Spatial distribution, determinants and trends of full vaccination coverage in children aged 12–59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

Abstract

ObjectiveTo assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12–59 months between 2010 and 2019 in Peru.Design, setting and analysisA cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran’s I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic.Outcome measureFVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age.ParticipantsA total of 5 751 and 14 144 children aged 12–59 months from 2010 and 2019 DHSs, respectively, were included.ResultsFVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified.ConclusionsAlthough FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.

Vaccination Coverage and associated factors among under-five children in Ethiopia: Mini Demographic and Health Survey 2019

“…Age of household heads who were 41-50 years of age had lower vaccination coverage than those who were 18-30 years old. The nding was supported by a study conducted in Mynamar and Peru [9,10]. It could explain by household head age evidence suggests that either maternal or paternal maturity of age at child growth has been shown to correlate positively with numerous children's health outcomes and development [11].…”

Inequalities in infant vaccination coverage during the COVID-19 pandemic: A population-based study in Peru

“…After a high FVC during the 2010-2019 period (albeit stagnant) [22], there was a substantial decline evidenced in 2021 among Peruvian infants. In fact, according to our findings, at least three out of ten Peruvian infants had incomplete vaccination coverage in 2021.…”

“…Nationwide, FVC was 66.19 % among infants aged 12 to 23 months in 2021, which represents a decrease of 7.97 % from 2019 (pre-pandemic era) [22]. Several studies conducted in the post-pandemic era have also revealed a marked decrease in routine vaccination coverage among infants and a slow recovery afterwards [33][34][35].…”

“…By implementing policies addressing the factors associated in the Peruvian setting, FVC would broaden. In addition, there are regional differences in FVC, which might be explained by the presence of clusters with different geographic, geopolitical, and demographic characteristics [12,22]. Therefore, these variations should be studied when it is a priority to identify inequalities in access to vaccines.…”

“…Its comprehensive character profiles it as one of the most complete vaccination plans in LATAM [23]. Nationwide, regional disparities and high-risk clusters for VPD [12,22] have been reported, suggesting potential sociodemographic factors and inequalities in FVC. Despite Peru has a very comprehensive and free-of-charge immunization schedule for infants under five years of age [23], it does not ensure broad coverage.…”