Predictors of uptake of newly introduced vaccines in Malawi – monovalent human rotavirus and pneumococcal conjugate vaccines: Evidence from the 2015–16 Malawi demographic and health survey

Ntenda, Peter Austin Morton; Mwenyenkulu, Edward Tisungane; Putthanachote, Nuntiput; Nkoka, Owen; Mhone, Thomas Gabriel; Motsa, Mfundi President Sebenele; Tizifa, Tinashe

doi:10.1093/tropej/fmy050

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…The non-uptake of both NVIs also varied throughout the regions. This finding was in line with multiple studies that have found residence to be a factor in vaccination uptake and coverage [11][12][13][14][15]. Stratified analyses for the RV resulted in small sample sizes which may have led to imprecise confidence intervals for some estimates.…”

Section: Discussionsupporting

confidence: 87%

“…A proper assessment of NVIs should include examining factors associated with uptake to identify potential areas for interventions in order to increase coverage. Previously established factors include structural issues related to immunization programs [8][9][10], residence [11][12][13][14][15], socioeconomic status [13,[16][17][18], parental education [14,16], and siblingship [12,16,[18][19][20]. The COVID-19 pandemic has greatly impacted individuals' wellbeing and further revealed the importance of understanding drivers of vaccine uptake.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with the Uptake of Rotavirus and Pneumococcal Conjugate Vaccines among Children in Armenia: Implications for Future New Vaccine Introductions

Agopian,

Young,

Quinlan

et al. 2023

Vaccines

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Advances in vaccinology have resulted in various new vaccines being introduced into recommended immunization schedules. Armenia introduced the rotavirus vaccine (RV) and the pneumococcal conjugate vaccine (PCV) into its national schedule in 2012 and 2014, respectively. Using data from the Armenia Demographic and Health Survey, the uptake of the RV and the PCV among children aged younger than three years was estimated. Multilevel logistic regression models were used to evaluate individual- and community-level factors associated with uptake. Intra-cluster correlations were estimated to explain variations in uptake between clusters. The uptake proportionof each RV dose were 90.0% and 86.6%, while each PCV dose had values of 83.5%, 79.4%, and 75.5%, respectively. Non-uptake was highest among children less than 6 months old, children with one sibling, children from a wealthy family, or children whose living distance to a health clinic was problematic. Significant variability in non-uptake due to cluster differences was found for both RV doses (30.5% and 22.8%, respectively) and for the second PCV dose (53.9%). When developing strategies for new vaccine implementation, characteristics of the child, such as age, siblingship, and distance to a health clinic or residence, should be considered. Further exploration of cluster differences may provide insights based on the increased uptake of these and other new vaccines.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Factors Associated with the Uptake of Rotavirus and Pneumococcal Conjugate Vaccines among Children in Armenia: Implications for Future New Vaccine Introductions

Agopian,

Young,

Quinlan

et al. 2023

Vaccines

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“…This makes it even more difficult to provide vaccination services. Regional variation of immunization coverage within a country has also been documented in several studies from other developing countries [18, 24, 30, 32–34].…”

Section: Discussionmentioning

confidence: 82%

“…Compared to the two-dose RVV, there is a higher possibility of dropout for the three-dose PCV [29]. Slight differences in coverage between the two vaccines have also been noted elsewhere [30]. According to the EDHS report, the coverage also varies between other vaccines included in the routine EPI schedule in Ethiopia [15].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the uptake of newly introduced childhood vaccinations in Ethiopia: the cases of rotavirus and pneumococcal conjugate vaccines

et al. 2019

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BackgroundChildhood immunization programmes have made substantial contributions to lowering the burden of disease among children in developing countries, however a large proportion of children still remain unimmunized. This study aimed to explore the determinants of rotavirus vaccine (RVV) and pneumococcal conjugate vaccine (PCV) uptake in Ethiopia.MethodsThe 2016 Ethiopian demographic and health survey dataset was used in this analysis. A total of 2004 children aged 12–23 months were included in the analysis. A multivariable logistic regression model was employed to identify the determinants of uptake of the complete schedules of RVV (two doses) and PCV (three doses). Crude and adjusted odds ratios with 95% confidence intervals (CIs) were calculated.ResultsThe uptakes of the complete schedules of RVV and PCV among children aged 12–23 months were 56 and 49.1%, respectively. The likelihood of immunization with the complete schedule of RVV was significantly lower among children from the relatively poor Afar region in Ethiopia (AOR 0.16; 95%-CI 0.04–0.61). Similarly, children living in not only the Afar region (AOR 0.10; 95%-CI 0.03–0.38), but also the Gambela region (AOR 0.25; 95%-CI 0.08–0.83), were less likely to be vaccinated with PCV. On the other hand, children from more wealthy households had higher odds of vaccination with RVV (AOR 1.69; 95%-CI 1.04–2.75). Also attending antenatal care (ANC) was found to be significantly associated with uptake of the complete schedule of RVV and PCV.ConclusionsThe uptake of RVV and PCV is suboptimal in Ethiopia. The uptake of the vaccines were found to be associated with region, ANC use and wealth status.

