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Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

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Delays in childhood vaccinations in countries of the former Soviet Union Armenia, Kazakhstan, Kyrgyzstan and Uzbekistan

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  • Manas Akmatov - School of Public Health, Bielefeld
  • Rafael Mikolajczyk - School of Public Health, Bielefeld
  • Alexander Krämer - School of Public Health, Bielefeld

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds466

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/gmds2007/07gmds466.shtml

Published: September 6, 2007

© 2007 Akmatov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Background: A frequently used indicator of vaccination coverage is total up-to-date vaccination, which is a proportion of vaccinated children within a defined age range, usually 12 to 23 months. However, up-to-date vaccination coverage does not consider possible delay in vaccination which can substantially affect the vaccination coverage. The aim of the study was to investigate the timeliness of vaccinations in former Soviet countries.

Methods: We used data from the Demographic and Health Surveys for four countries: Armenia (2000), Kazakhstan (1999), Kyrgyzstan (1997) and Uzbekistan (1996). The sample size with all available information included 1611 children in Armenia, 1345 children in Kazakhstan, 1024 children in Kyrgyzstan and 1245 children in Uzbekistan. Vaccination status was obtained from child health cards. Kaplan-Meier method was used to estimate the vaccination coverage for all vaccines at any given age. The survival function S(t) was estimated as the proportion of not vaccinated children at the end divided by those not vaccinated at the beginning of the time for each interval. Vaccination coverage was estimated as 1 – S(t) at any given time, which is a cumulative coverage over time.

Results: Total up-to-date vaccination coverage was at relatively high levels in all countries. For example it was 92.6% in Armenia, 82.3% in Kazakhstan, 90.4% in Kyrgyzstan and 94% in Uzbekistan for the third dose of polio vaccine. Overall, in Kazakhstan and Kyrgyzstan vaccination coverage displayed a steep increase at the recommended vaccination age but nearly no increase thereafter. In contrast, in Uzbekistan and Armenia the increase of vaccination coverage was slower, but ultimately a higher up-to-date coverage was achieved.

Conclusion: Although total up-to-date coverage was at high levels for all vaccines, a substantial percentage of children was vaccinated with delay. Age-appropriate vaccination should be taken into consideration when assessing vaccination coverage. Results will help to improve vaccination policies.

Outline

References

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Bardenheier BH, Yusuf HR, Rosenthal J, Santoli JM, Shefer AM, Rickert DL, et al. Factors associated with underimmunization at 3 months of age in four medically underserved areas. Public Health Rep. 2004;119(5):479-85.
2.
Demographic and Health Surveys. 2007. Available from http://www.measuredhs.com/. External link
3.
Dayan GH, Shaw KM, Baughman AL, Orellana LC, Forlenza R, Ellis A, et al. Assessment of delay in age-appropriate vaccination using survival analysis. Am J Epidemiol. 2006;163(6):561-70.