A cross-sectional vaccination coverage study in preschool children attending nurseries-kindergartens: Implications on economic crisis effect

Abstract

Vaccination coverage studies are important in determining a population's vaccination status and strategically adjusting national immunization programs. This study assessed full and timely vaccination coverage of preschool children aged 2-3 y attending nurseries-kindergartens (N-K) nationwide at the socioeconomic crisis onset. Geographically stratified cluster sampling was implemented considering prefectures as strata and N-K as clusters. The N-K were selected by simple random sampling from the sampling frame while their number was proportional to the stratum size. In total, 185 N-K (response rate 93.9%) and 2539 children (response rate 81.5%) participated. Coverage with traditional vaccines for diphtheria-tetanus-pertussis, polio and measles-mumps-rubella was very high (>95%), followed by Haemophilus influenzae type b and varicella vaccines. Despite very high final coverage, delayed vaccination was observed for hepatitis B (48.3% completed by 12 months). Significant delay was observed for the booster dose of pneumococcal conjugate vaccines (PCV) and meningococcal C conjugate vaccines (MCC). Of the total population studied, 82.3% received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months and 76.2% by 30 months. However, 89.6% received at least one MCC dose over 12 months. Timely vaccinated for hepatitis A with 2 doses by 24 months were 6.1%. Coverage was significantly low for Rotavirus (<20%) and influenza (23.1% one dose). High vaccination coverage is maintained for most vaccines at the beginning of the crisis in Greece. Coverage and timeliness show an increasing trend compared to previous studies. Sustained efforts are needed to support the preventive medicine system as socioeconomic instability continues.

Diversity in the emergency care for febrile children in Europe: a questionnaire study

“…Overall, immunisation rates are estimated to be over 90%–95%; however, in several countries regional data show large differences in immunisation rates. Actual immunisation rates can be lower in specific regions, specific age groups, for specific immunisations and for booster immunisations15; therefore, the shown WHO data might be an overestimation of actual immunisation rates.…”

A reflection on invasive pneumococcal disease and pneumococcal conjugate vaccination coverage in children in Southern Europe (2009–2016)

“… 25 E. IPD data adapted from Amodio et al, Ig Sanita Pubbl 2013 32 and D'Ancona et al, Epidemiol Prev 2015, 25 vaccination coverage (children 2 y of age, complete schedule) from D'Ancona et al, Epidemiol Prev 2015 25 34 ; the 2013 estimate (3 doses) is from a cross-sectional nationwide study 35 …”

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

“…Regarding the vulnerability of the 1-5-year age group, there is always the possibility of failure to develop a satisfactory immune response after the first dose of measles vaccine. Although in Greece measles vaccination coverage with the first dose exceeds 95%, there was a recent reduction in coverage, a fact that enlarges the reservoir of susceptible children under 5 years of age [ 18 , 19 ]. In addition, coverage with the second dose is under 90%, lower than the WHO target of 95% that is a precondition to herd immunity [ 3 , 4 ].…”