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Pediatr Infect Dis J. 2016 Jun 10. [Epub ahead of print]
On-Time Measles and Pneumococcal Vaccination of Shanghai Children: The Impact of Individual- and Neighborhood-Level Factors.
Wagner AL1 Sun X Huang Z Ren J Mukherjee B Wells EV Boulton ML.
Abstract
BACKGROUND:
Measles-containing vaccines (MCV) and pneumococcal vaccines (PCV) can prevent a large proportion of infant deaths and are recommended by international organizations for inclusion in pediatric immunization schedules. In China MCV but not PCV is publically funded and access to vaccination may be limited among non-locals who are rural migrants to cities. In this study we estimate the proportion of Shanghai children with on-time MCV and PCV administration; compare vaccination in non-locals versus locals; and assess the impact of township-level characteristics on vaccination outcomes.
METHODS:
Data from children in the Shanghai Immunization Program Information System were linked to township-level data from the 2010 China Census. We used generalized estimating equations with logistic regression models to assess the impact of residency and township-level predictors on on-time MCV and PCV administration.
RESULTS:
Non-locals had lower vaccination levels than locals. Compared with locals non-locals had 0.50 times the odds of MCV dose 1 by 9 months (95% CI: 0.47 0.53) 0.42 times the odds of MCV dose 2 by 24 months (95% CI: 0.39 0.45) 0.37 times the odds of PCV by 9 months of age (95% CI: 0.33 0.42) and 0.41 times the odds of PCV by 24 months of age (95% CI: 0.37 0.45). Overall children had less on-time MCV and PCV administration in non-local-majority than local-majority townships.
CONCLUSIONS:
Late vaccination negatively impacts disease control efforts in Shanghai. Non-locals particularly those living in non-local-majority townships should especially be targeted for vaccination in order to improve disease control efforts in Shanghai.