Vaccination coverage estimation in Mexico in children under five years old: Trends and associated factors

Abstract

We aimed to estimate vaccination coverage and factors associated in completing schemes in children under 5 years old between 2000 and 2018. A secondary analysis was carried out on five national health surveys between 2000 and 2018 in Mexico. The sample was 53,898 children under 5 years old, where 30% of missing vaccination information was imputed using chained equations. During this period two basic vaccination schemes (CBS) were identified. For each doses and vaccines of both schemes and completed CBS, the coverage was estimated using weighted logistic regression models. Additionally, the factors associated with incomplete schemes were reported. Between 2000 and 2018, the caretakers who did not show the vaccination card went from 13.8% to 45.6%. During this period, the estimated vaccination coverages did not exceed 95%, except for BCG and marginally the first doses of vaccines against pneumococcus, acellular pentavalent, and Sabin. In the same period, the CBS estimated coverage decreased steadily and was under 90%, except for children aged 6–11 months (92.6%; 91.5–93.7) in 2000. Not having health insurance stands out as an associated factor with incomplete vaccination schemes. In conclusion, the imputation allowed to recuperate information and obtain better data of vaccination coverage. The estimated vaccination coverage and CBS do not reach sufficient levels to guarantee herd immunity, hence innovative strategies to improve vaccination must be established in Mexico.

Socioeconomic and geographic inequities in vaccination among children 12 to 59 months in Mexico, 2012 to 2021

“…By 2012, data from the ENSANUT 2012 indicate that among children age 15 to 23 months, coverages were 96.7%, 68%, 88%, and 80% for BCG, pentavalent, pneumococcal conjugate (PCV), and rotavirus (RV), respectively, and 87% for measles, mumps, and rubella (MMR), and 0.2% of this age group was never vaccinated ( 11 ). In 2018, from the ENSANUT 2018, for children 12 to 23 months a coverage of 97.4% was estimated for BCG, and 92.1% for one dose of pentavalent vaccine ( 12 ).…”

“…However, more recent analyses suggest a reversal of trend. An analysis of the ENSANUT from 2000 to 2018 identified a negative trend in vaccination coverage for children under 5 in Mexico and found that the probability of incomplete vaccination was related to socioeconomic and geographic factors ( 12 ). A similar analysis using only the 2012 and 2018-100k rounds of the ENSANUT found similar results, with decreasing coverage for specific vaccines and overall coverage of the complete scheme around 50% ( 13 ).…”