Measles vaccination coverage, determinants of delayed vaccination and reasons for non-vaccination among children aged 24–35 months in Zhejiang province, China

Abstract

BackgroundThis study was aimed to assess the coverage of two doses of measles vaccine and identify the determinants of the delayed vaccination.MethodsA cluster survey among 1386 children aged 24–35 months was conducted. Characteristics on demographic and socio-economic and vaccination records was collected. The overall coverage was defined as the proportion of children receiving the first dose of measles vaccination and the second dose of measles vaccination by 24 months of age. The age-appropriate coverage was defined as the proportion of children receiving the measles vaccine doses within one month after its relevant due date. Timeliness was evaluated with the Kaplan-Meier analysis. Cox proportional hazard regression was adopted to identify determinants of the delayed vaccination.ResultsThe overall coverage was 96.9% for the first dose of measles vaccine and 93.9% for the second dose of measles vaccine. The age-appropriate coverage of the first and the second dose of measles vaccine was 76.6 and 68.2%, respectively. Household having more than one child, non-local children were associated with the delayed vaccination for the first and the second dose of measles vaccine. Children delivered at home, younger mothers, low maternal education background, mothers with a fixed job, and low household income were associated with the delayed vaccination for the second dose of measles vaccine.ConclusionsThe coverage of measles vaccine had been improved for both the first and the second dose, while the timeliness still needed improvement. We suggested the policy-makers pay more attention to the reasons for non-vaccination and determinants of delayed vaccination when planning efforts to ensure the high age-appropriate coverage of measles vaccination.

Age-appropriate vaccination coverage and its associated factors for pentavalent 1-3 and measles vaccine doses, in northeast Ethiopia: A community-based cross-sectional study

“…This calls for age appropriateness of vaccination to be considered as another indicator of vaccination program performance to ensure timely administration of vaccination for children. In contrast to this, a study done in Zhejiang province of China found a comparably high proportion of age-appropriate measles vaccination [33]. Nonetheless, as the national experience of Italy tells us [34,35], measles elimination, of course to all VPDs elimination, will remain unrealized dream unless the vaccination program is being monitored against its schedule with strong political commitment.…”

Urban-rural differences in factors associated with incomplete basic immunization among children in Indonesia: A nationwide multilevel study

“…10,12 Policy-level factors include policies about health and social insurance. 13,14 One focus of this study was to examine rural-urban differences in the incomplete immunization of children. 15 Currently, there are large rural-urban differences in population health and health service utilization in Indonesia.…”

Sero-survey of measles virus antibodies among symptomatic children attending Abuja Teaching Hospital, Nigeria

“…Delayed vaccination extends the period of the risk of disease for the individual child, but under-vaccination/low coverage is what affects herd immunity. Hence, the current indicator for 2 doses MCV is diphtheria-tetanus-pertussis (DTP3) vaccination coverage level [ 5 ], [ 7 ]. Delayed vaccination weakens herd immunity and increases the probability of outbreaks due to a large gap between the protection from vaccination and the loss of maternal antibodies [ 7 ].…”

“…Hence, the current indicator for 2 doses MCV is diphtheria-tetanus-pertussis (DTP3) vaccination coverage level [ 5 ], [ 7 ]. Delayed vaccination weakens herd immunity and increases the probability of outbreaks due to a large gap between the protection from vaccination and the loss of maternal antibodies [ 7 ]. Vaccination coverage is an indicator widely used for evaluating the immunisation program [ 7 ].…”