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Timeliness of Childhood Primary Immunization and Risk Factors Related with Delays: Evidence from the 2014 Zhejiang Provincial Vaccination Coverage Survey

Author

Listed:
  • Yu Hu

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

  • Qian Li

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

  • Yaping Chen

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

Abstract

Background: this study aimed to assess both immunization coverage and timeliness, as well as reasons for non-vaccination, and identity the risk factors of delayed immunization, for the vaccines scheduled during the first year of life, in Zhejiang province, east China. Methods: A cluster survey among children aged 24–35 months was conducted. Demographic information and socio-economic characteristics of the selected child, the mother, and the household were collected. Immunization data were transcribed from immunization cards. Timeliness was assessed with Kaplan–Meier analysis for each vaccine given before 12 months of age, based on the time frame stipulated by the expanded program on immunization of China. Cox proportional hazard regression was applied to identify risk factors of delayed immunization. Results: A total of 2772 eligible children were surveyed. The age-appropriate coverage ranged from 25.4% (95% CI: 23.7–27.0%) for Bacillus Calmette–Guerin (BCG) to 91.3% (95% CI: 90.2–92.3%) for the first dose of oral poliomyelitis vaccine (OPV1). The most frequent reason for non-vaccination was parent’s fear of adverse events of immunization. Delayed immunizations were associated with mother having a lower education level, mother having a job, delivery at home, increasing number of children per household, and having a lower household income. Conclusions: Although the timeliness of immunization has improved since 2011, necessary steps are still needed to achieve further improvement. Timeliness of immunization should be considered as another important indicator of expanded program on immunization (EPI) performance. Future interventions on vaccination coverage should take into consideration demographic and socio-economic risk factors identified in this study. The importance of adhering to the recommended schedule should be explained to parents.

Suggested Citation

  • Yu Hu & Qian Li & Yaping Chen, 2017. "Timeliness of Childhood Primary Immunization and Risk Factors Related with Delays: Evidence from the 2014 Zhejiang Provincial Vaccination Coverage Survey," IJERPH, MDPI, vol. 14(9), pages 1-13, September.
  • Handle: RePEc:gam:jijerp:v:14:y:2017:i:9:p:1086-:d:112541
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    References listed on IDEAS

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    1. Yu Hu & Yaping Chen & Bing Zhang & Qian Li, 2016. "An Evaluation of Voluntary Varicella Vaccination Coverage in Zhejiang Province, East China," IJERPH, MDPI, vol. 13(6), pages 1-10, June.
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    Cited by:

    1. Yu Hu & Yaping Chen & Ying Wang & Hui Liang, 2019. "Validity of Maternal Recall to Assess Vaccination Coverage: Evidence from Six Districts in Zhejiang Province, China," IJERPH, MDPI, vol. 16(6), pages 1-9, March.
    2. Yu Hu & Ying Wang & Yaping Chen & Hui Liang, 2019. "Analyzing the Urban-Rural Vaccination Coverage Disparity through a Fair Decomposition in Zhejiang Province, China," IJERPH, MDPI, vol. 16(22), pages 1-10, November.
    3. Yu Hu & Hui Liang & Ying Wang & Yaping Chen, 2018. "Inequities in Childhood Vaccination Coverage in Zhejiang, Province: Evidence from a Decomposition Analysis on Two-Round Surveys," IJERPH, MDPI, vol. 15(9), pages 1-12, September.
    4. Yu Hu & Yaping Chen & Hui Liang & Ying Wang, 2018. "An Overview of Coverage of BCG Vaccination and Its Determinants Based on Data from the Coverage Survey in Zhejiang Province," IJERPH, MDPI, vol. 15(6), pages 1-12, June.

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