Abstract:This study assessed age-appropriate childhood vaccination coverage in a national cohort of children. While the overall vaccination coverage stands in line with the WHO goals, vaccination timeliness and equity are inadequate and targeted public health intervention programs aimed at vaccination timeliness are necessary.
“…This could be because the national vaccination policy, which had targeted to achieve a more than 95% pentavalent and measles vaccination coverage in 2020, had simply focused on the up to date coverage, irrespective of the time of vaccination [10,11]. This finding is also in line with previous reports from developing and developed countries [7,15,21,23,31,32] that reported a high proportion of age-inappropriate vaccinations despite high up to date vaccination coverage. This calls for age appropriateness of vaccination to be considered as another indicator of vaccination program performance to ensure timely administration of vaccination for children.…”
Section: Discussionsupporting
confidence: 85%
“…Globally, studies showed that few children received all recommended vaccine doses on time, even with high up-to-date coverage [8,9,21]. Similarly, in Sub-Sahara African countries, researchers observed a substantial delay in timely vaccination receipt [7,22,23].…”
Background
In Ethiopia, there are limited studies on age-appropriate vaccinations that children received at the recommended specific ages. Therefore, we assessed age-appropriate vaccinations coverage and its associated factors among children 12 to 23 months of age in Menz Lalo district, northeast Ethiopia.
Methods
A community-based cross-sectional study was conducted in Menz Lalo district from March to April/2018 among 417 mothers/caregivers with children 12 to 23 months of age using simple random sampling technique. Data were collected using a pretested structured questionnaire. Information about children’s vaccination status was collected from vaccination cards. Age-appropriate vaccination coverage was measured using World Health Organization vaccination schedule recommendation. Data was entered into Epi-Info
7
software and exported to SPSS-20 for analysis. Four consecutive logistic regression models were performed to identify factors associated with age-inappropriate vaccinations. A P-value of ≤ 0.05 was considered to state statistically significant associations.
Results
Age-appropriate vaccination coverage was
39.1%
(95% CI: 34.3 to 44) for
pentavalent
1,
36.3%
(95% CI: 31.6 to 41.5) for
pentavalent
2,
30.3%
(95% CI: 25.6 to 35) for
pentavalent
3 and
26.4%
(95% CI: 21.7 to 31) for measles vaccine doses. Age-inappropriate
pentavalent
1–3 vaccinations was associated with being male sex (AOR: 0.47, 95% CI: 0.29–0.74), lack of telephone (AOR: 2.2, 95% CI: 1.4–3.6), lack of usual caretaker (AOR: 2.6, 95% CI: 1.3–5.2), unplanned pregnancy (AOR: 1.9, 95% CI: 1.1–3.5), missing pregnant women’s conference (AOR: 2.7, 95% CI: 1.3–5.7), decreasing birth order (AOR: 0.34, 95% CI: 0.17–0.68) and insufficient knowledge (AOR: 2.7, 95% CI: 1.6–4.4).
Conclusion
The proportions of age-appropriate vaccination coverage were low in the study area. Modifiable factors were associated with age-inappropriate vaccinations. Vaccination interventions should consider identified modifiable factors to improve age-appropriate vaccinations coverage.
“…This could be because the national vaccination policy, which had targeted to achieve a more than 95% pentavalent and measles vaccination coverage in 2020, had simply focused on the up to date coverage, irrespective of the time of vaccination [10,11]. This finding is also in line with previous reports from developing and developed countries [7,15,21,23,31,32] that reported a high proportion of age-inappropriate vaccinations despite high up to date vaccination coverage. This calls for age appropriateness of vaccination to be considered as another indicator of vaccination program performance to ensure timely administration of vaccination for children.…”
Section: Discussionsupporting
confidence: 85%
“…Globally, studies showed that few children received all recommended vaccine doses on time, even with high up-to-date coverage [8,9,21]. Similarly, in Sub-Sahara African countries, researchers observed a substantial delay in timely vaccination receipt [7,22,23].…”
Background
In Ethiopia, there are limited studies on age-appropriate vaccinations that children received at the recommended specific ages. Therefore, we assessed age-appropriate vaccinations coverage and its associated factors among children 12 to 23 months of age in Menz Lalo district, northeast Ethiopia.
Methods
A community-based cross-sectional study was conducted in Menz Lalo district from March to April/2018 among 417 mothers/caregivers with children 12 to 23 months of age using simple random sampling technique. Data were collected using a pretested structured questionnaire. Information about children’s vaccination status was collected from vaccination cards. Age-appropriate vaccination coverage was measured using World Health Organization vaccination schedule recommendation. Data was entered into Epi-Info
7
software and exported to SPSS-20 for analysis. Four consecutive logistic regression models were performed to identify factors associated with age-inappropriate vaccinations. A P-value of ≤ 0.05 was considered to state statistically significant associations.
