Timeliness and completeness of routine childhood vaccinations in young children residing in a district with recurrent vaccine-preventable disease outbreaks Jerusalem Israel.

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Euro Surveill. 2019 Feb;24(6). doi: 10.2807/1560-7917.ES.2019.24.6.1800004.

Timeliness and completeness of routine childhood vaccinations in young children residing in a district with recurrent vaccine-preventable disease outbreaks Jerusalem Israel.

Stein-Zamir C¹² Israeli A³⁴.

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Abstract

BackgroundChildhood vaccination schedules recommend vaccine doses at predefined ages.AimWe evaluated vaccination completeness and timeliness in Jerusalem a district with recurrent vaccine-preventable disease outbreaks.MethodsVaccination coverage was monitored by the up-to-date method (vaccination completeness at age 2 years). Timeliness of vaccination was assessed in children (n = 3098 born in 2009 followed to age 48 months re-evaluated at age 7 years) by the age-appropriate method (vaccine dose timeliness according to recommended schedule). Vaccines included: hepatitis B (HBV: birth 1 month and 6 months); diphtheria tetanus acellular pertussis polio Haemophilus influenzae b (DTaP-IPV-Hib: 2 4 6 and 12 months); pneumococcal conjugate (PCV: 2 4 and 12 months); measles-mumps-rubella/measles-mumps-rubella-varicella (MMR/MMRV: 12 months) and hepatitis A (HAV: 18 and 24 months).ResultsOverall vaccination coverage (2014 cohort evaluated at age 2 years) was 95% and 86% for MMR/MMRV and DTaP-IPV-Hib4 respectively. Most children (94% 91% 79% 95% 92% and 82%) were up-to-date for HBV3 DTaP-IPV-Hib4 PCV3 MMR/MMRV1 HAV1 and HAV2 vaccines at 48 months but only 32% 28% 38% 58% 49% and 20% were vaccinated timely (age-appropriate). At age 7 years the median increase in vaccination coverage was 2.4%. Vaccination delay was associated with: high birth order ethnicity (higher among Jews vs Arabs) birth in winter delayed acceptance of first dose of DTaP-IPV-Hib and multiple-dose vaccines (vs MMR/MMRV). Jewish ultra-Orthodox communities had low vaccination coverage.ConclusionsConsiderable vaccination delay should be addressed within the vaccine hesitancy spectrum. Delays may induce susceptibility to vaccine-preventable disease outbreaks; tailored programmes to improve timeliness are required.

KEYWORDS:

childhood vaccination; children; infants; measles; routine vaccinations; toddlers; vaccination completeness; vaccination coverage; vaccination schedules; vaccination timeliness; vaccines and immunisation

PMID: 30755293 DOI: 10.2807/1560-7917.ES.2019.24.6.1800004