Childhood immunization in the Kingdom of Saudi Arabia

Exploring influential factors in childhood vaccine delays in Riyadh, Saudi Arabia

Introduction

Infectious diseases present a substantial worldwide health challenge, yet vaccines have played a crucial role in significantly decreasing illness rates. Despite their effectiveness, global vaccination coverage stands at 85%, leaving a considerable number of infants without routine immunization. Our study seeks to examine the occurrence of delayed primary vaccination and the factors influencing it in Riyadh, Saudi Arabia addressing a critical void in current research.

Methodology

A cross-sectional investigation was carried out in the primary care facilities of the first health cluster in Riyadh, Saudi Arabia. Information was gathered utilizing a well-structured questionnaire, modified from a prior study. The study encompassed children aged two years and younger, accompanied by their parents who brought their vaccination cards for the visit. Non-probability convenience sampling was employed for data collection. Subsequently, the data underwent thorough cleaning in Excel (Microsoft Excel) and was subjected to analysis using IBM SPSS 29 (IBM SPSS Statistics 29).

Results

The study involved 402 participants, primarily over 12 months old, with a balanced gender distribution. Noteworthy findings indicate a 20.9% prevalence of childhood vaccine delays, with reasons such as high-grade fever (33.3%) and travel (26.2%). Significant associations were found in children aged 6-12 months (25.8%, P = 0.039), families with over four children (31%, P = 0.010), perceptions of vaccine harm (50.0%, P = 0.013), and acknowledgment of neglect (96.4%, P = 0.001).

Conclusion

The research illuminates the complex factors influencing childhood vaccine delays in Saudi Arabia. Stressing the significance of personalized interventions, it underscores the necessity to tackle challenges specific to age, parental perspectives, and access issues for improved vaccination outcomes.

Rubella Humoral Immunity Among the Saudi Population of Madinah in the Western Region of Saudi Arabia

Maintaining herd immunity against the rubella virus is important for controlling the spread and recurrence of rubella. Rubella vaccination for children has been affordable in Saudi Arabia since 1982. To assess the immune response derived from vaccination, we assessed the seroprevalence against the rubella virus among the population of the Madinah region. An indirect enzyme-linked immunosorbent assay (ELISA) was used to measure anti-rubella IgG antibodies in 791 serum samples obtained from 336 (42.5%) men and 455 (57.5%) women, ranging from 14 to 49 years in age. Among all participants, 94.2% were seropositive for rubella IgG antibodies, indicating a high degree of immunization. However, 5.8% of participants were seronegative, suggesting a population of either poor vaccine responders or the potential risk of waning vaccine-induced immunity. No significant difference or association with rubella seropositivity was identified according to age, sex, or pregnancy status. The median anti-rubella IgG antibody concentrations differed significantly between age groups (p < 0.001). Although a high percentage of the tested population in Madinah demonstrated anti-rubella IgG antibody seropositivity, a notable percentage of the population were seronegative, making them susceptible to infection.

Vaccine hesitancy towards childhood immunizations as a predictor of mothers' intention to vaccinate their children against COVID-19 in Saudi Arabia

Background

Despite the success of childhood immunization in reducing vaccine-preventable diseases, vaccine hesitancy is now a global health threat to this achievement. The current COVID-19 pandemic may change the picture of vaccine hesitancy toward childhood immunizations, which could influence the mothers’ intention to vaccinate their children against COVID-19.

Aim

To measure the prevalence and related factors of vaccine hesitancy towards childhood immunization during the era of COVID-19 along with the prevalence of mothers’ intention to vaccinate their children the future COVID-19 and its association with childhood vaccine hesitancy.

Methods

Cross sectional study was conducted among 270 Saudi mothers attending outpatient clinics at King Abdullah University Hospital (KAAUH) in Riyadh by purposive sampling technique. Data were collected from January to February 2021 using SAGE Group standardized questionnaire.

Results

Although most mothers strongly agree on the importance of the vaccine (79%), almost one-fourth of mothers were hesitant towards childhood immunization (24.31%). Similar percentage of mothers’ intended to vaccinate their children against COVID-19 in the next 6 months was reported (24%). Vaccine hesitancy was found to be a significant predictor of mothers’ intention. Mothers’ education level was significantly associated with being hesitant towards childhood immunization as well as the intention to accept the future COVID-19 vaccine (p < 0.05). Main reason that was highly significantly associated with being hesitant is the concerns about the side effect (50%).

Conclusion

The present study reported a considerable percentage of mothers who are hesitant towards childhood immunization which predicts their intension to vaccinate towards COVID19 and is associated with the level of education.

