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Timeliness of routine vaccination among children and determinants associated with age-appropriate vaccination in
Santosh Kumar Rauniyar1, Enkhtuya Munkhbat1, Peter Ueda1,2
1Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Insights
Timely childhood vaccinations are crucial. This study in Mongolia found that while initial vaccine doses were often on time, subsequent doses were frequently delayed, highlighting the need for improved age-appropriate vaccination monitoring and interventions.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Routine childhood immunizations are vital for preventing vaccine-preventable diseases.
- Assessing timely vaccination is essential for public health strategies.
- This study focuses on Mongolia's vaccination landscape.
Purpose of the Study:
- To determine the proportion of children receiving routine immunizations on schedule.
- To identify factors influencing timely (age-appropriate) vaccination in Mongolian children.
- To evaluate the coverage of specific vaccines including BCG, Hepatitis B, OPV, Pentavalent, and MMR.
Main Methods:
- A cohort of 879 children aged 12-23 months in Mongolia was studied.
- Kaplan-Meier method was used to assess age-appropriate vaccine administration.
- Multilevel logistic regression analyzed determinants of timely vaccination.
Main Results:
- Crude vaccination coverage exceeded 90% for most vaccines, except MMR1 (86.0%).
- While initial doses (BCG, Hep B, OPV0) were timely, later doses showed significant delays.
- Age-appropriate vaccination coverage varied widely, from 35.9% (MMR1) to 67.7% (OPV1).
- Socio-economic status, religion, residence, mobile phone ownership, and birth season influenced timely vaccination.
- Children from richer households had better odds for timely OPV, Pentavalent, and MMR vaccination.
Conclusions:
- 'Age-appropriate vaccination' is a critical metric to supplement 'crude vaccination coverage' for identifying vaccination gaps.
- Household wealth, place of residence, and religion are key factors for targeted interventions.
- Interventions should focus on improving timely vaccination to achieve adequate coverage in Mongolia.
Introduction:
Routine vaccination at the recommended age is crucial to minimize the risk of acquiring vaccine preventable diseases. This study aimed to assess the proportion of children receiving routine immunization at the recommended age and determinants of timely (age-appropriate) vaccination in Mongolia.
Material And Method:
A total of 879 eligible children aged 12-23 months were included in this study. We investigated age-appropriate administration of Bacillus Calmette-Guerin vaccine (BCG); hepatitis B vaccine (Hep B); oral polio vaccine (OPV); pentavalent vaccine; and measles, mumps, and rubella vaccine (MMR) using Kaplan-Meier method. Multilevel logistic regression with random intercept at cluster level was used to assess the determinants of age-appropriate vaccination.
Results:
Overall, the crude vaccination coverage for routine vaccinations were above 90% for all vaccines except MMR1 which was 86.0% (95% CI, 83.6-88.2). While the first dose of almost all the vaccines given at birth; BCG, Hep B, and OPV0, were administered in a timely manner, a substantial proportion of second and third doses of these vaccines were not given in a timely manner with age-appropriate vaccination coverage ranging from 35.9% (32.8-39.1%) for MMR1 to 67.7% (64.5-70.7%) for OPV1 respectively. Factors associated with age-appropriate administration of the investigated vaccines included socio-economic status of household, religion of household heads, area of residence, owning mobile phone, and season of childbirth. For instance, children belonging to households from richer wealth quintile had higher possibilities of getting age-appropriate OPV1-OPV3, PE1-PE3 and MMR1 vaccines compared to those from the poorest household wealth quintile.
Conclusion:
Our findings suggest that the commonly used indicator 'crude vaccination coverage' could be supplemented by 'age-appropriate vaccination' to help to identify gaps in timely vaccinations and stimulate interventions in Mongolia. Factors such as household wealth quintile, place of residence and religion associated with timely vaccination in our study could be considered to promote effective intervention aiming to improve adequate vaccination coverage.
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