Immunization Coverage Rates Research Articles

The role of management elements in achieving complete basic immunization in infants

Effective efforts to prevent sickness and death of children with Immunization. Immunization protects children from several diseases. The achievement of UCI Puskesmas is still below the national target of 100%. The availability of human resources, costs, facilities infrastructure, and functions management implementation immunization base influences the success of the immunization program base complete in babies. This study aimed to determine the role of management elements in achieving complete basic Immunization in infants. Quantitative research type with cross-sectional design. The population of the study was 32 immunization program holders. The sampling technique used was Total Sampling. Data collection method by interview. Data analysis with Chi-Square Test. The results showed that the elements of poor management were 15 (46.9%), good management elements were 17 (53.1%), immunization coverage was not achieved by 13 (40.6%), and immunization coverage was achieved by 19 (59.4%). There is a relationship between management elements and immunization coverage with a p-value of 0.001. It is expected that there will be the development of immunization health workers in terms of number and competence and rewards for good health workers in the immunization program to achieve immunization coverage rates in each health center area.

Missed Measles Immunisations Places Individuals and Communities at Risk: The Equity Argument for Including Measles in Under-Immunised Definitions

Background: Measles is consistently one of the leading causes of death from vaccine-preventable diseases in children, and cases and deaths have increased globally since 2019. While measles often serves as a ‘canary in the coalmine’ for health system weaknesses, global definitions of zero-dose and under-immunised children continue to centre on those who have missed diphtheria-tetanus-pertussis (DTP) containing vaccine. We propose that lack of receipt of measles vaccine is included in global definitions of ‘under-immunised’ children. Methods: We used publicly available WHO/UNICEF estimates of national immunization coverage (WUENIC) data to determine the number and proportion of children missing out on routine immunisations in each country globally in 2019 and 2022. We stratified countries by income status to further investigate inequalities in vaccine coverage between different countries. Results: In 2022, 50% more children missed out on their first dose measles-containing vaccine compared to DTP1, and 96% of these children resided in low-middle income countries (LMICs), highlighting the compounding inequities in measles immunisations globally. Furthermore, countries with the largest number of children missing out on DTP1 were not reflective of countries with the lowest measles immunisation coverage rates, suggesting targeted programs are needed to reach children who are missing out on measles vaccination. Recommendations: Given the high transmissibility and inequitable burden measles outbreaks pose to both at-risk individuals and communities, especially in LMICs, measles immunisation coverage should be included as a key metric when reporting and estimating the number of under-immunised children globally.

Countries' progress towards Global Health Security (GHS) increased health systems resilience during the Coronavirus Disease-19 (COVID-19) pandemic: A difference-in-difference study of 191 countries.

Research on health systems resilience during the Coronavirus Disease-2019 pandemic frequently used the Global Health Security Index (GHSI), a composite index scoring countries' health security and related capabilities. Conflicting results raised questions regarding the validity of the GHSI as a reliable index. This study attempted to better characterize when and to what extent countries' progress towards Global Health Security (GHS) augments health systems resilience. We used longitudinal data from 191 countries and a difference-in-difference (DiD) causal inference strategy to quantify the effect of countries' GHS capacity as measured by the GHSI on their coverage rates for essential childhood immunizations, a previously established proxy for health systems resilience. Using a sliding scale of cutoff values with step increments of one, we divided countries into treatment and control groups and determined the lowest GHSI score at which a safeguarding effect was observed. All analyses were adjusted for potential confounders. World Bank governance indicators were employed for robustness tests. While countries with overall GHSI scores of 57 and above prevented declines in childhood immunization coverage rates from 2020-2022 (coef: 0.91; 95% CI: 0.41-1.41), this safeguarding effect was strongest in 2021 (coef: 1.23; 95% CI: 0.05-2.41). Coefficient sizes for overall GHSI scores were smaller compared to several GHSI sub-components, including countries' environmental risks (coef: 4.28; 95% CI: 2.56-5.99) and emergency preparedness and response planning (coef: 1.82; 95% CI: 0.54-3.11). Our findings indicate that GHS was positively associated with health systems resilience during the pandemic (2020) and the following two years (2021-2022), that GHS may have had the most significant protective effects in 2021 as compared with 2020 and 2022, and that countries' underlying characteristics, including governance quality, bolstered health systems resilience during the pandemic.

