Abstract
To assess the Bacille Calmette-Guérin (BCG) vaccination coverage in Zhejiang province and to investigate predictors of the BCG vaccination, we used data from the 2017 Zhejiang provincial coverage survey. Demographic and immunization data on the selected children, their mothers, and their families were also collected by using a pre-tested questionnaire. BCG scars were verified among children who were available at the moment of survey. Coverage of BCG and other expanded program on immunization (EPI) vaccines scheduled before the first year of life was calculated. BCG coverage through the scar assessment and timeliness of BCG were also presented. Multivariate analyses of the predictors associated with the BCG vaccination and its timeliness were conducted separately. In total, 1393 children agreed to participate in the survey and presented the immunization cards. Of them, the coverage of BCG was 92.0% and 88.3% received the BCG within the first 28 days after birth. Besides this, 1282 out of the 1393 children were screened for the BCG scars and 97.1% of them had developed the scars. The multivariable logistic regression analyses indicated that hospital delivery, higher maternal education, a mother with no job, and a resident child were positively associated with the higher BCG vaccination coverage and its timely administrations. BCG coverage was optimal and it was administered in a timely manner. The majority of children vaccinated with BCG developed scars. Tailored interventions should be more greatly focused on and targeted to children with the risk factors identified in this study.
Highlights
Tuberculosis (TB) remains a global concern of public health as it is one of the leading causes of death by infectious agents worldwide and is responsible for an estimate of over one million deaths annually [1]
1393 children presented an immunization card to the field interviewer for transcription of the information on immunization and 1282 children were screened for Bacille Calmette-Guérin (BCG) scars as they were at home during the interview
Of the children with immunization cards, 51.5% were male, 92.0% were delivered in hospital, 40.1% were migrants, 49.0% lived in rural areas, and 58.0% were within a distance of 5 km to the immunization clinics
Summary
Tuberculosis (TB) remains a global concern of public health as it is one of the leading causes of death by infectious agents worldwide and is responsible for an estimate of over one million deaths annually [1]. The efficacy of Bacille Calmette-Guérin (BCG) against pulmonary TB is controversial [2], it is the only available vaccine to prevent the most severe forms of childhood. TB, with a vaccine efficacy against TB meningitis and miliary TB of 73% and 77%, respectively [3,4]. An additional importance of BCG vaccination is its proximity to the delivery and being an entry point to an expanded program on immunization (EPI) and other public health services [7]. The immunization policy of BCG issued by the Chinese center for disease and prevention includes three aspects: first, all newborns need to be administrated BCG at birth, except for a positive or suspicion of HIV infection; second, children three months to three years old without BCG vaccination
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