Coverage and timeliness of vaccination and the validity of routine estimates: Insights from a vaccine registry in Kenya

Adetifa, Ifedayo; Karia, Boniface; Mutuku, Alex; Bwanaali, Tahreni; Makumi, Anne; Wafula, Jackline; Chome, Martina; Mwatsuma, Pauline; Bauni, Evasius; Hammitt, Laura L.; Mataza, Christine; Tabu, Collins; Kamau, Tatu; Williams, Thomas N.; Scott, J. Anthony G.

doi:10.1016/j.vaccine.2018.11.005

Cited by 35 publications

(39 citation statements)

References 34 publications

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“…In this study, one third of children had not completed their vaccination and the coverage rate for specific vaccines declined for subsequent doses of vaccines with high dropout rates. This finding corroborates with other evidences where missing measles and third doses of polio and pentavalent vaccine were the main reason for not being fully vaccinated [3,24,43]. In addition, the study indicated different coverage's for specific vaccines provided in the same vaccination visits.…”

Section: Discussionsupporting

confidence: 91%

“…Full vaccination was defined as the child vaccination status once an infant has received all recommended vaccines included in the national schedule: a dose of Bacille Calmette Guérin (BCG); three doses of Oral Polio Vaccine (OPV); three doses each of Penta-valent and Pneumococcal Conjugate Vaccine (PCV); one dose of Inactivated Polio Vaccine (IPV); two doses of rotavirus and one dose of measles vaccines by the age of 12 months [5,22,26,40,41]. On-time vaccination for specific vaccines was defined as vaccine dose administered within 4 days prior [31,[42][43][44][45] and within 4 weeks after the recommended age specified in the national immunization schedule [12,30,31,37,[43][44][45][46][47][48][49]. On-time full vaccination was also defined as all vaccine doses administered within 4 days prior [31,[42][43][44][45] and within 4 weeks after the recommended age specified in the national immunization schedule.…”

Section: Independent Variablesmentioning

confidence: 99%

“…On-time vaccination for specific vaccines was defined as vaccine dose administered within 4 days prior [31,[42][43][44][45] and within 4 weeks after the recommended age specified in the national immunization schedule [12,30,31,37,[43][44][45][46][47][48][49]. On-time full vaccination was also defined as all vaccine doses administered within 4 days prior [31,[42][43][44][45] and within 4 weeks after the recommended age specified in the national immunization schedule. Otherwise, it was not considered as on-time full vaccination if at least one vaccine dose was given early, late or missed at all [30,31,43,44,48,[50][51][52][53].…”

Section: Independent Variablesmentioning

confidence: 99%

“…On-time full vaccination was also defined as all vaccine doses administered within 4 days prior [31,[42][43][44][45] and within 4 weeks after the recommended age specified in the national immunization schedule. Otherwise, it was not considered as on-time full vaccination if at least one vaccine dose was given early, late or missed at all [30,31,43,44,48,[50][51][52][53].…”

Section: Independent Variablesmentioning

confidence: 99%

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Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

et al. 2020

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Background: Timely vaccination is key to prevent unnecessary childhood mortality from vaccine-preventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar city administration, northwest , Ethiopia. Method: This study employed a community-based cross sectional study design. A sample size of 821 children aged 12 to 23 months were considered. Two stages random sampling technique was used to select study subjects. To account the effect of clustering, bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95% confidence intervals (CIs). Results: Of the 774 children included for analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers who had secondary education and above (AOR = 2.391; 95% CI: 1.317-4.343), from richest households (AOR = 2.381; 95% CI: 1.502-3.773), children whose mother attended four or more ante natal care visits (AOR = 2.844; 95% CI: 1.310-6.174) and whose mother had two or more post natal care visits (AOR = 2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination. In contrary, caregivers aged above 35 years (AOR = 0.469; 95 % CI: 0.253-0.869], being vaccinated at health post (AOR = 0.144; 95%CI: 0.048-0.428) and travelling more than 30 min to the vaccination site (AOR = 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities. Conclusion: In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as important indicator of the immunization program performance in Ethiopia.

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Section: Discussionsupporting

confidence: 91%

Section: Independent Variablesmentioning

confidence: 99%

Section: Independent Variablesmentioning

confidence: 99%

Section: Independent Variablesmentioning

confidence: 99%

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Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

et al. 2020

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“…Challenges to implementing a high-quality household survey are well-known (4,17,18) but even when surveys are well-implemented, presentation of results may be hampered by a lack of standardized definitions of potential indicators and/or failure to report enough information to define those indicators clearly (10,(19)(20)(21). WHO and partners therefore recently developed a white paper to help harmonize the collection and analysis of vaccination coverage data across the major survey programs (22).…”

Section: Introductionmentioning

confidence: 99%

Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria

Wagai¹,

Rhoda²,

Prier³

et al. 2020

Preprint

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In 2015, the World Health Organization substantially revised its guidance for vaccination coverage cluster surveys (revisions were finalized in 2018) and has since developed a set of accompanying resources, including definitions for standardized coverage indicators and software to calculate them. In addition to tabular presentations of coverage by vaccine and age group, the guidance document and software (named the Vaccination Coverage Quality Indicators - VCQI) – provide insight into crude coverage versus valid doses, vaccination timeliness, missed opportunities for simultaneous vaccination, and vaccination campaign coverage stratified by several parameters, including the number of previous doses received. The VCQI software furnishes several helpful ways to visualize survey results. The current WHO survey guidance was used to design and conduct two nationally representative vaccination coverage surveys in Nigeria – one to assess routine immunization and one to measure post campaign coverage. The primary analysis for both surveys was conducted using VCQI. This paper describes those surveys and highlights some of the analyses that are facilitated by the new resources.

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Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

et al. 2022

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Highlights Immunisation coverage has an inverse relationship with age, while delay in vaccine uptake has a direct relationship with age. High vaccine coverage rates do not translate to timely receipt of routine childhood vaccines. Time-at-risk for vaccine preventable diseases is positively associated with increasing immunisation age timepoints. Preschool attendance and having adult caregivers are protective against delaying vaccine uptake. Low and upper-middle socio-economic quartiles are associated with delayed uptake of routine childhood vaccines.

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Coverage and timeliness of vaccination and the validity of routine estimates: Insights from a vaccine registry in Kenya

Cited by 35 publications

References 34 publications

Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

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