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Vaccination coverage and sociodemographic determinants of measles-mumps-rubella vaccination in three different age
Corinne Vandermeulen1, Mathieu Roelants, Heidi Theeten
1Centre for Youth Health Care, Katholieke Universiteit Leuven, Kapucijnenvoer 35, Block D, Box 7001, 3000, Leuven, Belgium. corinne.vandermeulen@med.kuleuven.be
Insights
Achieving 95% measles, mumps, and rubella (MMR) vaccination coverage is crucial for elimination. While toddlers in Flanders approach this goal, documentation issues and lower rates in older children and adolescents require attention.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- The World Health Organization (WHO) European region aims to eliminate measles and rubella by 2010, necessitating 95% coverage for both doses of the measles, mumps, and rubella (MMR) vaccine.
- Belgian vaccination schedules recommend the first MMR vaccine at 12 months and a second dose at 10-12 years of age.
Purpose of the Study:
- To assess the MMR vaccination coverage rates among toddlers, primary school children, and adolescents in Flanders, Belgium.
- To identify sociodemographic factors associated with lower MMR vaccination coverage.
Main Methods:
- A cross-sectional study utilizing a two-stage random cluster sampling method was conducted in Flanders, Belgium, in 2005.
- The study included 1,500 toddlers (18-24 months), 900 primary school children (born in 1997), and 1,500 adolescents (born in 1991).
- Data on MMR vaccination status and sociodemographic factors were collected through home interviews and verified with medical records.
Main Results:
- Overall MMR first-dose coverage was 94.0% in toddlers, 88.0% in 7-year-olds, and 80.6% in adolescents.
- Documentation of the second MMR dose was a concern, with only 74.6% of adolescents having proof of both vaccinations.
- Lower coverage was associated with factors such as single/divorced parents, larger families, non-Belgian parental origin, lower parental education or unemployment, low family income, and vaccination by a general practitioner.
Conclusions:
- The target MMR vaccination coverage of 95% is nearly achieved in toddlers in Flanders.
- Vaccination documentation is a significant issue in older age groups, potentially leading to underestimated coverage rates.
- Children from less privileged backgrounds require targeted interventions to improve MMR vaccination uptake and ensure disease elimination goals are met.
Abstract:
WHO-Europe's goal is to eliminate measles and rubella by 2010 which will require a coverage rate of 95% for both MMR-vaccine doses. Belgian recommendations include a first MMR vaccine at 12 months and a second at 10-12 years of age. To survey MMR vaccination coverage, EPI two-stage random cluster samples of 1,500 toddlers (18-24 months of age), 900 primary school children (born in 1997), and 1,500 adolescents (born in 1991) living in Flanders (Belgium) were drawn. Documented MMR-vaccination was recorded and a questionnaire on sociodemographic factors was completed at home by trained interviewers in 2005. Missing data were retrieved from well-baby clinics and school health service documents. The overall response rate was 89.5%, leaving 3,490 subjects fit for analysis. MMR coverage (first dose) was 94.0% in the toddler group, 88.0% in the 7-year-olds, and 80.6% in adolescents. The 10- to 12-year dose was documented in 83.6% of the adolescents, but only 74.6% had proof of both MMR vaccines. A lower MMR coverage was noted in single or divorced parents (toddlers, adolescents), families with more than four children (toddlers, adolescents), non-Belgian parental origin (children, adolescents), lower education or unemployment of parents (toddlers, children, adolescents), low family income (children, adolescents), vaccination by the GP (toddlers, children), and education-related factors (children, adolescents). The recommended WHO coverage rate of 95% for MMR is within reach in toddlers. Documentation of vaccination is a major concern in older age groups and may explain lower coverage estimates. Children growing up in a less privileged environment deserve special attention.
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