Evaluation of potentially achievable vaccination coverage of the second dose of measles containing vaccine with simultaneous administration and risk factors for missed opportunities among children in Zhejiang province, east China

Measles second dose vaccine uptake and associated factors among under-five children in Jigjiga City, Somali Region, Eastern Ethiopia: a community-based cross-sectional study

Background

Measles is one of the leading causes of under-five mortality and morbidity worldwide. Although the routine service for the second dose of the measles-containing vaccine (MCV2) was introduced in Ethiopia recently, there is a paucity of evidence regarding its coverage and the factors that hinder its uptake at both the local and national levels. Thus, this study aimed to assess the uptake of MCV2 and its associated factors among children aged between 15 and 36 months old in Jigjiga City, Somali Region, Ethiopia.

Methods

A community-based cross-sectional study was conducted among 429 children aged between 15 and 36 months old with their mothers/caregivers in Jigjiga City from April 1 to May 1, 2023. A multistage sampling technique was used and data were collected by using structured interviewer-administered questionnaires. The collected data were entered into Epi-data version 3.2 and analyzed in a statistical package for the social sciences (SPSS) version 26. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with the uptake of the measles second dose vaccine. An adjusted odds ratio with 95% CI were reported and statistical significance was declared at p < 0.05.

Results

The coverage of MCV2 among children aged between 15 and 36 months was 21.4% (95% CI: 17.7, 25.2). The educational status of the mother (AOR = 3.154; 95% CI: 1.68, 5.93), place of delivery (AOR = 1.90; 95% CI: 1.08, 3.25), postnatal care visits of the mother (AOR = 2.40; 95% CI: 1.37, 4.22), time taken to reach a health facility (AOR = 2.67; 95% CI: 1.28, 5.57), and knowledge about child vaccination (AOR = 2.43; 95% CI: 1.45, 4.08) were factors significantly associated with the uptake of the measles second dose vaccine.

Conclusion

The coverage of MCV2 in the study area was low compared to the national immunization targets. Educational status of the mother/caregivers, place of delivery, postnatal care visits of the mother, time to reach a health facility, and knowledge about vaccination of children were significantly associated with measles second dose vaccination. The focus should be given to improving the awareness of mothers on the importance of child vaccination to improve the uptake of measles second dose vaccine and reduce the burden of measles in the region.

Second Dose Measles Vaccination Utilization and Associated Factors in Jabitehnan District, Northwest Ethiopia

Background

Herd immunity against measles is essential to interrupt measles transmission, and this can only be attained by reaching at least 95% coverage for each of the 2 doses of measles vaccine provided in infancy and early childhood age group. It is important to provide everyone with 2 doses of the measles vaccine in order to effectively safeguard the population. Despite this, little is known about the second dosage of the measles vaccine utilization status and the factors that affect it. Therefore, this study aimed to assess second dose of measles vaccination utilization and its associated factors among children aged 24-35 months in Jabitehnan district, 2020.

Methods

A community-based cross-sectional study design was conducted at Jabitehnan District, Northwest Ethiopia, from September 1st, 2020 to October 1st, 2020. Systematic random sampling technique was used to select 845 mothers/caregivers who had children aged 24-35 months. Both bi-variable and multivariable logistic regression was fitted to identify the determinant factors of second dose measles vaccination utilization. Finally, the statistical significant variables were declared by using 95% CI and P value less than .05 in the multivariable logistic regression analysis. The Hosmer and Lemeshow test was used to check the model's fit to the data, and the variance inflation factor was used to assess multi-collinearity.

Results

The overall second dose of measles vaccination utilization was 48.1%, (95% CI: 44.7-51.6). Mothers with primary school education (AOR = 1.91, 95% CI: 1.15-3.17), information about MCV2 (AOR = 6.53, 95% CI: 4.22-10.08), distance from vaccination site (AOR = 3.56, 95% CI: 2.46-5.14), knowledge about immunization (AOR = 1.935, 95% CI: 1.29-2.90), and favorable attitude about immunization (AOR = 5.19, 95% CI: 3.25-8.29) were significantly associated factors with second dose of measles vaccination utilization.

Conclusion

Second dose measles vaccination utilization in the district was lower than the national target. Maternal education, distances from vaccination site, information about MCV2, and knowledge about immunization were significantly associated variables with second dose measles vaccination utilization. Therefore, in order to increase the utilization of the second dose of the measles vaccine, improved health education and service expansion to difficult-to-reach areas are required.

Less than one-fifth of Ethiopian children were vaccinated for measles second dose; evidence from the Ethiopian mini demographic and health survey 2019

