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Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

Ntombifuthi Blose1,2, Edina Amponsah-Dacosta1,2, Benjamin M Kagina1,2

  • 1Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Western Cape, South Africa.

Vaccine: X
|January 5, 2022
PubMed

Insights

Timely childhood immunisation in South Africa is crucial for preventing vaccine-preventable diseases (VPDs). This study found delays in routine childhood vaccinations, particularly for DTP and measles vaccines, increasing infant susceptibility to VPDs.

Area of Science:

  • Public Health
  • Epidemiology
  • Immunisation Science

Background:

  • Adherence to immunisation schedules is vital for vaccine effectiveness against vaccine-preventable diseases (VPDs).
  • Limited data exists on immunisation timeliness in sub-Saharan Africa.
  • Routine childhood immunisation timeliness is a critical public health concern.

Purpose of the Study:

  • To assess the timeliness of age-specific routine childhood immunisation in the Western Cape Province, South Africa.
  • To identify risk factors associated with delayed immunisation uptake.
  • To inform strategies for improving vaccine adherence.

Main Methods:

  • Analysis of participant records (N=709) from a prospective health-facility based study in Cape Town (2012-2016).
  • Outcome measure: receiving age-specific immunisations ≥4 weeks after the recommended age per the South African Expanded Programme on Immunisation (EPI-SA) schedule.
  • Statistical methods included proportions, medians, inter-quartile ranges (IQR), and regression analysis.

Main Results:

  • Immunisation coverage declined with age, from 94.9% at birth to 72.0% at 18 months.
  • The highest delay was observed for the 3rd dose of the DTP vaccine (34.6%), while the lowest was for BCG (6.5%).
  • Low and upper-middle socio-economic quartiles were associated with delayed vaccine uptake. The longest median time-at-risk of VPDs was for the 2nd measles vaccine dose (12.9 weeks).

Conclusions:

  • Delayed vaccination increases infant and childhood susceptibility to VPDs.
  • Strategies are needed to mitigate factors contributing to delayed routine childhood vaccine uptake in the Western Cape.
  • Recommendations include enhanced vaccine education and mobile reminder systems for caregivers.

Keywords:
Childhood immunisationSouth AfricaVaccineVaccine adherenceVaccine coverageVaccine preventable diseases

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