Child's Vaccination History Research Articles

The Evaluation of human papillomavirus vaccination coverage for school aged girls in Badung District, Bali, Indonesia, 2016 – 2018

Background and purpose: Since 2016, Badung District, Bali has implemented a free HPV vaccination program for school children, with vaccination coverage reported to be over 90% in 2016-2018. This study aims to objectively assess the coverage of HPV vaccination among school children in Badung District. Methods: This survey used a cross-sectional design that conducted between March and June 2019. Sample selection was done by systematic random sampling, following the WHO guidelines. A total of 216 families met the sample criteria, with a total of 249 children from all families. Respondents in this study were eligible girls' mothers or families who knew the child's vaccination history. Variables of this study were sociodemographic characteristics of respondents and children, HPV vaccination recall and HPV child vaccination validation. The data collected were analyzed descriptively to calculate the coverage of recall and validation of HPV vaccination. Results: The majority of respondents were mothers (70.83%) with a high school education (51.85%). The median age was 43 years (IQR=8 years). Each family had a mean of 1.15 eligible children (SD=0.39). Of the 249 children, most were aged 16-19 years (43.37%), with age at vaccination mostly ≤12 years (46.52%). HPV vaccination coverage by recall was 82.32% (95%CI: 77.56-87.09), with HPV vaccination coverage by validation was 76.59% (95%CI: 70.74-82.43). Conclusion: After validation, vaccination coverage was lower than vaccination coverage by recall. The health office needs to improve the vaccination registration system, in particular the uniformity of registration and record keeping to ensure proper traceability of vaccination history.

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme.

The WHO recommended the use of the RTS,S/AS01 malaria vaccine (RTS,S) based on a pilot evaluation in routine use in Ghana, Kenya, and Malawi. A longitudinal qualitative study was conducted to examine facilitators and barriers to uptake of a 4-dose RTS,S schedule. A cohort of 198 caregivers of RTS,S-eligible children from communities where RTS,S was provided through the pilot were interviewed three times over a ≈22-month, 4-dose schedule. The interviews examined caregiver perceptions and behaviors. Children's vaccination history was obtained to determine dose uptake. 162 caregivers remained at round 3 (R3); vaccination history was available for 152/162 children. Despite early rumors/fears, the uptake of initial doses was high, driven by vaccine trust. Fears dissipated by R2, replaced with an enthusiasm for RTS,S as caregivers perceived its safety and less frequent and severe malaria. By R3, 98/152 children had received four doses; 34 three doses; 9 one or two doses; and 11 zero doses. The health system and information barriers were important across all under-dose cases. Fears about AEFIs/safety were important in zero-, one-, and two-dose cases. Competing life/livelihood demands and complacency were found in three-dose cases. Regardless of the doses received, caregivers had positive attitudes towards RTS,S by R3. Findings from our study will help countries newly introducing the vaccine to anticipate and preempt reasons for delayed acceptance and missed RTS,S doses.

Treatment outcomes and associated factors among children with severe acute malnutrition at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a retrospective cohort study.

Ethiopia is one of the countries with the highest under-five child mortality rates, with malnutrition remaining the major cause of death. Overall, 10% of children in Ethiopia are wasted, and 3% are severely wasted. To assess the treatment outcomes and associated factors among children with severe acute malnutrition (SAM) at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia, data of 162 under-five children admitted from January to December, 2020, at Hiwot Fana Specialized University hospital were collected retrospectively from 1 January to 20 February 2021. Pre-tested structured questionnaire was used to extract data from medical records. The data was entered into Statistical Package for the Social Sciences version 21 for analysis. A p-value <0.05 was considered statistically significant. In this study, 162 participants were included and 54% were males. The majority (80.2%) of children were newly admitted and 49.7% had less than 7 days of hospital stay, 70.99% recovered from malnutrition, and 42.6% had marasmus. Amoxicillin and gentamycin combination (47.5%) was the most commonly prescribed intravenous antibiotics. Having diarrhoea (AOR = 22, 95% CI: 2.86-169.46), presence of comorbidities such as malaria (AOR = 103.29, 95% CI: 7.42-1437.74) and human immunodeficiency virus (HIV) (AOR = 42.72, 95% CI: 4.47-408.23) were statistically associated with poor recovery from severe malnutrition. More than 70% of children with SAM had good treatment outcomes. Child vaccination history, length of hospital stay, admission weight for height, and presence of comorbidities such as diarrhoea, pneumonia, measles, HIV, malaria, and tuberculosis were factors associated with bad malnutrition and treatment outcomes.

