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Coverage and Timing of Children's Vaccination: An Evaluation of the Expanded Programme on Immunisation in The Gambia

Susana Scott · Aderonke A. Odutola · Grant Austin Mackenzie · Tony J Fulford · Muhammed Olanrewaju Afolabi · Yamundow Lowe-Jallow +5 more

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Vaccine Coverage and Hesitancy Global Maternal and Child Health Immune responses and vaccinations

Abstract

OBJECTIVE: To evaluate the coverage and timeliness of the Expanded Programme on Immunisation (EPI) in The Gambia. METHODS: Vaccination data were obtained between January 2005 and December 2012 from the Farafenni Health and Demographic Surveillance System (FHDSS), the Basse Health and Demographic Surveillance System (BHDSS), the Kiang West Demographic surveillance system (KWDSS), a cluster survey in the more urban Western Health Region (WR) and a cross sectional study in four clinics in the semi-urban Greater Banjul area of WR. Kaplan-Meier survival function was used to estimate the proportion vaccinated by age and to assess timeliness to vaccination. FINDINGS: BCG vaccine uptake was over 95% in all regions. Coverage of DPT1 ranged from 93.2% in BHDSS to 99.8% in the WR. Coverage decreased with increasing number of DPT doses; DPT3 coverage ranged from 81.7% in BHDSS to 99.0% in WR. Measles vaccination coverage ranged from 83.3% in BHDSS to 97.0% in WR. DPT4 booster coverage was low and ranged from 43.9% in the WR to 82.8% in KWDSS. Across all regions, delaying on previous vaccinations increased the likelihood of being delayed for the subsequent vaccination. CONCLUSIONS: The Gambia health system achieves high vaccine coverage in the first year of life. However, there continues to be a delay to vaccination which may impact on the introduction of new vaccines. Examples of effectively functioning EPI programmes such as The Gambia one may well be important models for other low income countries struggling to achieve high routine vaccination coverage.

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References

2018Meeting of the Strategic Advisory Group of Experts on Immunization, April 2012-Conclusions and Recommendations 2009Timing of children's vaccinations in 45 low-income and middle-income countries: an analysis of survey data 2018Global Routine Vaccination Coverage — 2017 2012Timeliness of Childhood Vaccinations in Kampala Uganda: A Community-Based Cross-Sectional Study 2006Assessment of Delay in Age-appropriate Vaccination Using Survival Analysis 2006Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens 2011Vaccination coverage and timeliness in three South African areas: a prospective study 2002Detection of delayed vaccinations: a new approach to visualize vaccine uptake

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2018Vaccine wastage in The Gambia: a prospective observational study 2022Determinants of pentavalent and measles vaccination dropouts among children aged 12–23 months in The Gambia 2022Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978–2021: A scoping review to map measurement and methodological gaps 2020

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