Relationship between vaccination and nutritional status in children: Analysis of recent Demographic and Health Surveys

Abstract

Background: A body of evidence suggests that vaccines support the development of the immune system and also improve overall health. Objective: To study the effect of the complete basic vaccination schedule (Bacille Calmette-Guerin, i.e., BCG; measles; polio 3; and Diphtheria, Tetanus toxoids, and Pertussis, i.e., DTP3) on nutritional status of children under 2 years of age. Methods: Recent DHS data from 16 countries conducted after 2013 were used. After a bivariate descriptive analysis, a logistic regression analysis was conducted to predict the likelihood of underweight, stunting, and wasting by immunization status. A combined odds ratio was computed and adjusted for background variables. Results: A significantly higher prevalence of underweight was found among children with incomplete vaccination schedules in seven countries. Similarly, wasting and stunting were frequently observed in under-vaccinated children in four countries. Moreover, logistic regression adjusted for background variables revealed a relation between incomplete vaccination and underweight in Angola, Chad, and Guatemala (95% CI lower bound > 1). Combining data of all countries, underweight (adjusted Odds Ratio, aOR 1.21, 95% CI 1.11‒1.31), wasting (aOR 1.18, 95% CI 1.05‒1.33), and stunting (aOR 1.07, 95% CI 1.00‒1.14) were associated with poor vaccination status. The overall effect was consistent with both sexes except the results for wasting for females and stunting for males, though insignificant. Contribution: To our knowledge, this is the first paper assessing the relation between vaccination and nutritional status at a multi-country level with a huge dataset. Our analysis suggests a poor nutritional status in children with an incomplete vaccination schedule.