Determinants of vaccination coverage and adherence to the Greek national immunization program among infants aged 2-24 months at the beginning of the economic crisis (2009-2011)

Abstract

BackgroundChildhood immunization has significantly reduced the incidence of vaccine preventable diseases. Parental mistrust over vaccine safety has been associated with vaccine refusal creating barriers on vaccine coverage. Recently, economic crisis has imposed additional impediment.MethodsStudy aim was to evaluate vaccine coverage among infants 2-24 months old in the Athens metropolitan area at the beginning of the economic crisis (2009-2011).ResultsOverall, 1,667 infants were enrolled (mean age 13 months). Less than 5% of parents admitted omitting or postponing vaccination secondary to their beliefs. Although vaccination coverage was acceptable for most vaccines, lower rates of immunization were found for some newer vaccines such as hepatitis A and rotavirus. Multiple regression analysis indicated that parental age, occupational, educational statuses and family size were independently associated with immunization coverage at 6 and 12 months. Interestingly, lack of insurance was not associated with missed vaccine doses.ConclusionIncomplete vaccination coverage was associated with socioeconomic factors. It becomes apparent, that reassessing vaccination priorities under the current economic situation may be needed.

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

“…Rates remained very high for all 4 doses, both for the general population and immigrant children. 13,14,20,21 Coverage with 3 DTP doses by 12 months (95.7%), a key WHO indicator, was similar to the estimated coverage for the European region of WHO in 2013. 22 Delay in completing 4 doses by 24 months, although lower than in 2012, is possibly due to the increased number of vaccines in the second year of life.…”

“…1A), in concordance with local data and suboptimal coverage rates in other countries. 13,14,20,21,28,29 The delay is attributable to the overcrowded vaccination schedule in the first 6 months as well as the nonuniversal use of hexavalent vaccines. The use of combined vaccines has potential benefits, including reduced number of patient visits, fewer complications associated with multiple injections, decreased stocking and visit costs, and lowering the risk of delayed or missed vaccinations.…”

“…However, vaccination rates are much higher than those in 2 recent local studies in the Athens area and a prospective one in Athens and Viotia. 20,21,32 Apart from the overcrowding of the NIP, reduced coverage with the fourth dose and delayed vaccination completion in the general population and especially immigrant children may be linked to an increasing number of uninsured children during the socioeconomic crisis and the relatively high vaccine cost. Similar observations of non adherence to recommended PCV schedules have been made in other European countries and may impact protection against pneumococcal disease.…”

“…[15][16][17][18] In addition, socioeconomic factors, parental perceptions and concerns regarding vaccine safety along with the growing complexity of immunization schedules undermine adherence to the NIP. [19][20][21] The study aimed to assess full and timely vaccination coverage among preschool children attending nurseries-kindergartens (N-K) nationwide and the socioeconomic crisis impact on it.…”

Time trends in pediatric hospitalizations for hepatitis A in Greece (1999–2013): Assessment of the impact of universal infant immunization in 2008

“…Vaccine coverage studies in children 1-3 y old, have indicated that although hepatitis A vaccine is well accepted by both pediatricians and parents, it is often administered just before entering kindergarten rather then at 12 months of age as recommended by our National Immunization Program. 16,17 This is possibly due to the overcrowded vaccination schedule during the first 24 months of life.…”