Factors associated with untimely vaccination among children aged 12 to 23 months in Tororo District, Uganda

Abstract

ABSTRACT Background: Vaccination is one of the most cost effective child survival interventions preventing an estimated 2 to 3 million deaths due to Vaccine Preventable Diseases (VPD’s) annually. However, these diseases are still responsible for a majority of childhood deaths globally and this could partly be due to delayed vaccination. Timely vaccination is crucial to ensuring optimal immune response. Objective: This study measured the level of untimely vaccination among children aged 12 to 23 months and identified factors associated with it. Methods: A household cluster survey among 410 children aged between 12 to 23 months was conducted between March and April 2016 in 2 sub-counties in Tororo district in Uganda. Vaccination dates were obtained from child health cards and timeliness was assessed based on the recommended age ranges for Bacille Calmette Guerin (BCG) (birth–8 weeks), Oral Polio Vaccine (OPV0) (birth-2weeeks), Diptheria Pertusis Tetanus (DPT), Oral Polio Vaccine, Pneumococcal Conjugate Vaccine (PCV) (6 weeks–4 months; 10 weeks–5 months; 14 weeks–6 months) and measles vaccine (38 weeks–12 months). Independent variables were obtained using a semi-structured questionnaire. Factors associated with untimely vaccination were determined using Modified Poisson Regression for survey analysis using STATA version 12. Results: Overall, 59% (162/399) of children were untimely vaccinated. Timely receipt of vaccination was lowest for PCV1 (70.7%, 282/399) and highest for BCG (97.5%, 389/399). The prevalence of untimely vaccination was 19% lower among children whose caretakers perceived a high risk of VPDs compared to those that did not (Adjusted PRR: 0.81, 95% CI: 0.79-0.83). Conclusions and Recommendations: Vaccination coverage was high but mostly untimely. Strategies to improve timeliness of vaccination should target changing caretakers’ perceptions about vaccination through reinforcing and health education of masses on children’s susceptibility and benefits of vaccination.