Cara Bess Janusz1, Margaret Frye2, Martin K Mutua3, Abram L Wagner4, Mousumi Banerjee5, Matthew L Boulton6. 1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; The Global Institute for Vaccine Equity, University of Michigan, Ann Arbor, Michigan. Electronic address: cjanusz@umich.edu. 2. Department of Sociology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, Michigan. 3. African Population and Health Research Center, Nairobi, Kenya. 4. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; The Global Institute for Vaccine Equity, University of Michigan, Ann Arbor, Michigan. 5. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes & Policy, University of Michigan, Ann Arbor, Michigan. 6. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; The Global Institute for Vaccine Equity, University of Michigan, Ann Arbor, Michigan; Infectious Disease Division, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan.
Abstract
INTRODUCTION: Improving the timeliness and completion of vaccination is the key to reducing under-5 childhood mortality. This study examines the prevalence of delayed vaccination for doses administered at birth and age 6 weeks, 10 weeks, 14 weeks, and 9 months and its association with undervaccination among infants in Sub-Saharan Africa. METHODS: Pooling data across 33 Sub-Saharan Africa countries, vaccination timing and series completion were assessed for children aged 12-35 months who were included in the immunization module of the Demographic and Health Surveys conducted between 2010 and 2019. Survey design-adjusted logistic regression modeled the likelihood of not fully completing the basic immunization schedule associated with dose-specific delays in vaccination. Data were obtained and analyzed in May 2020. RESULTS: Among children with complete date records (n=70,006), the proportion of children vaccinated with delays by ≥1 month was high: 25.9% for Bacille Calmette-Guerin (at birth); 49.1% for the third dose of pentavalent combination vaccine (at 14 weeks); and 63.9% for the first dose of measles vaccines (at 9 months). Late vaccination was more common for children born to mothers with lower levels of educational attainment (p<0.001) and wealth (p<0.001). Controlling for place, time, and sociodemographics, vaccination delays at any dose were significantly associated with not completing the immunization schedule by 12 months (Bacille Calmette-Guerin: AOR=1.93, [95% CI=1.83, 2.02]; pentavalent 3: AOR=1.50 [95% CI=1.35, 1.64]; measles: AOR=3.76 [95% CI=3.37, 4.15]). CONCLUSIONS: Timely initiation of vaccination could contribute to higher rates of immunization schedule completion, improving the reach and impact of vaccination programs on child health outcomes in Sub-Saharan Africa. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
INTRODUCTION: Improving the timeliness and completion of vaccination is the key to reducing under-5 childhood mortality. This study examines the prevalence of delayed vaccination for doses administered at birth and age 6 weeks, 10 weeks, 14 weeks, and 9 months and its association with undervaccination among infants in Sub-Saharan Africa. METHODS: Pooling data across 33 Sub-Saharan Africa countries, vaccination timing and series completion were assessed for children aged 12-35 months who were included in the immunization module of the Demographic and Health Surveys conducted between 2010 and 2019. Survey design-adjusted logistic regression modeled the likelihood of not fully completing the basic immunization schedule associated with dose-specific delays in vaccination. Data were obtained and analyzed in May 2020. RESULTS: Among children with complete date records (n=70,006), the proportion of children vaccinated with delays by ≥1 month was high: 25.9% for Bacille Calmette-Guerin (at birth); 49.1% for the third dose of pentavalent combination vaccine (at 14 weeks); and 63.9% for the first dose of measles vaccines (at 9 months). Late vaccination was more common for children born to mothers with lower levels of educational attainment (p<0.001) and wealth (p<0.001). Controlling for place, time, and sociodemographics, vaccination delays at any dose were significantly associated with not completing the immunization schedule by 12 months (Bacille Calmette-Guerin: AOR=1.93, [95% CI=1.83, 2.02]; pentavalent 3: AOR=1.50 [95% CI=1.35, 1.64]; measles: AOR=3.76 [95% CI=3.37, 4.15]). CONCLUSIONS: Timely initiation of vaccination could contribute to higher rates of immunization schedule completion, improving the reach and impact of vaccination programs on child health outcomes in Sub-Saharan Africa. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
Authors: Justice Moses K Aheto; Oliver Pannell; Winfred Dotse-Gborgbortsi; Mary K Trimner; Andrew J Tatem; Dale A Rhoda; Felicity T Cutts; C Edson Utazi Journal: PLoS One Date: 2022-05-25 Impact factor: 3.752
Authors: Emma Hahesy; Ligia Maria Cruz-Espinoza; Gabriel Nyirenda; Birkneh Tilahun Tadesse; Jerome H Kim; Florian Marks; Raphael Rakotozandrindrainy; Wibke Wetzker; Andrea Haselbeck Journal: Front Public Health Date: 2022-09-16