Barriers to timely administration of birth dose vaccines in The Gambia, West Africa

Reiko Miyahara · Momodou Jasseh · Pierre Gomez · Yusuke Shimakawa · Brian M Greenwood · Karamba Keita +3 more

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

Abstract

OBJECTIVE: Although vaccine coverage in infants in sub-Saharan Africa is high, this is estimated at the age of 6-12 months. There is little information on the timely administration of birth dose vaccines. The objective of this study was to assess the timing of birth dose vaccines (hepatitis B, BCG and oral polio) and reasons for delayed administration in The Gambia. METHODS: We used vaccination data from the Farafenni Health and Demographic Surveillance System (FHDSS) between 2004 and 2014. Coverage was calculated at birth (0-1 day), day 7, day 28, 6 months and 1 year of age. Logistic regression models were used to identify demographic and socio-economic variables associated with vaccination by day 7 in children born between 2011 and 2014. RESULTS: Most of the 10,851 children had received the first dose of hepatitis B virus (HBV) vaccine by the age of 6 months (93.1%). Nevertheless, only 1.1% of them were vaccinated at birth, 5.4% by day 7, and 58.4% by day 28. Vaccination by day 7 was associated with living in urban areas (West rural: adjusted OR (AOR)=6.13, 95%CI: 3.20-11.75, east rural: AOR=6.72, 95%CI: 3.66-12.33) and maternal education (senior-educations: AOR=2.43, 95%CI: 1.17-5.06); and inversely associated with distance to vaccination delivery points (≧2km: AOR=0.41, 95%CI: 0.24-0.70), and Fula ethnicity (AOR=0.60, 95%CI: 0.40-0.91). CONCLUSION: Vaccine coverage in The Gambia is high but infants are usually vaccinated after the neonatal period. Interventions to ensure the implementation of national vaccination policies are urgently needed.

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References

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2019Vaccination timeliness and delay in low- and middle-income countries: a systematic review of the literature, 2007-2017 2017Maternal education, empowerment, economic status and child polio vaccination uptake in Pakistan: a population based cross sectional study 2018Implementing a Birth Dose of Hepatitis B Vaccine in Africa: Findings from Assessments in 5 Countries 2022Implementation Approaches for Introducing and Overcoming Barriers to Hepatitis B Birth-Dose Vaccine in sub-Saharan Africa

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