The researchers examined the fraction of and extent to which vaccinations were administered earlier than recommended (age-invalid) or with too short intervals between vaccine doses (interval-invalid) in countries of the World Health Organisation (WHO) African Region and (b) individual- and community-level factors associated with invalid vaccinations using multilevel techniques. Data from the Demographic and HealthSurveys conducted in the last 10 years in 31 countries were used. Information about childhood vaccinations was based on vaccination records (n = 134,442). Invalid vaccinations (diphtheria, tetanus, pertussis[DTP1, DTP3] and measles-containing vaccine (MCV)) were defined using the WHO criteria.
The median percentages of invalid DTP1, DTP3 and MCV vaccinations across all countries were 12.1% (interquartile range, 9.4–15.2%), 5.7% (5.0–7.6%), and 15.5% (10.0–18.1%), respectively. Of the invalid DTP1 vaccinations, 7.4% and 5.5% were administered at child’s age of less than one and two weeks, respectively. In 12 countries, the proportion of invalid DTP3 vaccinations administered with an interval of less than two weeks before the preceding dose varied between 30% and 50%. In 13 countries, the proportion of MCVdoses administered at child’s age of less than six months varied between 20% and 45%.
Community-level variables explained part of the variation in invalid vaccinations. Invalid vaccinations are common inAfrican countries. Timing of childhood vaccinations should be improved to ensure an optimal protectionagainst vaccine-preventable infections and to avoid unnecessary wastage in these economically deprived countries.
Elizabeth, a Public Health Nutrition Specialist and a Research Scientist is the head of the Maternal and Child Wellbeing Unit at APHRC. She is also a Wellcome Trust International Engagement Fellow, undertaking public engagement on the...