The impact of information and communication technology on immunisation and immunisation programmes in low-income and middle-income countries: a systematic review and meta-analysis.

Low-income and Middle-income Countries (LMIC) are continually working to ensure everyone can access life-saving vaccines. Recognising the considerable impact of Information and Communication Technology (ICT) in healthcare, we performed a systematic review and meta-analysis to summarise ICT effectiveness in improving vaccine delivery in LMICs. A systematic search from January 2010 to August 2023 in MEDLINE, EMBASE, Cochrane Library, BMJ Health & Care Informatics, and grey literature was performed. This search focused on randomised controlled trials (RCTs), non-RCTs, observational, and mixed-methods studies in English, examining ICT's effects on childhood immunisation in LMICs. Risk of bias in RCTs and non-RCTs was assessed using the Joanna Briggs Institute tool, and mixed-methods studies were evaluated with the Mixed Methods Appraisal Tool. A meta-analysis summarised ICT's impact on third pentavalent dose coverage and full immunisation by age one. The study is registered with PROSPERO (CRD42023446062). Of 6535 screened studies, 27 involving 354,979 children were included. All apart from one study demonstrated a positive impact on immunisation coverage and timeliness, completeness and accuracy of records, number of adverse events reporting, vaccine stockouts, and cold chain expansion. The meta-analysis demonstrated that reminders effectively improved coverage rate of the third dose of the pentavalent vaccine (OR 2.32, 95% CI 1.34-4.03) and the full immunisation at one year of age (OR 2.61, 95% CI 1.2-5.67) with significant degrees of heterogeneity, respectively I2 82% and I2 89%. Main concerns for bias in RCTs included unblinded outcome assessors and intervention providers. Interpreting quasi-experimental studies was more challenging due to the higher risk of baseline differences between study arms, statistical methods, and dropouts. Mixed-methods studies often lacked clarity in integrating qualitative and quantitative data. This systematic review confirms the benefits of ICT in immunisation programmes by enhancing various stages of vaccine delivery. Specifically, reminders have been shown to enhance childhood immunisation coverage rates. Deutsche Gesellschaft für Internationale Zusammenarbeit (German Corporation for International Cooperation, GIZ) as part of the Digital Innovation in Pandemic Control (DIPC) Initiative, financed by the Bundesministerium für Wirtschaftliche Zusammenarbeit (Federal Ministry for Economic Cooperation and Development, BMZ).

Inequalities in ownership and availability of home-based vaccination records in 82 low- and middle-income countries

IntroductionHome-based records (HBRs) are widely used for recording health information including child immunisations. We studied levels and inequalities in HBR ownership in low-income and middle-income countries (LMICs) using data from...

Trends and predictors of full immunization coverage in Nigeria

BackgroundImmunization plays a significant role in global health, yet many children in Nigeria do not receive full immunization due to several influencing factors. Therefore, this study examined the trends in Nigeria’s full immunization coverage and identified key predictors that influence full coverage.MethodsThe data for children aged one to five years, across the six geopolitical zones of Nigeria was retrieved from the 2007, 2011, 2016/17, and 2021 national Multiple Indicator Cluster surveys We analyzed the data using univariate logistic regression. Results were presented as adjusted odds ratios (aORs), and statistical significance was set at 0.05.ResultsThe results showed that 12,229 children (74.2%) had been fully immunized. The trend of immunization coverage was 63.6%, 82%, 63.7%, and 76.4% in 2007, 2011, 2016/17, and 2021 respectively. Children of educated mothers (aOR: 2.6; 95% CI 1.45, 4.76) and from the richest families (aOR: 2.1; 95% CI 1.41, 3.11), were more likely to be fully immunized. Conversely, children in rural areas (aOR: 0.6; 95% CI 0.42, 0.81) and from families of more than five (aOR: 0.6; 95% CI 0.46, 0.81) were less likely to be fully immunized.ConclusionAs of 2021, the rate of full immunization coverage in Nigeria was 76.4%, an improvement from the low 2003 rate (12.3%). Maternal education and wealth index are significant sociodemographic determinants for full immunization coverage. Adopting policies that improve access to education for females nationally and access to healthcare, especially in rural areas may significantly increase full immunization coverage.

