The Canadian Index of Multiple Deprivation (CIMD) is an area-based index that is composed of four dimensions of deprivation and marginalization: residential instability; situational vulnerability; economic dependency; and ethnocultural composition. Within each dimension, the component scores are ordered from smallest to largest and then divided into five equally sized groups, or quintiles, and categorized from 1 through 5. A value of 1 corresponds to the least deprived neighbourhoods for that dimension, and a value of 5 corresponds to the most deprived ones.
- Economic dependency
- Economic dependency is one of the four dimensions of the Canadian Index of Multiple Deprivation. It relates to reliance on the workforce, or a dependence on sources of income other than employment income. For example, the indicators included in this dimension, at the national-level, measure concepts such as the proportion of the population aged 65 and older, the dependency ratio (the population aged 0-14 and population aged 65 and older divided by the population aged 15-64), and the proportion of the population not participating in the labour force.
- Ethnocultural composition
- Ethnocultural composition is one of the four dimensions of the Canadian Index of Multiple Deprivation. It refers to a community’s make-up of immigrant populations, and at the national-level, for example, takes into consideration factors such as the proportion of the population who are recent immigrants, the proportion of the population who self-identified as visible minority, the proportion of the population born outside of Canada, and the proportion of the population with no knowledge of either official language (linguistic isolation).
- Residential instability
- Residential instability is one of the four dimensions of the Canadian Index of Multiple Deprivation. It speaks to the tendency of neighbourhood inhabitants to fluctuate over time, taking into consideration both housing and familial characteristics. For example, the indicators in this dimension at the national-level measure concepts such as the proportion of the population who have moved in the past five years, the proportion of persons living alone, and the proportion of occupied units that are rented rather than owned.
- Situational vulnerability
- Situational vulnerability is one of the four dimensions of the Canadian Index of Multiple Deprivation. It refers to variations in sociodemographic conditions in the areas of housing and education, while taking into account other demographic characteristics. For example, the indicators in this dimension at the national-level measure concepts such as the proportion of the population aged 25 to 64 without a high-school diploma, the proportion of the population identifying as Aboriginal, and the proportion of dwellings needing major repairs.
- Neighbourhood income ranking
- The household-size adjusted average income per person was calculated for each neighbourhood (i.e., census dissemination area or DA) and then used to rank the neighbourhoods in each CMA/CA and nationally from lowest to highest. To calculate the household size-adjusted average income per person for each neighbourhood, the total before-tax income of the neighbourhood was divided by the total number of single-person equivalents (a 2-person household counts as 1.24 persons, a 3-person household counts as 1.53 persons, etc.) living in the neighbourhood.
- CMA/CA
- A census metropolitan area (CMA) or a census agglomeration (CA) is formed by one or more adjacent municipalities centred on a population centre (known as the core). A CMA must have a total population of at least 100,000 of which 50,000 or more must live in the core based on adjusted data from the previous Census of Population Program. A CA must have a core population of at least 10,000 also based on data from the previous Census of Population Program.
- Remoteness of residence
- This indicator was derived using the Index of Remoteness. In 2021, the Index of Remoteness was calculated and used to quantify how isolated communities are, based on their distance and accessibility to population centers. The Index of Remoteness is a score derived based on the distance from population centres and population size; the higher the score the more remote the community. Population centre is defined as an area with a population of at least 1,000 and no fewer than 400 persons per square kilometre and is further classified into small, medium, and large urban population centre.
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