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Timeliness of routine vaccination among 24-35 months children in Urban Gambia

Bakalilu Kijera1, Alieu Sowe2, Mary Bobb3

  • 1Expanded Program on Immunization, Ministry of Health, Banjul, The Gambia.

Plos One
|April 3, 2026
PubMed

Insights

Routine childhood vaccination timeliness in urban Gambia has improved but still falls short of targets, particularly for Hepatitis B vaccine and second-year vaccines. Further efforts are needed to reach all children and emphasize timely immunization for disease prevention.

Area of Science:

  • Public Health
  • Pediatrics
  • Epidemiology

Background:

  • High coverage and timely delivery of routine childhood vaccinations are crucial for maximizing protection against vaccine-preventable diseases (VPDs).
  • Assessing vaccination coverage and timeliness in urban settings is essential for identifying gaps and informing public health interventions.

Purpose of the Study:

  • To evaluate the coverage and timeliness of routine childhood vaccinations among children in urban areas of The Gambia.
  • To identify specific vaccines and age groups with suboptimal timeliness for targeted improvement strategies.

Main Methods:

  • A cross-sectional quantitative study was conducted in urban Gambia using a multi-stage cluster sampling method (WHO 30 X 7 approach).
  • Vaccination data were collected from Infant Welfare Cards for children aged 24-35 months.
  • Vaccinations were classified as 'early', 'timely', or 'delayed' based on the Gambia Expanded Program on Immunization (EPI) guidelines; Kaplan-Meier curves were used for analysis.

Main Results:

  • Of 355 children, 88.7% had Infant Welfare Cards; first-year vaccines showed higher coverage than second-year vaccines.
  • Pentavalent vaccine (Penta 1) had the highest timeliness (75.4%), while Oral Polio Vaccine booster (OPVb) had the lowest (29.7%).
  • The Hepatitis B vaccine birth dose had the highest delay rate (68.2%); timeliness decreased for subsequent pentavalent doses.

Conclusions:

  • Vaccination timeliness in urban Gambia has improved but remains below target, necessitating enhanced public health efforts.
  • Specific focus is required on the Hepatitis B vaccine and vaccines administered in the second year of life to combat VPDs effectively.
  • Strategies such as defaulter tracing and strengthened interpersonal communication are recommended to improve vaccination coverage and timeliness.
Abstract

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