Dustin G Gibson1, Benard Ochieng2, Eunice W Kagucia3, David Obor2, Frank Odhiambo2, Katherine L O'Brien3, Daniel R Feikin4. 1. Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, United States. Electronic address: dgibso28@jhu.edu. 2. Kenya Medical Research Institute/Centers for Disease Control and Prevention Public Health and Research Collaboration, Kisumu, Kenya. 3. Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, United States. 4. Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, United States; Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Abstract
BACKGROUND: Estimating vaccination coverage and delays are important because these measures can identify at risk sub-populations who can be targeted with interventions and public health policies. This paper sought to determine estimates and risk factors for children in rural western Kenya who did not receive immunization, received immunization with delay, or were severely underimmunized. METHODS: Caregivers of children aged 12-23 months old were surveyed for immunization history using written records from the immunization booklet. Risk factors for not receiving immunization, delayed immunization, and severe underimmunization were calculated using log-binomial regression. Children were categorized as delayed if a given immunization was received greater than four weeks from the age-appropriate scheduled date. Severely underimmunized children were those who were fully unvaccinated for more than 90 days and had three or more vaccines delayed or not given. RESULTS: Immunization coverage for pentavalent1, pentavalent3, measles, and fully immunized child (FIC; BCG, three doses of polio, three doses of pentavalent, and measles vaccines) were 99%, 94%, 83%, and 80%, respectively. Approximately, 10%, 24%, and 29%, of children were delayed for pentavalent1, pentavalent3, and measles, respectively. Each model produced a unique combination of risk factors with only advanced maternal age as a risk factor common to all models. Children with delayed receipt of pentavalent1 were at risk for not receiving pentavalent3 (RR: 5.20; 95%CI 3.48, 7.77), measles vaccine (RR: 1.48; 95%CI 1.12, 1.95), and not achieving FIC (RR: 1.88; 95%CI 1.51, 2.34) compared with children who received pentavalent1 on time. CONCLUSIONS: Immunization coverage among 12-23 month old children was high, yet a substantial proportion of children were vaccinated with delay. Although vaccine coverage and timeliness are often conceptualized as separate measures, the finding that delayed pentavalent1 receipt was a strong risk factor for not receiving future immunizations indicates the two measures are intertwined.
BACKGROUND: Estimating vaccination coverage and delays are important because these measures can identify at risk sub-populations who can be targeted with interventions and public health policies. This paper sought to determine estimates and risk factors for children in rural western Kenya who did not receive immunization, received immunization with delay, or were severely underimmunized. METHODS: Caregivers of children aged 12-23 months old were surveyed for immunization history using written records from the immunization booklet. Risk factors for not receiving immunization, delayed immunization, and severe underimmunization were calculated using log-binomial regression. Children were categorized as delayed if a given immunization was received greater than four weeks from the age-appropriate scheduled date. Severely underimmunized children were those who were fully unvaccinated for more than 90 days and had three or more vaccines delayed or not given. RESULTS: Immunization coverage for pentavalent1, pentavalent3, measles, and fully immunized child (FIC; BCG, three doses of polio, three doses of pentavalent, and measles vaccines) were 99%, 94%, 83%, and 80%, respectively. Approximately, 10%, 24%, and 29%, of children were delayed for pentavalent1, pentavalent3, and measles, respectively. Each model produced a unique combination of risk factors with only advanced maternal age as a risk factor common to all models. Children with delayed receipt of pentavalent1 were at risk for not receiving pentavalent3 (RR: 5.20; 95%CI 3.48, 7.77), measles vaccine (RR: 1.48; 95%CI 1.12, 1.95), and not achieving FIC (RR: 1.88; 95%CI 1.51, 2.34) compared with children who received pentavalent1 on time. CONCLUSIONS: Immunization coverage among 12-23 month old children was high, yet a substantial proportion of children were vaccinated with delay. Although vaccine coverage and timeliness are often conceptualized as separate measures, the finding that delayed pentavalent1 receipt was a strong risk factor for not receiving future immunizations indicates the two measures are intertwined.
Authors: Jessica E Deyoe; James Akiruga Amisi; Daria Szkwarko; Dan N Tran; Maya Luetke; Sina Kianersi; Shin H Lee; Jane Namae; Becky Genberg; Jeremiah Laktabai; Sonak Pastakia; Molly Rosenberg Journal: Matern Child Health J Date: 2021-08-18
Authors: Peter Francis Raguindin; Merrylle Morales-Dizon; Josephine Aldaba; Lailani P Mangulabnan; Renelyn P Reyes; Nyambat Batmunkh; Maria Joyce Ducusin; Anna Lena Lopez Journal: J Public Health Policy Date: 2021-01-04 Impact factor: 3.526
Authors: Dustin G Gibson; E Wangeci Kagucia; Benard Ochieng; Nisha Hariharan; David Obor; Lawrence H Moulton; Peter J Winch; Orin S Levine; Frank Odhiambo; Katherine L O'Brien; Daniel R Feikin Journal: JMIR Res Protoc Date: 2016-05-17
Authors: Dustin G Gibson; Benard Ochieng; E Wangeci Kagucia; Joyce Were; Kyla Hayford; Lawrence H Moulton; Orin S Levine; Frank Odhiambo; Katherine L O'Brien; Daniel R Feikin Journal: Lancet Glob Health Date: 2017-04 Impact factor: 26.763