Ethiopia introduced the measles second dose vaccine from the routine expanded immunization program in 2018. Shreds of evidence are scarce on the measles second dose vaccination coverage and its associated factors in Ethiopia. We aimed to assess the measles second dose vaccination coverage and associated factors in Ethiopia using the recent Ethiopian Mini Demographic and Health Survey (EMDHS) 2019 data. An in-depth secondary data analysis was conducted based on the Ethiopian mini demographic and health survey 2019 data; which was a cross-sectional survey targeted on key indicators of maternal and child health. A weighted sample of 965 children was included in the analysis. A multi-level mixed effect logistics regression model was fitted. Adjusted Odds Ratio (AOR) with 95 %CI was reported for statistically significant variables. The measles second dose coverage was 12.36 % (95 %CI = 10.89, 15.44). Not vaccinated for the third dose of pentavalent vaccine (Penta 3) (AOR = 0.60, 95 %CI: 0.37, 0.95), age of the child [13 to 23 months (AOR = 2.14, 95 %CI: 1.05, 4.36), 24 to 36 months (AOR = 2.58, 95 %CI: 1.32, 5.05)], household head educational status [no education (AOR = 0.51,95 %CI: 0.26, 0.99), primary (AOR = 0.44, 95 %CI: 0.23, 0.85)], and living in south nation, nationalities and peoples region (SNNPR) (AOR = 2.83,95 %CI: 1.12, 7.11) were significantly associated with measles second dose vaccination coverage. Measles second dose vaccination coverage was low in Ethiopia. Age of the child, being vaccinated for the Penta 3, educational status of the household head, and region of residence were significant determinants of measles second dose vaccination coverage.

Organisational and Structural Drivers of Childhood Immunisation in the European Region: A Systematic Review

Despite the implementation of widespread vaccination programs, the European Health Systems continue to experience care challenges attributable to organizational and structural issues. This study aimed to review the available data on aspects within the organizational and structural domains that might impact vaccination coverage. We searched a comprehensive range of databases from 1 January 2007 to 6 July 2021 for studies that reported quantitative or qualitative research on interventions to raise childhood vaccine coverage. Outcome assessments comprised organizational and structural factors that contribute to vaccine concern among pediatric parents, as well as data reported influencing the willingness to vaccinate. To analyze the risk of bias, the Ottawa, JBI’s (Joanna Briggs Institute) critical appraisal tool, and Amstar quality assessment were used accordingly. The inclusion criteria were met by 205 studies across 21 articles. The majority of the studies were conducted in the United Kingdom (6), the European Union (3), and Italy (3). A range of interventions studied in primary healthcare settings has been revealed to improve vaccination coverage rates including parental engagement and personalization, mandatory vaccination policies, program redesign, supply chain design, administering multiple/combination vaccines, improved vaccination timing and intervals, parental education and reminders, surveillance tools and Supplemental Immunisation Activity (SIA), and information model.

The effect of community comprehensive nursing using scenario-based health education on the infant and young child immunization rates

OBJECTIVE

To investigate the effect of community comprehensive nursing using scenario-based health education on the infant and young child immunization rates.

METHODS

Ninety-eight infants and young children who were given immunizations in our hospital were divided into two groups, with 49 participants in each group. The control group was administered routine nursing, and the research group underwent community comprehensive nursing using scenario-based health education. The vaccination rates, the mastery of vaccination knowledge before and after the nursing, the adverse effects, the compliance, the satisfaction with the nursing, and the incidence of medical disputes were recorded and analyzed.

RESULTS

The delayed vaccination rate was significantly lower in the research group than it was in the control group, and the timely vaccination rate in the research group was significantly higher than it was in the control group (P<0.05). There was no statistically significant difference in the incidences of medical disputes between the two groups (P>0.05). The basic and total vaccination awareness rates were significantly higher in the research group compared with the control group (P<0.05). The incidence of adverse effects in the research group was significantly lower than it was in the control group (P<0.05). The full and total compliance rates in the research group were both significantly higher than they were in the control group (P<0.05). The proportions of very satisfied and completely satisfied were both significantly higher in the research group compared to the control group (P<0.05).

CONCLUSION

In the infant and young child immunization program, community comprehensive nursing using scenario-based health education can effectively increase the vaccination rate, increase the parents' knowledge, enhance their compliance, reduce the adverse effects, and improve the satisfaction with the nursing.

Factors associated with measles vaccination status in children under the age of three years in a post-soviet context: a cross-sectional study using the DHS VII in Armenia

BACKGROUND

The resurgence of measles globally and the increasing number of unvaccinated clusters call for studies exploring factors that influence measles vaccination uptake. Armenia is a middle-income post-Soviet country with an officially high vaccination coverage. However, concerns about vaccine safety are common. The purpose of this study was to measure the prevalence of measles vaccination coverage in children under three years of age and to identify factors that are associated with measles vaccination in Armenia by using nationally representative data.

METHODS

Cross-sectional analysis using self-report data from the most recent Armenian Demographic Health Survey (ADHS VII 2015/16) was conducted. Among 588 eligible women with a last-born child aged 12-35 months, 63 women were excluded due to unknown status of measles vaccination, resulting in 525 women included in the final analyses. We used logistic regression models in order to identify factors associated with vaccination status in the final sample. Complex sample analyses were used to account for the study design.

RESULTS

In the studied population 79.6% of the children were vaccinated against measles. After adjusting for potential confounders, regression models showed that the increasing age of the child (AOR 1.07, 95% CI: 1.03-1.12), secondary education of the mothers (AOR 3.38, 95% CI: 1.17-9.76) and attendance at postnatal check-up within two months after birth (AOR 2.71, 95% CI: 1.17-6.30) were significantly associated with the vaccination status of the child.

CONCLUSIONS

The measles vaccination coverage among the children was lower than the recommended percentage. The study confirmed the importance of maternal education and attending postnatal care visits. However, the study also showed that there might be potential risks for future measles outbreaks because of delayed vaccinations and a large group of children with an unknown vaccination status.

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

Background

This study was aimed to assess the coverage of two doses of measles vaccine and identify the determinants of the delayed vaccination.

Methods

A 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.

Results

The 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.

Conclusions

The 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.