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Unvaccinated children in years of increasing coverage : how many and who are they? : Evidence from 96 low- and middle-income countries

Bosch-Capblanch, X. and Banerjee, K. and Burton, A.. (2012) Unvaccinated children in years of increasing coverage : how many and who are they? : Evidence from 96 low- and middle-income countries. Tropical medicine and international health, 17 (6). pp. 697-710.

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Abstract

Objective While childhood immunisation coverage levels have increased since the 70s, inequities in coverage between and within countries have been widely reported. Unvaccinated children remain undetected by routine monitoring systems and strikingly unreported. The objective of this study was to provide evidence on the magnitude of the problem and to describe predictors associated with non-vaccination. Methods Two hundred and forty-one nationally representative household surveys in 96 countries were analysed. Proportions and changes in time of unvaccinated (children having not received a single dose of vaccine), partially vaccinated and fully vaccinated children were estimated. Predictors of non-vaccination were explored. Results The percentage of unvaccinated children was 9.9% across all surveys. 66 countries had more than one survey: 38 showed statistically significant reductions in the proportion of unvaccinated children between the first and last survey, 10 countries showed increases and the rest showed no significant changes. However, while 18 of the 38 countries also improved in terms of partially and fully vaccinated, in the other 20 the proportion of fully vaccinated decreased. The predictors more strongly associated with being unvaccinated were education of the caregiver, education of caregivers partner, caregivers tetanus toxoid (TT) status, wealth index and type of family member participation in decision-making when the child is ill. Multivariable logistic regression identified the TT status of the caregiver as the strongest predictors of unvaccinated children. Country-specific summaries were produced and sent to countries. Conclusion The number of unvaccinated children is not negligible and their proportion and the predictors of non-vaccination have to be drawn from specific surveys. Specific vaccine indicators cannot properly describe the performance of immunisation programmes in certain situations. National immunisation programmes and national an international immunisation stakeholders should also consider monitoring the proportion of unvaccinated children (i.e. those who have received no vaccines at all) and draw specific plans on the determinants of non-vaccination
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Swiss Centre for International Health (SCIH) > Health Systems Support (Prytherch)
UniBasel Contributors:Bosch-Capblanch, Xavier
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Blackwell Science
ISSN:1360-2276
Note:Publication type according to Uni Basel Research Database: Journal article -- This is the pre-peer reviewed version of the following article: "Unvaccinated children in years of increasing coverage : how many and who are they? : Evidence from 96 low- and middle-income countries", which has been published in final form at SEE DOI. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Language:English
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Last Modified:22 Jan 2018 08:25
Deposited On:19 Jul 2013 07:38

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