Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh

Abstract

Immunization has become one of the major contributors to public health globally as it prevents communicable disease, particularly in children. The objective of this study was to estimate the extent of timely immunization coverage and to investigate the determinants of incomplete and untimely vaccination. Methods: The study used data from the latest Bangladesh Demographic Health Survey (BDHS) 2014. A total sample of 1631 children aged 12–23 months who had an Expanded Program on Immunization (EPI) card and immunization history were analyzed. Multivariable logistic regression models were used to determine the significant influencing factors on untimely vaccination (BCG, pentavalent vaccine/OPV, and measles) and incomplete vaccination. The results were presented in terms of adjusted odds ratio (AOR) with a 95% confidence interval and a significance level p < 0.05. Results: The proportions of children who received timely vaccinations were 24% for BCG, 46% for pentavalent 3, and 53% for measles, whereas 76%, 51%, and 36% children failed to receive the BCG, pentavalent 3, and measles vaccines, respectively, in a timely manner. The proportion of early vaccination was 3% for pentavalent 3 and 12% for measles. Several significant influencing factors including age, maternal education and working status, awareness of community clinics, socioeconomic status, and geographic variation significantly contributed to untimely and incomplete vaccination of children in Bangladesh. Conclusions: The study identified some key determinants of untimely and incomplete childhood vaccinations in the context of Bangladesh. The findings will contribute to the improvement of age-specific vaccination and support policy makers in taking the necessary control strategies with respect to delayed and early vaccination in Bangladesh.

Vaccination timeliness and associated factors among children aged 12-23 months in northwest Ethiopia: community-based study

“…Children who were born from educated mothers were more likely to receive their vaccines timely than noneducated mothers. This nding was consistent with the ndings of the study done in Bangladesh (33).…”

“…Moreover, only 42.2% (95%CI: 38.1-46.8) children were received BCG vaccines timely. It is higher than the ndings in Ethiopia (23.9%) (23) and Bangladesh (24%) (33). On the contrary, this nding was lower than compared to studies conducted outside in Pakistan (89.3%) (29), Ghana (88.9%) (31), and Senegal (88.25%) (32).…”

“…Besides, this study also revealed that 16.4% (95%CI: 13.3-19.8) of children were received measles vaccine earlier than the recommended time interval. The nding was higher than a study conducted in Bangladesh (12%) (33) and lower than a study done in Pakistan (90%) (29). The possible justi cation might be health workers' appointment before nine months of age to prevent open dose vial wastage, mothers/caregivers being too busy on appointment day and forgotten vaccination appointment (22).…”

Timely completion of vaccination and its determinants among children in Northwest, Ethiopia: A multilevel analysis

“…On-time full vaccination coverage was higher among children of caregivers with high educational level. Several studies also support the finding of higher educational level being related to timely adherence to the vaccination schedules (13,16,31,32,50,51,63,65). The possible reason for this may be related with the fact that the low education level can hinder the caregiver's communication with health workers and might influence caregiver's awareness to seek and take advantage of public health services including child vaccination.…”

“…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).…”