Document Type
Journal Article
Publication Date
2-10-2016
Journal
Vaccine
Volume
34
Issue
7
Inclusive Pages
933-941
DOI
10.1016/j.vaccine.2015.12.061
Abstract
Background
Immunization programs currently measure coverage by assessing the proportion of children 12–24 months who have been immunized but this does not address the important question of when the scheduled vaccines were administered. Data capturing the timing of vaccination in first 6 months, when severe disease is most likely to occur, are limited.
Objective
To estimate the time to Bacillus Calmette–Guérin (BCG) (recommended at birth), diphtheria-tetanus-pertussis-H, influenza b-hepatitis B (DTP-Hib-HepB), and oral polio vaccine (OPV) (recommended at 6, 10, and 14 weeks) vaccinations and risk factors for vaccination delay in infants <6 months of age in a district in southern Nepal where traditional coverage metrics are high.
Design/methods
Infants enrolled in a randomized controlled trial of maternal influenza vaccination were visited weekly at home from birth through age 6 months to ascertain if any vaccinations had been given in the prior week. Infant, maternal, and household characteristics were recorded. BCG, DTP-Hib-HepB, and OPV vaccination coverage at 4 and 6 months was estimated. Time to vaccination was estimated through Kaplan–Meier curves; Cox-proportional hazards models were used to examine risk factors for delay for the first vaccine.
Results
The median age of BCG, first OPV and DTP-Hib-HepB receipt was 22, 21, and 18 weeks, respectively. Almost half of infants received no BCG by age 6 months. Only 8% and 7% of infants had received three doses of OPV and DTP-Hib-HepB, respectively, by age 6 months.
Conclusion
A significant delay in receipt of infant vaccines was found in a prospective, population-based, cohort in southern Nepal despite traditional coverage metrics being high. Immunization programs should consider measuring time to receipt relative to the official schedule in order to maximize benefits for disease control and child health.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
APA Citation
Hughes, M. M., Katz, J., Englund, J. A., Khatry, S. K., Shrestha, L., LeClerq, S. C., … Tielsch, J. M. (2016). Infant vaccination timing: Beyond traditional coverage metrics for maximizing impact of vaccine programs, an example from southern Nepal. Vaccine, 34(7), 933–941. doi:10.1016/j.vaccine.2015.12.061
Peer Reviewed
1
Open Access
1
Comments
Reproduced with permission of Elsevier B.V. Vaccine.