Persepsi Orang Tua dan Pengasuh terhadap Pemberian Imunisasi Rutin pada Balita Pasca Pandemi Covid-19

Immunization is an effective strategy of the government to reduce morbidity and mortality from Preventable Diseases by Immunization (PD3I). During the Covid-19 pandemic, this situation had a significant impact on the health sector, reducing immunization coverage rates. Currently, Indonesia is in the post-Covid-19 pandemic phase characterized by positive trends in pandemic control. This study aims to understand the perceptions of parents or caregivers regarding the provision of routine immunization to children in the post-Covid-19 pandemic era. The research method used a cross-sectional design with sampling using the quota sampling method, with a total of 100 respondents. Data were collected through a questionnaire adopting the health belief model theory to parents or caregivers who brought their children to the Posyandu for immunization. The results showed that perceptions of vulnerability (p value = 0,071), seriousness (p value = 0,121), and cues to action (p value = 0,731) had an insignificant effect on immunization for toddlers, while perceptions of benefits (p value = 0,008), barriers (p value = 0,000), and self-efficacy (p value = 0,000) had a significant effect on immunization for toddlers in the post-Covid-19 pandemic era (p value < 0.05). The components of the health belief model that form the perceptions of parents or caregivers towards immunization are interconnected, although not all are statistically significant. Therefore, perceptions of vulnerability, seriousness, and cues to action need to be improved to form a good perception of immunization after the Covid-19 pandemic

Foot and Mouth Disease Vaccine Matching and Post-Vaccination Assessment in Abu Dhabi, United Arab Emirates.

Despite the annual vaccination of livestock against foot and mouth disease (FMD) in the United Arab Emirates (UAE), outbreaks of the disease continue to be reported. The effective control of field outbreaks by vaccination requires that the vaccines used are antigenically matched to circulating field FMD viruses. In this study, a vaccine matching analysis was performed using the two-dimensional virus neutralization test (VNT) for three field isolates belonging to the O/ME-SA/PanAsia-2/ANT-10 and O/ME-SA/SA-2018 lineages collected from different FMD outbreaks that occurred within the Abu Dhabi Emirate in 2021 affecting Arabian oryx (Oryx leucoryx), goat, and sheep. In addition, post-vaccination antibodies in sheep and goats were measured using solid-phase competitive ELISA (SPCE) for FMDV serotypes A and O at five months after a single vaccine dose and a further 28 days later after a second dose of the FMD vaccine. An analysis of vaccine matching revealed that five out of the six vaccine strains tested were antigenically matched to the UAE field isolates, with r1-values ranging between 0.32 and 0.75. These results suggest that the vaccine strains (O-3039 and O1 Manisa) included in the FMD vaccine used in the Abu Dhabi Emirate are likely to provide protection against outbreaks caused by the circulating O/ME-SA/PanAsia-2/ANT-10 and O/ME-SA/SA-2018 lineages. All critical residues at site 1 and site 3 of VP1 were conserved in all isolates, although an analysis of the VP1-encoding sequences revealed 14-16 amino acid substitutions compared to the sequence of the O1 Manisa vaccine strain. This study also reports on the results of post-vaccination monitoring where the immunization coverage rates against FMDV serotypes A and O were 47% and 69% five months after the first dose of the FMD vaccine, and they were increased to 81 and 88%, respectively, 28 days after the second dose of the vaccine. These results reinforce the importance of using a second booster dose to maximize the impact of vaccination. In conclusion, the vaccine strains currently used in Abu Dhabi are antigenically matched to circulating field isolates from two serotype O clades (O/ME-SA/PanAsia-2/ANT-10 sublineage and O/ME-SA/SA-2018 lineage). The bi-annual vaccination schedule for FMD in the Abu Dhabi Emirate has the potential to establish a sufficient herd immunity, especially when complemented by additional biosecurity measures for comprehensive FMD control. These findings are pivotal for the successful implementation of the region's vaccination-based FMD control policy, showing that high vaccination coverage and the wide-spread use of booster doses in susceptible herds is required to achieve a high level of FMDV-specific antibodies in vaccinated animals.

