Assessing the timeliness of vaccine administration in children under five years in India, 2013.

Authors:
Brenda W Gillespie
Brenda W Gillespie
University of Michigan
United States
Joseph L Mathew
Joseph L Mathew
Advanced Pediatrics Centre
Matthew L Boulton
Matthew L Boulton
University of Michigan School of Public Health

Vaccine 2019 Jan 27;37(4):558-564. Epub 2018 Dec 27.

Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA; Department of Internal Medicine, Division of Infectious Disease, Michigan Medicine, 1500 E Medical Center Drive, Ann Arbor, MI, USA.

Morbidity from vaccine-preventable diseases is high in India, but precise estimates of vaccination timeliness are difficult to compute because many children lack records of vaccination dates. This study assessed vaccination timeliness after accounting for right and left censoring of data. This cross-sectional study used the 2012-2013 District Level Household and Facility Survey in India. The outcome was vaccination timeliness for 9 vaccine doses: 1 dose Bacillus Calmette-Guérin (BCG), 4 doses oral polio vaccine, 3 doses diphtheria-pertussis-tetanus vaccine (DPT), and 1 dose measles-containing vaccine. Age-specific probabilities of vaccination were calculated using Turnbull estimators: children not yet vaccinated were right censored, and children vaccinated but without a recorded date were left censored. Data from 108,783 children under 5 years were available. For children 25-60 months, maternal recall was a more common source of information than a vaccination record with dates. At one month past the recommended vaccination age, estimated coverage ranged from 35% for DPT-3 to 55% for BCG. Accounting for censored data improved vaccination timeliness measures, and demonstrated little increase in vaccination coverage after age one. Efforts to reduce morbidity from vaccine-preventable diseases in India should focus on eliminating missed opportunities for vaccination and instituting special vaccination programs for older children.

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Source
http://dx.doi.org/10.1016/j.vaccine.2018.12.035DOI Listing
January 2019
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