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Age-Appropriate Immunization Coverage in a Rural Community in Edo State, Nigeria
Abstract
Although assessing immunization status at a single point in time (such as 24 months) is a useful marker for national vaccination coverage, it does not provide sufficiently detailed information to identify and understand the intricacies of age-appropriate immunization coverage in a defined geographical area.
In two separate studies up to 45% of children were not up-to-date with their immunization at 24 months of age while delay at the first immunization has been shown to be a strong independent predictor of failure to be completely immunized. Furthermore, vaccination rates may lag for several years before disease incidence increase making susceptible populations difficult to identify in the absence of effective programme evaluation.
Therefore it is important to bench mark the proportion of children under one year who are immunized at the recommended age. This is because for many of these illness, children are susceptible to the infections should they be immunized later than when recommended.
We conducted a secondary analysis on immunization data collected from a rural community, Sabongidda-Ora in Edo State, Nigeria to determine the proportion of children who were immunized at the recommended age. The primary data was collected as a population based immunization coverage assessment using standardized methods. There were 229 children in the original survey. Only children (n=110) whose vaccination cards had information on date of birth and date of vaccination were included in the secondary analysis. This was to allow for computation of actual ages at which each antigen was received.
A child was considered immunized at the recommended age if the vaccine was given not later than 30 days after it was due. This follows the guidelines of the American Paediatric Association. Frequency distribution of variables were produced.
The proportion of children who received the antigens at the recommended ages is shown on Table 1. The proportion as well as the mean period of vaccination shows a wide fluctuation. For BCG, the range of vaccination was 0-225 days of life while for DPT1, it was from 4-32 weeks. Only 26% of the children received all their vaccines within the recommended period. The age-appropriate rates are much lower than was observed for the entire cohort.
These results show that the proportion of children who were vaccinated within 30 days of their being eligible to receive the vaccines was rather small and unsatisfactory. The proportion of children who were not up-to-date with their immunization in this study is similar to the rates reported by other researchers.
Thus there may be large numbers of children who are susceptible to these infections due to the deferment of their vaccination. For example a child who fails to be vaccinated at nine months of age may suffer an attack of measles at 12 months of age with serious complications.
In conclusion, age-appropriate immunization rates were found to be low amongst a subset of children living in a rural Nigeria community. We suggest that immunization coverage rates be detailed enough to include age-appropriate analyses while health education campaigns be mounted to motivate mothers to bring their children early in life for vaccination.
[J. of the Nig. Infection Control Assn. Vol.3(2) 2000: 9]
In two separate studies up to 45% of children were not up-to-date with their immunization at 24 months of age while delay at the first immunization has been shown to be a strong independent predictor of failure to be completely immunized. Furthermore, vaccination rates may lag for several years before disease incidence increase making susceptible populations difficult to identify in the absence of effective programme evaluation.
Therefore it is important to bench mark the proportion of children under one year who are immunized at the recommended age. This is because for many of these illness, children are susceptible to the infections should they be immunized later than when recommended.
We conducted a secondary analysis on immunization data collected from a rural community, Sabongidda-Ora in Edo State, Nigeria to determine the proportion of children who were immunized at the recommended age. The primary data was collected as a population based immunization coverage assessment using standardized methods. There were 229 children in the original survey. Only children (n=110) whose vaccination cards had information on date of birth and date of vaccination were included in the secondary analysis. This was to allow for computation of actual ages at which each antigen was received.
A child was considered immunized at the recommended age if the vaccine was given not later than 30 days after it was due. This follows the guidelines of the American Paediatric Association. Frequency distribution of variables were produced.
The proportion of children who received the antigens at the recommended ages is shown on Table 1. The proportion as well as the mean period of vaccination shows a wide fluctuation. For BCG, the range of vaccination was 0-225 days of life while for DPT1, it was from 4-32 weeks. Only 26% of the children received all their vaccines within the recommended period. The age-appropriate rates are much lower than was observed for the entire cohort.
These results show that the proportion of children who were vaccinated within 30 days of their being eligible to receive the vaccines was rather small and unsatisfactory. The proportion of children who were not up-to-date with their immunization in this study is similar to the rates reported by other researchers.
Thus there may be large numbers of children who are susceptible to these infections due to the deferment of their vaccination. For example a child who fails to be vaccinated at nine months of age may suffer an attack of measles at 12 months of age with serious complications.
In conclusion, age-appropriate immunization rates were found to be low amongst a subset of children living in a rural Nigeria community. We suggest that immunization coverage rates be detailed enough to include age-appropriate analyses while health education campaigns be mounted to motivate mothers to bring their children early in life for vaccination.
[J. of the Nig. Infection Control Assn. Vol.3(2) 2000: 9]
