Choosing immunisation coverage indicators at the local level

Rossi, Paolo Giorgi; Faustini, Annunziata; Spadea, Teresa; Perucci, Carlo A.

doi:10.1007/s10654-004-5758-6

Cited by 16 publications

(10 citation statements)

References 13 publications

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“…Some authors from developed countries have suggested that maternal recall is not a good enough indicator of vaccination status compared with health facility records [20,21]. However, a study from Italy found that parental recall alone was similar to other measures of vaccination status and concluded that "verbal recall should be accepted as reasonably reliable in the absence of cards" [22], while in Australia parental recall of measles vaccination coincided as well as vaccination cards with the presence of antibodies [23]. A study in Turkey, taking polio antibodies as the 'gold standard', found that parental recall was more sensitive but less specific than official records [24].…”

Section: Discussionmentioning

confidence: 99%

One size does not fit all: local determinants of measles vaccination in four districts of Pakistan

Cockcroft¹,

Andersson

Omer³

et al. 2009

BMC Int Health Hum Rights

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BackgroundRates of childhood vaccination in Pakistan remain low.There is continuing debate about the role of consumer and service factors in determining levels of vaccination in developing countries. MethodsIn a stratified random cluster sample of census enumeration areas across four districts in Pakistan, household interviews about vaccination of children and potentially related factors with 10,423 mothers of 14,542 children preceded discussion of findings in separate male and female focus groups. Logistic regression analyses helped to clarify local determinants of measles vaccination.ResultsAcross the four districts, from 17% to 61% of mothers had formal education and 50% to 86% of children aged 12-23 months had received measles vaccination. Children were more likely to receive measles vaccination if the household was less vulnerable, if their mother had any formal education, if she knew at least one vaccine preventable disease, and if she had not heard of any bad effects of vaccination. Discussing vaccinations in the family was strongly associated with vaccination. In rural areas, living within 5 km of a vaccination facility or in a community visited by a vaccination team were associated with vaccination, as was the mother receiving information about vaccinations from a visiting lady health worker. Focus groups confirmed personal and service delivery obstacles to vaccination, in particular cost and poor access to vaccination services. Despite common factors, the pattern of variables related to measles vaccination differed between and within districts.ConclusionsVaccination coverage varies from district to district in Pakistan and between urban and rural areas in any district. Common factors are associated with vaccination, but their relative importance varies between locations. Good local information about vaccination rates and associated variables is important to allow effective and equitable planning of services.

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Section: Discussionmentioning

confidence: 99%

One size does not fit all: local determinants of measles vaccination in four districts of Pakistan

Cockcroft¹,

Andersson

Omer³

et al. 2009

BMC Int Health Hum Rights

View full text Add to dashboard Cite

show abstract

“…Vaccine coverage is the most frequently used indicator of immunization among children between 12 and 23 months of age, but delays in delivery are overlooked (Chu et al [20]; Faustini et al [30]; Hull et al [33]; Akmatov et al [4]). Vaccines have the highest effectiveness during the recommended age range, and yet show lower compliance than uptake rates.…”

Section: Literature Reviewmentioning

confidence: 99%

Does birth under-registration reduce childhood immunization? Evidence from the Dominican Republic

2017

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The consequences of lacking birth certificates remain largely unexplored in the economic literature. We intend to fill this knowledge gap studying the effect of lacking birth certificates on immunization of children in the Dominican Republic. This is an interesting country because a significant number of children of Haitian descent face the consequences of lacking proper documentation. We use the distance to the civil registry office and the mother’s document of identification as instrumental variables of the child’s birth certificate. After controlling for distance to immunization services and other determinants, this paper finds that children between 0 and 59 months of age that do not have birth certificates are behind by nearly one vaccine (out of a total of nine) compared to those that have birth certificates.

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“…Many studies have shown that reported and recorded vaccination history data are fraught with biases and errors in recall and omission [4,6,8,11,16,36,37]. Studies in Bangladesh [38], Costa Rica [9], and England [39] found that maternal report inflated coverage estimates but our results illustrated that maternal report or card + history indicators performed well compared to serological and government estimates of MCV1 coverage.…”

Section: Discussionmentioning

confidence: 47%

Measles vaccination coverage estimates from surveys, clinic records, and immune markers in oral fluid and blood: a population-based cross-sectional study

et al. 2013

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BackgroundRecent outbreaks of measles and polio in low-income countries illustrate that conventional methods for estimating vaccination coverage do not adequately identify susceptible children. Immune markers of protection against vaccine-preventable diseases in oral fluid (OF) or blood may generate more accurate measures of effective vaccination history, but questions remain about whether antibody surveys are feasible and informative tools for monitoring immunization program performance compared to conventional vaccination coverage indicators. This study compares six indicators of measles vaccination status, including immune markers in oral fluid and blood, from children in rural Bangladesh and evaluates the implications of using each indicator to estimate measles vaccination coverage.MethodsA cross-sectional population-based study of children ages 12–16 months in Mirzapur, Bangladesh, ascertained measles vaccination (MCV1) history from conventional indicators: maternal report, vaccination card records, ‘card + history’ and EPI clinic records. Oral fluid from all participants (n = 1226) and blood from a subset (n = 342) were tested for measles IgG antibodies as indicators of MCV1 history and compared to conventional MCV1 coverage indicators.ResultsMaternal report yielded the highest MCV1 coverage estimates (90.8%), followed by EPI records (88.6%), and card + history (84.2%). Seroprotection against measles by OF (57.3%) was significantly lower than other indicators, even after adjusting for incomplete seroconversion and assay performance (71.5%). Among children with blood results, 88.6% were seroprotected, which was significantly higher than coverage by card + history and OF serostatus but consistent with coverage by maternal report and EPI records. Children with vaccination cards or EPI records were more likely to have a history of receiving MCV1 than those without cards or records. Despite similar MCV1 coverage estimates across most indicators, within-child agreement was poor for all indicators.ConclusionsMeasles IgG antibodies in OF was not a suitable immune marker for monitoring measles vaccination coverage in this setting. Because agreement between conventional MCV1 indicators was mediocre, immune marker surveillance with blood samples could be used to validate conventional MCV1 indicators and generate adjusted results that can be compared across indicators.

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Choosing immunisation coverage indicators at the local level

Cited by 16 publications

References 13 publications

One size does not fit all: local determinants of measles vaccination in four districts of Pakistan

One size does not fit all: local determinants of measles vaccination in four districts of Pakistan

Does birth under-registration reduce childhood immunization? Evidence from the Dominican Republic

Measles vaccination coverage estimates from surveys, clinic records, and immune markers in oral fluid and blood: a population-based cross-sectional study

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