Factors Associating Vaccination Delay among Jordanian Children under Two Years of Age

Vaccination delay and associated factors among children of age 12-23 months in Gomma district, Oromia, Ethiopia, 2022

Baby vaccination on time is still a concern, despite the fact that timely and full immunization of children could avert 90% of child mortality attributable to infectious diseases and nutritional problems that are preventable by vaccines. Although numerous research has been conducted on vaccination coverage, only a few studies have highlighted immunization delay and its associated factors in Ethiopia. Additionally, most of them were produced using data from urban populations. Therefore, this study aimed to determine the magnitude of vaccination delay and its associated factors among children aged 12-23 months in the Gomma district, which is one of the prevalently rural districts in Ethiopia. A community-based cross-sectional study was conducted at selected kebeles in the Gomma district from April 1 to 30, 2022, among 528 mother/caregiver-child pairs. A multistage sampling procedure was applied to select the study kebeles and households. Data were collected by face-to-face interviews using a structured questionnaire. The statistical software SPSS version 26 was used for analysis. Bivariable and multivariable binary logistic regression were fitted. Finally, an adjusted odds ratio (AOR) with a 95% CI and a p value < 0.05 was used to describe an association. A total of 528 participants were included in the study. The proportion of delayed vaccination was 40.50% (95% CI 36-44%). Home delivery (AOR 4.32; 95% CI 1.30-14.70), lack of post-natal follow-up [AOR 3.13; 95% CI (1.56-6.47)], and birth order of third and above (AOR 3.20; 95% CI 1.12-9.14) were found to be risk factors for vaccination delay. While a maternal age of above 31 years (AOR 0.40; 95% CI 0.10-0.80) was found to be a protective factor against vaccination delay. The proportion of delayed vaccination was considerable. Implementation of interventions that promote institutional delivery, post-natal service utilization, and increasing knowledge of vaccination schedules are important to minimize the proposition of vaccination delay among children in the study area.

Immunization information systems' implementation and characteristics across the world: a systematic review of the literature

INTRODUCTION

Immunization Information Systems (IISs) are essential public health tools, supporting the management and analysis of vaccination data to aid clinical and strategic decision-making.

METHODS

Following PRISMA guidelines, this systematic review investigated global state and operational characteristics of IISs. A comprehensive search across multiple databases up to 6 June 2023, identified 2,612 articles, with 238 included.

RESULTS

A significant increase in IIS research was observed in recent years, with a strong preference (84.5%) for electronic immunization registries (EIRs). Notably, 36% of IISs operate at the national level, and 47.7% meet the U.S. CDC definition, 17.0% are interoperable with personal health records, and 11.7% provide direct access to vaccination data for vaccinees or their guardians. Other key features include automated reminder systems for recipients and providers (12.1%), near real-time or real-time data entry (11.0%), the inclusion of demographic and socioeconomic data (16.7%), and the capacity to document vaccine refusal or hesitancy (10.2%).

CONCLUSIONS

IISs contribute to improving population-level surveillance of vaccine-preventable diseases. Persistent limitations related to data standardization, interoperability, and cost-effectiveness evaluation must be addressed. Strengthening these aspects is crucial to fully harness the potential of IISs in various healthcare settings, where enhanced vaccination tracking and targeting are most urgently needed.

The impact of the COVID-19 pandemic on childhood vaccination rates and the role of sociodemographic factors: A cohort study

OBJECTIVE

This study examines the impact of the COVID-19 pandemic on both routine and non-routine vaccinations in infants during their initial 18 months of life, concurrently exploring the complex influence of sociodemographic factors.

METHODS

A cohort study was conducted, involving 2007 children in two distinct periods: pre-pandemic (January-June 2018) and pandemic (March 2020-May 2021). Participants were classified into two cohorts: 962 children in the 2018 group and 1045 children in the 2020-21 group. Utilizing unconditional logistic regression, the association between vaccination (complete or non-routine) and socioeconomic factors was examined, with adjustments for potential confounding variables such as age, breastfeeding, gestational age, and twins.

RESULTS

The study's analysis reveals that in the post-pandemic period, mothers were three times more likely to opt for non-routine vaccines (95% CI 2.25-4.23). However, no significant alterations were observed in routine vaccination rates. Protective factors for complete vaccination included having an employed mother, higher education, and a medium-to-high income. Conversely, a higher income was associated with a reduced likelihood of complete vaccination (OR 0.34, 95% CI 0.20-0.59).