Results
Age-appropriate vaccination coverage was
39.1%
(95% CI: 34.3 to 44) for
pentavalent
1,
36.3%
(95% CI: 31.6 to 41.5) for
pentavalent
2,
30.3%
(95% CI: 25.6 to 35) for
pentavalent
3 and
26.4%
(95% CI: 21.7 to 31) for measles vaccine doses. Age-inappropriate
pentavalent
1–3 vaccinations was associated with being male sex (AOR: 0.47, 95% CI: 0.29–0.74), lack of telephone (AOR: 2.2, 95% CI: 1.4–3.6), lack of usual caretaker (AOR: 2.6, 95% CI: 1.3–5.2), unplanned pregnancy (AOR: 1.9, 95% CI: 1.1–3.5), missing pregnant women’s conference (AOR: 2.7, 95% CI: 1.3–5.7), decreasing birth order (AOR: 0.34, 95% CI: 0.17–0.68) and insufficient knowledge (AOR: 2.7, 95% CI: 1.6–4.4).
Conclusion
The proportions of age-appropriate vaccination coverage were low in the study area. Modifiable factors were associated with age-inappropriate vaccinations. Vaccination interventions should consider identified modifiable factors to improve age-appropriate vaccinations coverage.
“…A possible explanation underlying the fact that birth order plays a significant role relates to caregivers' practices since inexperienced first-time parents were more anxious for their children's health than those of later-born children. [47][48][49][50][51] Furthermore, it should be noted that more than one-third of the respondents was using Internet to search information and we are confident that this source must be consulted with caution because it can play a role in the activity of producing mistrust. 52,53 Indeed, this information may be uncontrolled and parents may be exposed to misleading information on the usefulness and safety of vaccines.…”
This cross-sectional survey was designed to assess the prevalence of vaccine hesitancy and to identify factors associated among a randomly selected sample of parents. A questionnaire was self-administered from October to December 2017 to a sample of parents of children aged 2 to 6 years attending five randomly selected pre-schools in the geographic area of Naples, Italy. Out of the 727 selected parents, 437 returned the questionnaires for a response rate of 60.1%. The median of Parent Attitudes about Childhood Vaccines Survey (PACV) score among participants was 45.8 with a total of 141 parents (34.7%) scored a value ≥50 and were defined hesitant about the childhood vaccinations. Vaccine hesitancy was significantly more common among those who were concerned and among those were not sure that any one of the childhood shots might not be safe, among those who were concerned that their children might have a serious side effect from a shot, among those who were concerned that a shot might not prevent the disease, among those who delayed and refused at least a shot of vaccine for their children, and in those who are not sure and uncertain in the pediatrician. More than half of parents (53.8%) expressed a desire to receive additional information about the childhood vaccinations. Parents who were not sure and uncertain that to follow the recommended shot schedule is a good idea for their children and those who were parents of first-born children were more likely to need additional information. This study finds a high prevalence of vaccine hesitancy among parents suggesting that in the immunization program is necessary to achieve a higher quality of the relationship between pediatricians and the community.
“…The number of children receiving a single type of vaccine on-time can be calculated along with how many received all vaccinations on-time. Large gaps in vaccination coverage have been found in some countries when comparing children receiving up-to-date versus age-appropriate vaccinations, demonstrating the added value EIRs provide by being able to actively track timeliness [24].Fig. 2Example of differing vaccination schedules.…”
Section: Potential Benefits Of Eirs To Improve Measurementmentioning
Vaccine coverage is routinely used as a performance indicator for immunization programs both at local and global levels. For many national immunization programs, there are challenges with accurately estimating vaccination coverage based on available data sources, however an increasing number of low- and middle-income countries (LMICs) have begun implementing electronic immunization registries to replace health facilities’ paper-based tools and aggregate reporting systems. These systems allow for more efficient capture and use of routinely reported individual-level data that can be used to calculate dose-specific and cohort vaccination coverage, replacing the commonly used aggregate routine health information system data. With these individual-level data immunization programs have the opportunity to redefine performance measures to enhance programmatic decision-making at all levels of the health system. In this commentary, we discuss how measures for assessing vaccination status and program performance can be redefined and recalculated using these data when generated at the health facility level and the implications of the use and availability of electronic individual-level data.
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