Population Immunity against Serotype-2 Poliomyelitis Leading up to the Global Withdrawal of the Oral Poliovirus Vaccine: Spatio-temporal Modelling of Surveillance Data.

BackgroundGlobal withdrawal of serotype-2 oral poliovirus vaccine (OPV2) took place in April 2016. This marked a milestone in global polio eradication and was a public health intervention of unprecedented scale, affecting 155 countries. Achieving high levels of serotype-2 population immunity before OPV2 withdrawal was critical to avoid subsequent outbreaks of serotype-2 vaccine-derived polioviruses (VDPV2s).Methods and FindingsIn August 2015, we estimated vaccine-induced population immunity against serotype-2 poliomyelitis for 1 January 2004–30 June 2015 and produced forecasts for April 2016 by district in Nigeria and Pakistan. Population immunity was estimated from the vaccination histories of children <36 mo old identified with non-polio acute flaccid paralysis (AFP) reported through polio surveillance, information on immunisation activities with different oral poliovirus vaccine (OPV) formulations, and serotype-specific estimates of the efficacy of these OPVs against poliomyelitis. District immunity estimates were spatio-temporally smoothed using a Bayesian hierarchical framework. Coverage estimates for immunisation activities were also obtained, allowing for heterogeneity within and among districts. Forward projections of immunity, based on these estimates and planned immunisation activities, were produced through to April 2016 using a cohort model.Estimated population immunity was negatively correlated with the probability of VDPV2 poliomyelitis being reported in a district. In Nigeria and Pakistan, declines in immunity during 2008–2009 and 2012–2013, respectively, were associated with outbreaks of VDPV2. Immunity has since improved in both countries as a result of increased use of trivalent OPV, and projections generally indicated sustained or improved immunity in April 2016, such that the majority of districts (99% [95% uncertainty interval 97%–100%] in Nigeria and 84% [95% uncertainty interval 77%–91%] in Pakistan) had >70% population immunity among children <36 mo old. Districts with lower immunity were clustered in northeastern Nigeria and northwestern Pakistan. The accuracy of immunity estimates was limited by the small numbers of non-polio AFP cases in some districts, which was reflected by large uncertainty intervals. Forecasted improvements in immunity for April 2016 were robust to the uncertainty in estimates of baseline immunity (January–June 2015), vaccine coverage, and vaccine efficacy.ConclusionsImmunity against serotype-2 poliomyelitis was forecasted to improve in April 2016 compared to the first half of 2015 in Nigeria and Pakistan. These analyses informed the endorsement of OPV2 withdrawal in April 2016 by the WHO Strategic Advisory Group of Experts on Immunization.

Validity of Parent-Reported Vaccination Status for Adolescents Aged 13–17 Years: National Immunization Survey-Teen, 2008

