Age appropriateness of vaccination with recommended childhood vaccines in Sri Lanka

Vaccination status is conventionally measured by up-to-date coverage. This method does not take in to account whether the vaccines were received at the correct age and interval which is essential for optimal disease protection. Sri Lanka - a lower middle-income country in the Indian Ocean, has previously presented with high vaccination coverage for all childhood vaccines. However, few studies investigating timeliness of vaccinations have until now been carried out in Sri Lanka. Aim: This study was carried out to investigate the individual coverage and age appropriateness of vaccination, in two different demographic settings in Anuradhapura district, Sri Lanka. The study of cross-sectional descriptive design included 633 children born in 2011. Public Health Midwives kept hand-written documentation of the birth and vaccination dates on each child in her geographic area. Vaccination ages were then compared to the timelines of vaccination provided by the Epidemiology Unit of Sri Lanka. The vaccination coverage for all antigens was 97.5% (94.2-99.7%) at age 5-6 years. Timeliness of doses was between 65.0 and 88.6 % (median 80.7%; 65.0-88.6) and significantly lower in the urban population compared to the rural. The present study shows that the vaccine coverage in both urban and rural areas in Sri Lanka was high and that the timeliness predominantly followed national recommendations.