Seroprevalence against the measles virus after vaccination or natural infection in an adult population in Madinah, Saudi Arabia

Background: Over the past few years, measles cases have increased worldwide, despite the availability of a safe and highly effective vaccine. Numerous countries have eliminated measles or have made substantial advancements toward elimination.Materials and Methods: This study investigated the seroprevalence of anti-measles antibodies and vaccination status among 362 men and 81 women in Madinah. All participants were vaccinated or acquired immunity naturally due to infection. We aimed to examine the persistence of anti-measles IgG antibodies, which were qualitatively and quantitatively determined using ELISA.Results: We showed that measles seropositivity (92%, n = 408) was significantly more frequent than negative (5.4%, n = 14) and equivocal results (2.5%, n = 11). Among men, 92.8% were seropositive for the anti-measles IgG antibody, whereas 88.9% of women were seropositive. In addition, a significant relationship was observed between age and measles seropositivity, with a significant positive correlation between age and anti-measles antibody concentration as assessed by Spearman's correlation analysis (r = 0.405, p < .001).Conclusion: Based on these results, observing the serological status of the population 20-38 y after vaccination may be necessary to minimize the proportion of individuals who may be vulnerable to contracting measles. Despite the efficacy of the measles, mumps, and rubella vaccine and the positive global impact associated with the use of this vaccine, including a general decline in measles cases, attention must still be paid to the issue of measles risk, and seronegative individuals should be identified and advised to receive a booster dose of the vaccine.

Determining the knowledge of primary healthcare (PHC) physicians and factors influencing practices in the implementation of the catch-up vaccination program in PHC clinics in Dammam, Saudi Arabia

OBJECTIVES

To determine the knowledge of primary healthcare (PHC) physicians and factors influencing implementation of the catch-up vaccination program in PHC clinics in Dammam, Saudi Arabia. Methods: A cross-sectional study was conducted with a sample of 136 general and family physicians between October 2018 and August 2019 in PHC clinics. A self-administered questionnaire related to knowledge, practices, and factors affecting their practices regarding vaccination was given to participants. Their responses were assessed for level of knowledge, practices regarding the vaccination program, and factors affecting their practices, and then compared between family and general physicians. Results: The majority of physicians (60%) surveyed had good knowledge of the catch-up vaccination program and no significant difference was observed between family and general physicians. Most physicians (60%) demonstrated correct knowledge of vaccination schedules and gaps between vaccines; no significant differences were observed between family and general physicians, except for the next scheduled child visit after 3 months, for the 18-month vaccination. A statistically significant difference was observed between family and general physicians related to attending educational lectures and seeing children younger than 5 years. General physicians were more involved in the vaccination program. Conclusion: The overall knowledge and practices of the catch-up vaccination program was satisfactory among PHC physicians. However, a lack of family physicians' involvement in the vaccination program was observed that needs to be addressed in their training program.

Causes of blindness in a pediatric age group at a tertiary healthcare center in the eastern province of Saudi Arabia

Objectives:

To describe causes of blindness and visual impairment (VI) in children in Eastern province, Saudi Arabia.

Methods:

A record-based descriptive cross-sectional study was conducted. Medical records of patients aged 2 to 16 years who were following up in the Pediatric Ophthalmology Clinics, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia between September and December 2018 were reviewed. Causes of vision loss according to visual acuity (VA) with best correction were recorded. Blindness was defined as VA <20/400, VI as VA from 20/400 to 20/60, and visual loss as VA of ≤20/60.

Results:

Of 818 patients, 39% had visual loss, 22.9% were blind, and 71.2% had VI. Common etiologies of bilateral blindness were retinal dystrophy disease and Leber’s congenital amaurosis, whereas unilateral blindness was most common due to trauma and refractive error (RE). Common etiologies of bilateral VI were RE, esotropia, and retinal dystrophy. Unilateral VI was mainly due to RE, cataract, congenital esotropia, and trauma. Of all patients, 58.8% had treatable causes, 22.6% had preventable causes, and 19.5% had non-preventable and non-treatable causes; mostly genetic or congenital (59.7%) rather than acquired (40.2%).

Conclusion:

Genetic or congenital causes are major factors causing blindness. Most causes are treatable and preventable, emphasizing on early detection and treatment of those causes.

How often do children receive their vaccinations late, and why?

OBJECTIVES

To assess vaccination timeliness, risk factors associated with delays and the reasons for delayed vaccinations among children below the age of 3 years in Jeddah, Kingdom of Saudi Arabia.

METHODS

This is a cross-sectional study conducted in Jeddah, Saudi Arabia during the period of May 2016 to August 2017. Data were obtained from parents of children under the age of 3 years using a structured questionnaire comprised of questions about sociodemographics, physical well-being of the child and the reasons that are used to justify delayed vaccinations. Vaccinations were considered delayed if they occurred more than 30 days after the time designated on the primary vaccination schedule. Logistic regression was used to assess the risk factors for vaccination delays.

RESULTS

The study included 351 children. Delayed vaccinations were observed in 85/351 (24.2%) of the sample. Delays were noted to occur most frequently for Measles, Mumps, Rubella vaccine (MMR), seconddose of meningococcal conjugate quadrivalent vaccine (MCV4), second  dose of oral polio vaccine (OPV) and fourth  dose of pneumococcal conjugate vaccine (PCV) in 19/125 (15.2%) of the sample. Traveling at the time of vaccination was the most common delay reason and was reported in 31/142 (21.3%) of the sample.

CONCLUSION

Adherence to vaccination is fairly common in this part of the country. However, vaccination delays are still present and should be addressed to improve health care.