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Comparison of two survey methodologies to assess vaccination coverage
Elizabeth T Luman1, Alemayehu Worku, Yemane Berhane
1Global Immunization Division, National Immunization Program, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. ECL7@cdc.gov
International Journal of Epidemiology
|April 11, 2007
Summary
Systematic random sampling (SystRS) offers methodological advantages over the Expanded Program on Immunization (EPI) methodology for vaccination coverage surveys. SystRS is recommended for its feasibility and accuracy in assessing immunization services.
Area of Science:
- Public Health
- Epidemiology
- Survey Methodology
Background:
- Vaccination coverage measurement is crucial for evaluating and targeting immunization services.
- The World Health Organization's Expanded Program on Immunization (EPI) methodology is widely used for vaccination coverage surveys.
- Concerns exist regarding the methodological rigor and potential bias introduced by the household selection in EPI sampling.
Purpose of the Study:
- To compare the Expanded Program on Immunization (EPI) sampling methodology with systematic random sampling (SystRS) for vaccination coverage surveys.
- To assess the methodological rigor, feasibility, and results of EPI sampling versus SystRS in Ethiopian districts.
Main Methods:
- Vaccination coverage surveys were conducted in urban (Ambo) and rural (Yaya-Gulelena D/Libanos) districts of Ethiopia.
- Households were selected using both EPI sampling and systematic random sampling (SystRS).
- Chi-square tests compared results; relative feasibility was assessed.
Main Results:
- High measles campaign coverage (95% in Ambo, 91-94% in Yaya-Gulelena D/Libanos) was observed.
- Routine vaccination coverage for 12-23 month olds was below 20% in both districts.
- EPI sampling yielded higher routine coverage estimates in Ambo, while SystRS showed methodological advantages and comparable feasibility.
Conclusions:
- Systematic random sampling (SystRS) is preferred over EPI sampling due to methodological advantages and demonstrated feasibility.
- Further validation of SystRS in diverse settings is recommended for robust vaccination coverage assessment.
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