Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania

• Published in: International health Vol. 5; no. 2; pp. 139 - 147
• Main Authors: Le Polain de Waroux, Olivier, Schellenberg, Joanna R. Armstrong, Manzi, Fatuma, Mrisho, Mwifadhi, Shirima, Kizito, Mshinda, Hassan, Alonso, Pedro, Tanner, Marcel, Schellenberg, David M.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-06-2013
• Subjects: BCG Vaccine - administration & dosage; Diphtheria-Tetanus-acellular Pertussis Vaccines - administration & dosage; Diphtheria-Tetanus-Pertussis Vaccine - administration & dosage; Educational Status; Ethnic Groups; Female; Health Care Surveys; Health Services Accessibility; Humans; Infant; Male; Measles Vaccine - administration & dosage; Mothers; Patient Acceptance of Health Care; Poverty; Rain; Risk Factors; Rural Population; Seasons; Tanzania; Vaccination; Tanzania; Coverage; Children; Vaccination; Risk factors; Timeliness; Tanzania
• ISSN: 1876-3413; 1876-3405
• DOI: 10.1093/inthealth/iht006

Background
We studied coverage and timeliness of vaccination and risk factors for low and delayed vaccine uptake in children aged <2 years in rural Tanzania.
Methods
We used data from a cluster survey conducted in 2004, which included 1403 children. Risk factors were analysed by log-binomial regression adjusted for the clustering. The analysis was restricted to BCG, first and third dose of Diphtheria-Tetanus-Pertussis vaccines (DTP-1 and DTP-3) and first dose of measles-containing vaccine (MCV-1).
Results
Coverage for BCG, DTP-1, DTP-3 and MCV-1 was 94%, 96%, 90% and 86%, respectively. Delayed vaccination (>1 month after the recommended age) occurred in 398/1205 (33%) children for BCG, 404/1189 (34%) for DTP-1, 683/990 (69%) for DTP-3 and 296/643 (46%) for MCV-1. Coverage was lower for all vaccines except DTP-1 in children living ≥5 km from a healthcare facility. Delayed uptake was associated with poverty. Low and delayed MCV-1 vaccination was associated with low maternal education. Delayed BCG vaccination was associated with ethnicity and rainy season.
Conclusion
Despite reasonably high vaccination coverage, we observed substantial vaccination delays, particularly for DTP-3 and MCV-1. We found specific factors associated with low and/or delayed vaccine uptake. These findings can help to improve strategies to reach children who remain inadequately protected.