Fiscal space for the immunisation program in Zambia– an efficiency analysis approach

ObjectiveThe immunisation programme in Zambia remains one of the most effective public health programmes. Its financial sustainability is, however, uncertain. Using administrative data on immunisation coverage rate, vaccine utilisation, the number of health facilities and human resources, expenditure on health promotion, and the provision of outreach services from 24 districts, we used Data Envelopment Analysis to determine the level of technical efficiency in the provision of immunisation services. Based on our calculated levels of technical efficiency, we determined the available fiscal space for immunisation.ResultsOut of the 24 districts in our sample, 9 (38%) were technically inefficient in the provision of immunisation services. The average efficiency score, however, was quite high, at 0.92 (CRS technology) and 0.95 (VRS technology). Based on the calculated level of technical efficiency, we estimated that an improvement in technical efficiency can save enough vaccine doses to supply between 5 and 14 additional districts. The challenge, however, lies in identifying and correcting for the sources of technical inefficiency.

Optimization of pediatric vaccines distribution network configuration under uncertainty

Millions of young people are not immunized in low income (LI) and lower middle income (LMI) countries because of low vaccine availability resulting from inefficiencies in cold supply chains. We create supply chain network design and distribution models to address the unique characteristics and challenges facing vaccine supply chains in LI and LMI countries. The models capture the uncertainties of demand for vaccinations and the resulting impacts on immunization, the unique challenges of vaccine administration (such as open vial wastage), the interactions between technological improvements of vaccines and immunizations, and the trade-offs between immunization coverage rates and available resources. The objective is to maximize both the percentage of fully immunized children and the vaccine availability in clinics. Our research examines how these two metrics are affected by three factors: number of tiers in the supply chain, vaccine vial size, and new vaccine technologies. We tested the model using Niger’s Expanded Program on Immunization, which is sponsored by the World Health Organization. We make many observations and recommendations to help LMI countries increase their immunization coverage.

Perbandingan Angka Cakupan Imunisasi Dasar Anak Sebelum, Selama dan Setelah Pandemi Covid-19

This research aims to provide a clear picture of the impact of the Covid-19 pandemic on children's basic immunization coverage at the Parongpong Community Health Center, West Bandung Regency from 2019-2023. The research uses a quantitative descriptive approach with sampling techniques using methodstotal sampling. The data used is secondary data from monthly reports of routine immunization results every month. The research results show that the basic immunization coverage rate for children in the Parongpong Community Health Center working area before the 2019 Covid-19 pandemic had good coverage with the highest coverage in December amounting to 1237 (115%). In 2020, during the pandemic, basic immunization coverage for children experienced a significant decline with the highest coverage in January being only 514 children (48%) and in 2021 increasing with the highest coverage being 953 children (88%). In 2022 there will be an insignificant decline. After the Covid-19 Pandemic in 2023, the figure for basic immunization coverage among children showed an increase of 88% or around 953 children were vaccinated. Conclusion, there is a comparison of basic immunization coverage rates for children before, during and after the Covid-19 pandemic. This shows the need for special attention in efforts to restore and increase children's basic immunization coverage after the pandemic. Keywords: Immunization Coverage, Covid-19, Basic Immunization

Space-time heterogeneity of measles, mumps, and rubella vaccination indicators in children from BrazilHeterogeneidad espaciotemporal de los indicadores de inmunización con la vacuna triple viral en la población infantil de Brasil

To evaluate immunization coverage and dropout rates of the measles, mumps, and rubella vaccine across Brazilian regions. This ecological study employing a space-time approach used data from the National Immunization Program (PNI) and the Live Births Information System (SINASC). We estimated the annual variation (2014 to 2021) in immunization coverage and dropout rate of the measles, mumps, and rubella vaccine in children aged 12 and 15 months in the 5 570 Brazilian municipalities. Statistical analysis was conducted for the municipalities contained in each Brazilian region using the space-time scan technique, considering the Poisson probabilistic model and the hypothesis that municipalities with lower immunization coverage or high dropout rates would form space-time clusters. From 2014 to 2021, 38.3% and 12.9% of municipalities achieved a coverage ≥ 95.0% in the first and second doses respectively; 53.6% of municipalities had a high dropout rate (20.0% to 49.9%) and 37.2% had a very high dropout rate. The Northeast region had primary clusters for low coverage of the first (2018 to 2021) and second vaccine doses (2020 to 2021) with higher relative risks (RR) compared to other primary clusters. The RR for high dropout rate was elevated in all Brazilian regions (1.57 to 26.23). In some Brazilian regions, the dropout rate has been high since 2014, signaling a risk of measles resurgence. In turn, space-time analysis indicated lower vaccination coverage in 2020, suggesting the influence of the COVID-19 pandemic.

