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Vaccines (Basel). 2017 Aug 12;5(3). pii: E22. doi: 10.3390/vaccines5030022.
Challenges in Estimating Vaccine Coverage in Refugee and Displaced Populations: Results From Household Surveys in Jordan and Lebanon.
Roberton T1 Weiss W2; Jordan Health Access Study Team34; Lebanon Health Access Study Team56789 Doocy S10.
Abstract
Ensuring the sustained immunization of displaced persons is a key objective in humanitarian emergencies. Typically humanitarian actors measure coverage of single vaccines following an immunization campaign; few measure routine coverage of all vaccines. We undertook household surveys of Syrian refugees in Jordan and Lebanon outside of camps using a mix of random and respondent-driven sampling to measure coverage of all vaccinations included in the host countrys vaccine schedule. We analyzed the results with a critical eye to data limitations and implications for similar studies. Among households with a child aged 12-23 months 55.1% of respondents in Jordan and 46.6% in Lebanon were able to produce the childs EPI card. Only 24.5% of Syrian refugee children in Jordan and 12.5% in Lebanon were fully immunized through routine vaccination services (having received from non-campaign sources: measles polio 1-3 and DPT 1-3 in Jordan and Lebanon and BCG in Jordan). Respondents in Jordan (33.5%) and Lebanon (40.1%) reported difficulties obtaining child vaccinations. Our estimated immunization rates were lower than expected and raise serious concerns about gaps in vaccine coverage among Syrian refugees. Although our estimates likely under-represent true coverage given the additional benefit of campaigns (not captured in our surveys) there is a clear need to increase awareness accessibility and uptake of immunization services. Current methods to measure vaccine coverage in refugee and displaced populations have limitations. To better understand health needs in such groups we need research on: validity of recall methods links between campaigns and routine immunization programs and improved sampling of hard-to-reach populations.
KEYWORDS:
Jordan; Lebanon; Syria; displaced populations; humanitarian assistance; refugee; vaccination; vaccination coverage
PMID: 28805672 PMCID: PMC5620553 DOI: 10.3390/vaccines5030022