Vaccination timeliness and delay in low- and middle-income countries: a systematic review of the literature, 2007-2017

Abstract

Background: Traditional measurements of vaccine coverage at specific ages can mask poor vaccine timeliness. However, optimal measurement of timing is unclear due to variations in countries’ recommended vaccination schedules and lack of a commonly accepted standard for “timeliness”. We conducted a systematic review of literature on vaccine timeliness and delay in low- and middle-income countries from 2007 to 2017.Methods: A search of articles published between January 1 2007 and December 31 2017, was performed in PubMed, EBSCOhost, and Embase.Results: 67 papers were included, of which 83% used a categorical measure of delay and 41% evaluated continuous delay. The most common age at assessment was 1 month, with earlier age benchmarks typically used with birth doses.Conclusions: Categorical definitions of vaccination timing vary widely, with benchmarks of delay varying from days to weeks to months. Use of a continuous measure of vaccine delay may be more informative and comparable.

Vaccination coverage and factors associated with incomplete childhood vaccination among children aged 12-59 months in Miagao, Iloilo, Philippines

“…High vaccination coverage does not necessarily mean timely vaccination, and high coverage may have a low level of timeliness. 12 In this study, the untimely (delayed) vaccination coverage ranged from 2.7% (MMR1) to 88.5% (PCV3). More than half (57.4%) of the BCG vaccination was delayed or untimely.…”

Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan: a secondary analysis of cross-sectional survey data

“…HBRs are a key tool to let families know when the child needs to go back for their next vaccine, however, in Pakistan, current HBR prevalence was 36% and HBR loss rate was 52% in 2012, which reflect that Pakistan has HBRs access problems 25 26. Therefore, it is necessary to conduct large nationally representative surveys or to introduce the electronic system such as m-health for improving the vaccination information and vaccination uptake 27 28…”

“…Reviewing the vaccination card is currently the only way to analyse children’s vaccination status and date in Pakistan. Also, most studies (49/62, 79%) used data from vaccination cards, according to the systematic review of vaccination status 28. Finally, other possible determinants of timely vaccination, such as the number of facility visits, previous experience of healthcare service use, and distance from a health facility or having transportation options/alternatives, were not included in this study.…”

Vaccination timeliness and associated factors among children aged 12-23 months in northwest Ethiopia: community-based study

“…Immunization is a central pillar of universal health coverage (3), and one of the most effective and successful means of public health interventions to control and eradicate serious diseases (4). It is a highly effective strategy that helps the parents to prevent their children from major infectious diseases, sequelae, hospitalization and even death (5).…”