Comprehensive Outreach: Reach Every Child Initiative Expanded Program on Immunization Khyber Pakhtunkhwa, Pakistan

Background: Vaccination is one of the most effective public health interventions for preventing infectious diseases. In regions like Khyber Pakhtunkhwa, Pakistan, where access to healthcare is limited, immunization coverage often remains below optimal levels. Targeted outreach activities can play a pivotal role in improving vaccine uptake, particularly in underserved populations. Objective: This study aimed to assess the effectiveness of immunization outreach activities in increasing vaccine coverage in Khyber Pakhtunkhwa over a defined period. Methods: A comprehensive methodological approach was utilized involving predefined Excel sheets for daily data collection by trained personnel. Data validation procedures were implemented to ensure accuracy, with regular feedback sessions to improve data collection processes. Monthly reports were compiled and analyzed using SPSS version 25 to summarize immunization activities and coverage rates. The outreach strategy included community announcements and door-to-door campaigns by Local Health Workers (LHWs), designed to identify and vaccinate zero-dose and defaulting children. Results: The outreach campaign significantly improved immunization coverage, with zero-dose vaccinations achieving 100% coverage. Penta I, II, and III vaccines saw coverage rates of 78.99%, 72.48%, and 78.02%, respectively. Measles vaccines MCV-I and MCV-II achieved coverage rates of 83.01% and 86.11%. The overall strategy effectively reduced gaps in vaccine coverage across various districts. Conclusion: The study confirms that structured and well-coordinated outreach activities can effectively increase immunization coverage in areas with limited healthcare access. Continuous effort and strategic planning are essential to sustain and build upon these gains to ensure comprehensive vaccine coverage.

IJCM_225A: Assessment of factors influencing measles vaccine uptake in a metropolitan city: A cross-sectional study

Background: Globally, measles deaths were estimated to be over 1,28,000 in the year 2021, despite the easy availability of safe and effective vaccines to prevent the infection. Routine childhood immunization coverage rates dropped during the COVID-19 pandemic and India has been one of the worst affected countries. The most recent measles outbreak was reported last year in Mumbai, Maharashtra. Objectives: 1. To estimate the level of uptake of measles vaccine in children aged 12 months to 5 years 2. To determine the factors associated with the uptake of measles vaccine. Methodology: This cross-sectional study was conducted over 2 months in a municipal ward of Mumbai during Oct-Nov 2023 in mothers with children aged 12 to 60 months, living in the area for at least past 6 months. Five out of fifteen clusters of Municipal Health Post areas were selected randomly & from each, 82 eligible households were chosen randomly for door-to-door interviews with the participants. Results: Among the sample of 428 children, measles vaccine coverage was 96.7%, but only 263 (61.45%) children were vaccinated in timely manner. The facilitator for mothers in vaccine uptake was receiving information from healthcare workers during and after pregnancy (77.57%). The barriers were lack of information about vaccination schedule (18.69%), and child being unwell during vaccination (10.74%). Conclusion: Huge efforts have been taken by the Public Health Department for achieving this level of vaccine coverage, however, measles elimination is still a challenge due to delayed vaccination.

Assessment of Immunization Coverage and its Determinants Amongst Children in an Urban Area. Study Protocol of a Cross Sectional Study

Abstract* Introduction The country’s immunization rate is frequently below the international and national goals, and it is not distributed evenly. Children should be immunized for several reasons, chief among them being that it is the main defense against a variety of serious and frequently life-threatening illnesses. Every year, it prevents debilitating illness and disability and saves millions of lives throughout the world. The urban population in India is experiencing exponential growth. However, the public sector’s urban healthcare delivery system has encountered difficulties in keeping up with the rapid pace, exhibiting limitations in its reach and falling short of meeting the increasing demands. There is a need for government to pay attention at immunization rates and related variables in children (12–23 months) in the urban area. Objectives • To assess the overall immunization coverage rate for children in the urban area. • To assess the determinants associated with immunisation coverage in an urban area. • To explore healthcare access and infrastructure: Examine the availability and accessibility of healthcare facilities and vaccination services within the urban area. Method Information will be collected using semi- structured questionnaire in kobo collect tool. The parents of the child will be asked whether they have their immunization cards with complete immunization of their children. Study implications This study seeks to appraise the participant’s current immunization status with association to various determinants related to immunisation coverage. The study will also explore the availability of health infrastructure in association with immunization coverage. Furthermore, the gathered data may be utilized in further studies.