The validity of parent-reported adolescent vaccination histories has not been assessed. This study evaluated the validity of parent-reported adolescent vaccination histories by a combination of immunization card and recall, and by recall only, compared with medical provider records. We analyzed data from the 2008 National Immunization Survey-Teen. Parents of adolescents aged 13-17 years reported their child's vaccination history either by immunization card and recall (n = 3,661) or by recall only (n = 12,822) for the hepatitis B (Hep B), measles-mumps-rubella (MMR), varicella (VAR), tetanus-diphtheria/tetanus-diphtheria-acellular pertussis (Td/ Tdap), meningococcal conjugate (MCV4), and quadrivalent human papillomavirus (HPV4) (for girls only) vaccines. We validated parental report with medical records. Among the immunization card/recall group, vaccines with > 20% false-positive reports included MMR (32.3%) and Td/Tdap (36.9%); vaccines with > 20% false-negative reports included VAR (35.2%), MCV4 (36.0%), and Tdap (41.9%). Net bias ranged from -25.0 to -0.1 percentage points. Kappa values ranged from 0.22 to 0.92. Among the recall-only group, vaccines with > 20% false-positive reports included Hep B (33.9%), MMR (61.4%), VAR (26.2%), and Td/Tdap (60.6%); vaccines with > 20% false-negative reports included Hep B (58.9%), MMR (33.7%), VAR (51.6%), Td/Tdap (25.5%), Tdap (50.3%) MCV4 (63.0%), and HPV4 (20.5%). Net bias ranged from -46.0 to 0.5 percentage points. Kappa values ranged from 0.03 to 0.76. Validity of parent-reported vaccination histories varies by type of report and vaccine. For recently recommended vaccines, false-negative rates were substantial and higher than false-positive rates, resulting in net underreporting of vaccination rates by both the immunization card/recall and recall-only groups. Provider validation of parent-reported vaccinations is needed for valid surveillance of adolescent vaccination coverage.

Childhood Vaccinations: Are Rates Really Declining?

To the Editor. —The health objectives of the United States for the year 2000 established the goal of completing the basic vaccination series in at least 90% of 2-year-olds. 1 However, coverage rates among preschool-aged children in the United States remain relatively low. Recently, 45 states and the District of Columbia estimated preschool coverage levels by examining the vaccination histories of children who entered school in 1991 and 1992; two additional states conducted surveys of children who were 2 years old in 1991. These assessments showed that median coverage rates at 2 years of age were 59.9% for four doses of diphtheria-tetanus-pertussis (DTP) vaccine, 74.4% for three doses of polio vaccine, and 78.2% for one dose of measles-containing vaccine (Centers for Disease Control and Prevention, unpublished data, 1992). Results from similar assessments conducted in more than 20 urban areas showed that complete coverage rates of the vaccine series were 10%

Anamnestic skin reactivity upon repeated tuberculin tests in the BCG vaccinated or unvaccinated primary school children.

Restoration of skin reactivity to 1 TU of tuberculin (RT23) by repeated tests at 10 days interval has been investigated in the BCG vaccinated or unvaccinated primary school children. The results obtained are as follows. 1) Tuberculin reactors showing 6 mm or larger induration to the first tests were 20.0% in the first grade school children and 33.3% in the sixth grade children. Six millimeter or larger reaction than that of the first reaction was found in 14.9% of the first grade children and in 34.6% of the sixth grade children. 2) Six millimeter or larger reactors were 10.8% of the first grade children without BCG scar against both first and second tests and 11.8% of the sixth grade children on first tests and 10.6% on second tests. There was none or very few, if any, in number of 6 mm or larger difference between the first and second tests among children without BCG scar. In addition, there was no children shown 6 mm or larger second reaction than that of the first reaction and thus those reactors seemed to be natural infection. 3) From questionaire survey, parents of 73.3% of the first grade children and of 72.7% of the sixth grade children were aware of BCG vaccination of their children, while parents of 15.1% and 24.6% of the first and sixth grade children did not know their children's vaccination history even if children possessed BCG scar. 4) Of the first grade children whose parents remembered their BCG vaccination, 65.6% were vaccinated within 4 weeks after birth and 25.5% between 4 weeks and one year. Six millimeter or larger reaction on the first tests was observed in 20.2% of the former group and 15.9% of the latter group, however reactors on the second tests were 32.1% and 31.9% respectively. BCG scar was not observed in 13.9% of children. 5) The majority of children (87.3%) were vaccinated in the skin of deltoid area and some (7.7%) at buttock or other areas. Children received first vaccination at the health centers were 68.5% and 30.3% at hospitals. More than 5 mm reaction was found in 18.7% of the former children and in 15.0% of the latter children. From this study restoration of tuberculin reactivity by repeated tests was found very common among the vaccinated children and thus it should be taken into account for the vaccination policy if it is performed after tuberculin testing.