Abstract
Immunization has become one of the major contributors to public health globally as it prevents communicable disease, particularly in children. The objective of this study was to estimate the extent of timely immunization coverage and to investigate the determinants of incomplete and untimely vaccination. Methods: The study used data from the latest Bangladesh Demographic Health Survey (BDHS) 2014. A total sample of 1631 children aged 12–23 months who had an Expanded Program on Immunization (EPI) card and immunization history were analyzed. Multivariable logistic regression models were used to determine the significant influencing factors on untimely vaccination (BCG, pentavalent vaccine/OPV, and measles) and incomplete vaccination. The results were presented in terms of adjusted odds ratio (AOR) with a 95% confidence interval and a significance level p < 0.05. Results: The proportions of children who received timely vaccinations were 24% for BCG, 46% for pentavalent 3, and 53% for measles, whereas 76%, 51%, and 36% children failed to receive the BCG, pentavalent 3, and measles vaccines, respectively, in a timely manner. The proportion of early vaccination was 3% for pentavalent 3 and 12% for measles. Several significant influencing factors including age, maternal education and working status, awareness of community clinics, socioeconomic status, and geographic variation significantly contributed to untimely and incomplete vaccination of children in Bangladesh. Conclusions: The study identified some key determinants of untimely and incomplete childhood vaccinations in the context of Bangladesh. The findings will contribute to the improvement of age-specific vaccination and support policy makers in taking the necessary control strategies with respect to delayed and early vaccination in Bangladesh.
Highlights
Immunization has become one of the major contributors to public health globally as it prevents communicable disease, especially among children
This study identified several significant influencing factors, including age, education, and working status of mothers, awareness of community clinic, wealth status, and geographic variation that contribute to untimely vaccination and incomplete vaccination of children in Bangladesh
We found that maternal education is a crucial factor for childhood vaccination, which is in a similar line with other studies in that caregiver education had a positive influence on Bacille Calmette-Guerin (BCG) and measles vaccine coverage [20,21]
Summary
Immunization has become one of the major contributors to public health globally as it prevents communicable disease, especially among children. The Expanded Program on Immunization (EPI) was established in early 1974 to provide all basic vaccines and to immunize every child around the world [1]. Vaccine-preventable diseases remain a potential public health problem in South-East Asia (including Bangladesh) and sub-Saharan Africa because of early or delayed, incomplete, and low vaccination coverage [6]. Bangladesh has had a successful history of immunization and is able to achieve high vaccination coverage against vaccine-preventable diseases. In spite of substantial improvements in maternal and child health and high crude coverage of vaccination, under-five child mortality is still 46 per 1000 live births in Bangladesh [11]. To maintain the quality of immunization services, the World Health Organization (WHO) recommended improving monitoring and surveillance systems involving age-appropriate vaccinations in low-and-middle income countries (LMICs), including Bangladesh [5]. It is necessary to prioritize and monitor the immunization program efficiently in order to reduce delayed and incomplete vaccination and ensure the benefits of immunization
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