Immunization of Children under 2 Years Old in the Coastal Hadhramaut Governorate, Yemen, during Public Health Emergencies: A Trend Analysis of 2013-2020.

Although immunization is one of the most successful and cost-effective interventions that prevents millions of infant and child deaths yearly, it has failed to achieve its intended goals in some low-income countries. Yemen is currently experiencing the most extreme humanitarian crisis globally, which has affected health and worsened its economy and political governance instability. There are few reports on Yemeni vaccination statuses. The present study aimed to investigate the effect of the public health emergency crises on childhood immunization in Yemen. A retrospective descriptive study was conducted in the Coastal Hadhramaut Governorate, Yemen. Secondary data from governorate annual reports for 2013-2020 were extracted. The assessment of the annual immunization coverage rate according to each vaccine was tabulated. The analysis revealed that the 2013-2019 vaccination coverage in Coastal Hadhramaut demonstrated an increasing trend. However, vaccination coverage decreased for all vaccines in 2015-2016 and 2020. Although all three doses of the pentavalent vaccine demonstrated >85% coverage in all years, the coverage of the first and second doses decreased in 2016, and the coverage of all doses decreased in 2020 during the COVID-19 pandemic. Public health emergencies negatively affected routine immunization coverage in Yemen. The trend correlated with the humanitarian crisis and other research findings in Yemen. The national response to public health threats during emergency crises must involve strengthening the program for monitoring and evaluating vaccine-preventable diseases.

A Holistic Strategy of Mother and Child Health Care to Improve the Coverage of Routine and Polio Immunization in Pakistan: Results from a Demonstration Project.

The eradication of poliovirus and improving routine immunization (RI) coverage rates present significant challenges in Pakistan. There is a need for interventions that focus on strengthening community engagement to improve routine immunization coverage. Our primary objective is to assess the impact of an integrated strategy designed to enhance community engagement and maternal and child health immunization campaigns on immunization coverage in Pakistan's high-risk union councils of polio-endemic districts. We implemented an integrated approach for routine immunization and maternal and child health in the polio-endemic district of Pakistan. This approach involved setting up health camps and actively engaging and mobilizing the local community. An independent team conducted surveys at three key points: baseline, midline, and endline, to evaluate immunization coverage among children under the age of five. The primary outcome measures for the study were coverage of OPV, IPV, and changes in the proportion of unvaccinated and fully vaccinated children. To select clusters and eligible households in each cluster, we utilized a 30 × 15 cluster sampling technique. Multivariable associations between socio-demographic factors and changes in the proportion of fully vaccinated children at the UC level were assessed using hierarchical linear regression models. A total of 256,946 children under the age of five (122,950 at baseline and 133,996 at endline) were enrolled in the study. By the endline, full immunization coverage had increased to 60% or more in all three study areas compared to the baseline. Additionally, there was a significant increase in the coverage of both OPV and IPV across all three provinces at the endline. The full immunization rates were assessed on three levels of the framework: the distal, intermediate (access and environment), and proximal level (camp attendance and effectiveness). At the distal level, on multivariate analysis, family size was found to be a significant predictor of change in immunity within the families (β = 0.68; p ≤ 0.0001). At the intermediate level, the likelihood of full immunization decreased with the decrease in knowledge about vaccination (β = -0.38; p = 0.002), knowledge about polio vaccine (β = -0.25; p = 0.011), and knowledge about IPV (β = -0.06; p = 0.546). Perceived obstacles to vaccination were fear of adverse events (β = -0.4; p ≤ 0.0001) and lack of education (β = 0.23; p = 0.031), which were found to be significant in bivariate and multivariate analyses. At the proximal level, community mobilization (β = 0.26; p = 0.008) and attendance at health camp (β = 0.21; p ≤ 0.0001) were found to enhance full immunization coverage. On the other hand, the most prominent reason for not attending health camp included no need to attend the health camp as the child was not ill (β = -0.13; p = 0.008). This study found that community mobilization and attendance at health camps significantly enhanced full immunization coverage. The findings highlight the importance of community engagement and targeted interventions in improving immunization coverage and addressing barriers to healthcare seeking.