CONCLUSION

Contrary to initial expectations, this study concludes that the COVID-19 pandemic did not have a substantial impact on childhood complete vaccination rates. Nevertheless, a noticeable increase in the choice of non-routine vaccination was observed. Sociodemographic factors, such as maternal education, income, and employment status, emerged as key influencers, particularly in the context of deciding on non-routine vaccinations.

Iraqi Parents' Knowledge, Attitudes, and Practices towards Vaccinating Their Children: A Cross-Sectional Study

The focus of coronavirus disease 2019 (COVID-19) vaccination campaigns has been the adult population, particularly the elderly and those with chronic diseases. However, COVID-19 can also affect children and adolescents. Furthermore, targeting this population can accelerate the attainment of herd immunity. The aim of the current study was to evaluate parental intentions to vaccinate their children and the variables associated with them. An online questionnaire was circulated via generic Iraqi Facebook groups to explore parental intentions regarding the vaccination of their children. Multinomial regression analysis was conducted to evaluate variables associated with parental vaccination acceptance. A total of 491 participants completed the study questionnaire. Only 38.3% of the participants were willing to vaccinate their children against COVID-19, while the rest either refused to vaccinate their children (35.6%) or were unsure whether they would (26.1%). Participants’ perceptions about the effectiveness (OR = 0.726, 95% CI = 0.541−0.975, p = 0.033) and safety (OR = 0.435, 95% CI = 0.330−0.574, p < 0.0001) of COVID-19 vaccines were significantly associated with parental acceptance of having children vaccinated. Participants who had received or who were planning to receive the COVID-19 vaccine were significantly less likely to reject vaccinating their children (OR = 0.156, 95% CI = 0.063−0.387, p < 0.0001). There is high refusal/hesitancy among Iraqi parents to vaccinate their children, which is associated with concerns related to the safety and efficacy of COVID-19 vaccines. More efforts, including educational and awareness campaigns to promote the safety and efficacy of COVID-19 vaccines, should be made to increase parental acceptance of childhood COVID-19 vaccinations in Iraq.

Nationwide Routine Childhood Vaccination Coverage During the COVID-19 Pandemic in Jordan: Current Situation, Reasons, and Predictors of Vaccination

BACKGROUND

The healthcare system in Jordan faced substantial burden during the 2020 COVID-19 pandemic including disruption of routine childhood vaccination services.

AIMS

We sought, for the first time, to describe the impact of the 2020 pandemic on vaccination coverage of Jordanian children in Jordan and to identify the key contributing factors.

METHODS

Nationwide vaccination rates were retrieved from the electronic records at the Ministry of Health (2018-2020) enrolling crude births of 220,057 Jordanian children during 2020. Records of doses administered were compared for each month of 2020 with the baseline of 2018-2019. A cross-sectional survey (March-August 2021) was also conducted enrolling a convenient sample of adults aged ≥18 who were Jordanian caregivers for vaccine-eligible children (0-23 months) between 1 January 2020 and the date of the interview. The survey aimed to address caregivers' adherence to routine vaccination during 2020-2021 and to describe the determinants of the current and future adherence to vaccination where multiple logistic regression model was utilized.

RESULTS

The electronic records revealed a significant decline in vaccination coverage during 2020. The greatest decline was observed during the lockdown period from 21 March 2020 to 21 April 2020 (32.4%-46.8%) followed by the decline observed by the entry of the first wave during September-October 2020 (18.4%-22.8%). A drop of 14-16% was observed for the vaccines recommended under the age of 12 months and of 6-7% for those recommended in 1-2-year-old children. The yearly coverage rates for measles-1 (at 9 months), 2 (at 12 months as part of measles-mumps-rubella (MMR) vaccine), and 3 (at 18 months as part of MMR) were 76%, 90%, and 87%, respectively, and for hexavalent-1, 2, and 3 were 78%, 78%, and 77%, respectively. The results of the survey revealed that the main reason for vaccination delay for at least 1 month from the recommended administration time was the lockdown, followed by child illness and smart lockdowns (regional lockdown/health center closure). Vaccination delay was less likely to be observed in children aged ≥12 months (P value < 0.001; OR: 0.18; CI: 0.11-0.29) or children with chronic diseases (P value < 0.05; OR: 0.5; CI: 0.33-0.88).

CONCLUSION

The current study demonstrates a decline in vaccination coverage of Jordanian children during the 2020 COVID-19 pandemic. It is important to formulate future strategies to promote catch-up vaccination and to avoid future backsliding of vaccination rates during further waves of the COVID-19 pandemic or other pandemics. These include improving health services, allaying caregivers' concerns about contracting COVID-19, and arranging vaccination campaigns outside health centers.