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Vaccination timeliness and co-administration among Kenyan children
Nina B Masters1, Abram L Wagner1, Bradley F Carlson1
1Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
Insights
Timely childhood vaccination in Kenya is low, but co-administering vaccines increases the likelihood of timely receipt. Educational programs for low socio-economic groups are crucial for improving vaccine timeliness.
Area of Science:
- Public Health
- Epidemiology
- Immunization Practices
Background:
- Timely vaccination is essential for protecting infants against communicable diseases.
- Co-administration of multiple vaccines is common in the first year of life.
- Understanding factors influencing timely vaccine receipt is critical for public health.
Purpose of the Study:
- To estimate the proportion of timely vaccinations in Kenyan children.
- To determine the proportion of co-administered vaccines.
- To assess the relationship between vaccine co-administration and timeliness.
Main Methods:
- Utilized the 2014 Kenyan Demographic and Health Survey (DHS) data.
- Defined co-administration as vaccines given on the same day.
- Defined timely vaccination as within ±4 days to 4 weeks of the recommended interval.
Main Results:
- Timely vaccination rates varied widely, from 90.2% (Oral Polio Vaccine 0) to 56.0% (Measles).
- Co-administration of the 6-week dose increased odds of timely Penta dose 1 by 2.81 times.
- Birth-dose co-administration significantly increased odds of timely BCG vaccination (AOR 7.43).
Conclusions:
- Despite high overall vaccine coverage, timely vaccination in Kenya is suboptimal.
- Vaccine co-administration, residence, wealth, and child age are linked to timely vaccine receipt.
- Targeted educational interventions for socio-economic groups can improve vaccine timeliness.
Background:
Timely administration of recommended vaccines requires children to have multiple vaccines co-administered in the first year of life. The objectives of this study were to estimate the proportion of timely vaccinations and the proportion of co-administered vaccines, and to assess the relationship between vaccine co-administration and vaccine timeliness in Kenyan children.
Methods:
Using the 2014 Kenyan Demographic and Health Survey (DHS), we calculated the proportion of children who received co-administered and timely vaccine doses. Co-administration was defined as doses administered on the same day with dates recorded on vaccination cards. Vaccines were considered timely if given within four days before to four weeks after the recommended interval for administration.
Results:
10,385 children aged 1-4 years in the Kenyan 2014 DHS dataset had vaccination cards which comprised the study sample. Analysis revealed wide a range for receipt of timely doses, from 90.2% for OPV0 to 56.0% for Measles. Co-administration of the 6-week dose was associated with 2.81 times higher odds of a timely Penta dose 1 (95% CI: 2.28, 3.46) and birth-dose co-administration was associated with a substantial increase in timely BCG vaccination: AOR 7.43 (95% CI: 6.31, 8.75).
Conclusions:
Though vaccine coverage in Kenya was high, timely vaccination was markedly low, with resultant implications for population immunity and potential spread of communicable diseases in unvaccinated infants. Co-administration of vaccines, place of residence, wealth index, and child age were consistently related to the odds of timely vaccine receipt. These relationships reinforce the importance of dedicating resources to programs that educate low socio-economic groups about the importance of vaccine co-administration.
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