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“…For example, measles-vaccine uptake in 2019 was estimated to be 92% for the rst dose but only 75% for the second dose (WHO, 2020b; Chirwa et al, 2020). There has overall been a good vaccine uptake for newly introduced immunisations such as the rotavirus (91%) and pneumococcal vaccine (89%) (Ntenda et al, 2019); however, HPV vaccination showed a drop from the rst to the second dose, for example, in the districts of Rumphi (98% to 88%) and Zomba (89% to 76%) (MOH, 2014(MOH, , 2019. In general, less than 70% of eligible children received at least one vaccine dose despite availability; meanwhile, over 90% of eligible caregivers who are in-and out-patients on nonvaccination visits to hospitals have missed at least one vaccination, while about 60% missed more (Ogbuanu et al, 2019;Okeibunor et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Exploring the Drivers of Vaccine Hesitancy Toward Childhood and Adolescent Vaccination in Malawi: A Qualitative Study

Adeyanju¹,

Betsch²,

Adamu³

et al. 2021

Preprint

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Background: Vaccine hesitancy is the delay or refusal of vaccines despite the availability of vaccination services. Although it is considered an important global health threat, it has only rarely been systematically studied within the African context. In this study, we explored the factors that influence vaccine hesitancy among caregivers of children and adolescent girls that are eligible for routine childhood immunisation and the human papillomavirus (HPV) vaccine in Malawi. Methods: The study employed a qualitative exploratory research design. In-depth information was obtained from caregivers of children and adolescent girls eligible for routine immunisation (RI) and the HPV vaccine, respectively, as well as national and district-level representatives of the expanded program on immunisation (EPI) and community stakeholders through key informant interviews and focus-group discussions. These participants were purposively selected using predefined criteria A total of 25 key informant interviews and two focus-group discussions with 13 participants were conducted. Data collection took place between April 20 and May 24, 2020. The interviews were audio-recorded, transcribed verbatim, and then analysed using a thematic content analysis approach. Results: The study shows that most of the vaccine-hesitancy drivers for RI also influenced the newly introduced HPV vaccine. Such drivers were inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, inability to translate knowledge and attitudes into actual vaccination behaviour, low literacy levels of caregivers, complacency occasioned by the stress of distance and transportation logistics, and disconnection between the community healthcare system and community leaders, among others. Conclusion: This study provides deeper insights into the determinants of vaccine hesitancy within the Malawian context. The findings can inform the design of context-specific interventions by decision-makers. While the study provided behavioural insights regarding vaccination behaviour in Malawi, there is need for further quantitative studies that can assess the prevalence of the determinants as well as their causal relationships to vaccine uptake.

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Predictors of uptake of newly introduced vaccines in Malawi – monovalent human rotavirus and pneumococcal conjugate vaccines: Evidence from the 2015–16 Malawi demographic and health survey

Abstract: Strategies aimed at increasing further uptake of rotavirus and pneumococcal vaccines should target uneducation women to improve health knowledge on vaccination.

Cited by 4 publications

References 21 publications

Factors Associated with the Uptake of Rotavirus and Pneumococcal Conjugate Vaccines among Children in Armenia: Implications for Future New Vaccine Introductions

Factors Associated with the Uptake of Rotavirus and Pneumococcal Conjugate Vaccines among Children in Armenia: Implications for Future New Vaccine Introductions

Factors associated with the uptake of newly introduced childhood vaccinations in Ethiopia: the cases of rotavirus and pneumococcal conjugate vaccines

Exploring the Drivers of Vaccine Hesitancy Toward Childhood and Adolescent Vaccination in Malawi: A Qualitative Study

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