FAKTOR TINGKAT KEPATUHAN IBU DALAM PEMBERIAN IMUNISASI DASAR PADA MASA PANDEMI COVID-19 DI WILAYAH KERJA PUSKESMAS SINGOSARI KABUPATEN MALANG

Background: Immunization is a low-cost health measure to lower morbidity, mortality, and disability resulting from diseases that can be prevented by vaccination (PD3I). The implementation of health programs, such as immunization services and surveillance of diseases that can be prevented by immunization (PD3I) has been impacted by the COVID- 19 outbreak in Indonesia. For instance, Integrated Healthcare Center service disruptions and a decline in immunization coverage rates. Objective: To determine the level of maternal compliance in providing primary immunization during the COVID-19 pandemic in the Singosari Public Health Center’s Work Area, Malang Regency. These factors consist of knowledge, family support and perceived barriers that mothers feel towards compliance in providing basic immunizations. Methods: A cross-sectional strategy was used in this study along with an analytical observational methodology. There were 110 mother’s of youngsters under 2 years old as respondents. Data were collected using online survey and the data analyzed using chi-square test. Results and Discussion: The findings of the chi-square test on the knowledge variable and compliance to primary immunization revealed no association (p-value = 0,617), as well as there was no relationship between the family support and compliance (p-value = 0,632). There was a substantial correlation between mother's barriers perceptions and primary immunization compliance (p-value = 0,020). Conclusions: In providing primary immunization during the COVID-19 pandemic in the Singosari Public Health Center, Malang Regency. There is a relationship between the barriers perceived by the mother and immunization compliance. There is no relationship between knowledge and immunization compliance, and there is no relationship between family support and immunization compliance.

THE EFFECTIVENESS OF THE EDUCATIONS TO POSTPARTUM ON IMMUNIZATION BEHAVIOR

Introduction: Immunization coverage in Cipelah village, Rancabali sub-district Bandung Regency in the last 3 months has decreased. So that the immunization coverage rate is below the set target of 80% (UCI). This happens, among others, because the education and knowledge of mothers is lacking so that mothers consider that immunizing babies is not necessary, while immunization itself has a very important function, namely to increase immunity in infants.. Method: This research uses analytic quantitative method with quasy experimental design. The population in this study were first-day postpartum mothers in Cipelah Village, Rancabali District, while 36 sample to be used in this study was taken from the population using purposive sampling technique where each member of the population must meet the inclusion criteria to become a sample in this study. Data analysis used in this study is the Chi square test.. Objectives: The purpose of this study was to determine the effect of providing education on maternal behavior in providing immunization to infants in Cipelah Village, Rancabali District, Bandung Regency. Result: The results showed that the characteristics of the two groups were homogeneous, namely most of them were 20-35 years old, had 1-3 children, the last education was high school, and the respondents' work status was housewives. The statistical test results show a value of p=0.01 <0.05 which means that there is a relationship between the provision of education to postpartum mothers with the behavior of immunization in infants.. Conclusion: There is an influence between the provision of education on maternal behavior in providing immunization to infants.

Benefits and Challenges of Sealing Deceased Individual Immunization Records in Immunization Information Systems (IIS): An Overview of Iowa's Process.

Data cleansing practices aimed to improve data quality in immunization information systems (IIS) continue to be identified and evaluated by immunization programs to generate accurate and reliable immunization coverage rates. The Iowa Immunization Program has implemented several automated, daily data cleansing practices to improve the quality of records in Iowa's Immunization Registry Information System (IRIS), including the process of sealing records of deceased individuals through vital records matching. This process removes deceased individual records from the active IIS population, which helps reduce denominator inflation and improve the accuracy of immunization rate calculations. Other benefits to this process include decreasing record fragmentation, increasing completeness and accuracy of IIS data, improving reminder/recall functionality, and supporting better clinical decision-making for providers. This process is one of multiple practices implemented in IIS to improve data quality and is limited by several factors, including the inability to capture deaths for out-of-state records.