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Infant vaccination timing: Beyond traditional coverage metrics for maximizing impact of vaccine programs, an example

Michelle M Hughes1, Joanne Katz1, Janet A Englund2

  • 1Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Disease Epidemiology and Control, 615 North Wolfe Street, Baltimore, MD 21205, USA.

Vaccine
|January 21, 2016
PubMed

Insights

Infant vaccination timing is delayed in Nepal, with many missing crucial early doses despite high coverage rates. This study highlights the need to track vaccine timeliness for better child health outcomes.

Area of Science:

  • Pediatrics
  • Public Health
  • Vaccinology

Background:

  • Current immunization programs assess coverage but not the timeliness of vaccine administration.
  • Limited data exist on vaccination timing within the critical first six months of life.
  • Severe infant diseases are most prevalent during the first six months.

Purpose of the Study:

  • To estimate the time to Bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis-Hepatitis B-Haemophilus influenzae type b (DTP-Hib-HepB), and oral polio vaccine (OPV) vaccinations.
  • To identify risk factors for delayed infant vaccinations in southern Nepal.
  • To assess vaccination timeliness in infants under six months.

Main Methods:

  • Weekly home visits were conducted from birth to six months to record vaccinations.
  • Kaplan-Meier curves estimated time to vaccination.
  • Cox-proportional hazards models identified risk factors for vaccination delay.

Main Results:

  • Median age for BCG, OPV, and DTP-Hib-HepB receipt was 22, 21, and 18 weeks, respectively.
  • Nearly half of infants did not receive BCG by six months.
  • Only 8% and 7% of infants completed three doses of OPV and DTP-Hib-HepB by six months.

Conclusions:

  • Significant delays in infant vaccine receipt were observed in southern Nepal.
  • High traditional coverage metrics mask critical delays in timely vaccination.
  • Immunization programs should monitor vaccine timeliness to optimize disease control and child health.
Abstract

Keywords:
Childhood immunizationNepalVaccination coverageVaccination timeliness

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