Young children face the risk of being infected by a variety of diseases; this makes it necessary to resort to vaccination as a failsafe for ensuring healthy life of the child. However the success of the immunisation drive is conditioned by prevailing conditions. Some of these also determine whether family members opt for full, partial or no immunisation. This paper attempts to identify and estimate the impacts of various socio-economic factors on childhood immunisation coverage in the East district of Sikkim. The study is based on primary data consisting of 204 respondents collected through household survey. The ordered probit and Heckman probit models have been utilised to estimate the significant change in childhood immunisation coverage. The study found that the birth order of child (BOC), mother’s age, the standard of living, caste and religion have a significant impact on childhood immunisation coverage. With regard to the extent of immunisation, the important elements are mother’s education, mother’s age, gender of the household head and distance from hospital.
AIMS We recently conducted a large survey amongst parents of young children exploring attitudes concerning immunisation and the general immunisation status of the children and their parents in Switzerland. Since little is known about the immunisation status of fathers of young children, we present our findings here; data on mothers were previously published elsewhere. METHODS We performed standardised interviews with parents of children born on or after 1 January 2013, and hospitalised at the University of Basel Children’s Hospital, Switzerland, between January and June 2017. If participation was declined, partial consent was sought for four questions regarding age, education level, attitudes towards vaccinations in general and availability of vaccination records of the parents. To compare our study results with other studies focusing on the completeness of the immunisation status of fathers, we conducted a literature search using broad search terms for studies published between 1 April 2009 and 1 December 2019. RESULTS Thirty-nine (20%) fathers of 199 enrolled children participated. The great majority had a positive or mostly positive attitude towards vaccinations, but only 2 (15%) of 13 fathers who participated in immunisation counselling were up-to-date with all generally recommended immunisations. Fifty-two percent of participating fathers reported that the last assessment of their immunisation status by a physician was >5 years ago. After the birth of their child, 56% of fathers had received a recommendation for immunisation against pertussis and 65% of them followed the recommendation. We identified three studies matching our review’s inclusion criteria. None of them reported specific findings for fathers. CONCLUSIONS This is the first study to analyse the complete immunisation status of fathers of young children. It is often incomplete with potentially missed opportunities for updating vaccinations during recent physician consultations. The low participation rate of fathers is a limitation which prohibits generalisation of our findings. However, as healthcare personnel have been shown to have the strongest impact on vaccination uptake, we propose that this group be further sensitised and educated with the goal of improving immunisation rates in fathers of young children.
Mirjam L. Erb, Tobias E. Erlanger, Ulrich Heininger
Background: Tuberculosis in children is still found in East Java Province at 2017 with 2,749 cases of paediatric tuberculosis. The Bacille Calmette-Guérin (BCG) immunisation coverage and healthy houses in East Java Province increase every year. Purpose: This study aims to analyse the correlation between BCG immunisation and healthy houses with paediatric tuberculosis discovery in East Java Province during 2015–17. Methods: This study is observational with a correlation study design. The population in this study were children aged 0–14 years who suffered from tuberculosis in a district or city in East Java Province in 2015–17. Sampling of this study uses aggregate data on paediatric tuberculosis discovered in children aged 0–14 years, coverage of BCG immunisation and coverage of healthy houses in districts/cities in East Java in 2015–17 found in Health Profile of East Java Province 2015–17. The variables studied were paediatric tuberculosis in children aged 0–14 years, BCG immunisation coverage and healthy house; the analysis techniques were the Kolmogorov-Smirnov normality test and Pearson correlation. Results: This study shows that there is correlation between BCG immunisation and paediatric tuberculosis (p = 0.01, p <0.05) with a correlation value of 0.67, indicating a strong and positive correlation. The results also show that there is a correlation between healthy houses and children with tuberculosis (p = 0.01, p <0.05) with a correlation value of 0.63, indicating a strong and positive correlation. Conclusion: BCG immunisation coverage and healthy houses are positively correlated with paediatric tuberculosis discovered in East Java district/city.
We analysed Australian Immunisation Register (AIR) data, predominantly for National Immunisation Program funded vaccines, as at 2 April 2023 for children, adolescents and adults, focusing on the calendar year 2022 and on trends from previous years. This report aims to provide comprehensive analysis and interpretation of vaccination coverage data to inform immunisation policy and programs. Children: Fully vaccinated coverage in Australian children in 2022 was 0.6–1.1 percentage points lower than in 2021 at the 12-month (93.3%), 24-month (91.0%) and 60-month (93.4%) age assessment milestones. This follows the 0.6–0.8 percentage point decrease at the 12- and 60-month milestones between the 2020 and 2021 reports, which came after eight years of generally increasing coverage. Due to the lag time involved in assessment, fully vaccinated coverage figures for 2021 and 2022 predominantly reflect vaccinations due in 2020 and 2021, respectively, and therefore reflect impacts of the first two years of the coronavirus disease 2019 (COVID-19) pandemic. Fully vaccinated coverage in Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) children was 1.2–2.2 percentage points lower in 2022 than in 2021 at the 12-month (90.0%), 24-month (87.9%) and 60-month (95.1%) milestones, indicating differential impacts of the pandemic. However, at the 60-month milestone, coverage in Indigenous children was 1.7 percentage points higher than in children overall. There were also clear pandemic impacts on on-time (within 30 days of recommended age) vaccination. On-time coverage of both the second dose of diphtheria-tetanus-pertussis and the first dose of measles-mumps-rubella-containing vaccines decreased progressively from mid-2020 onwards (6 and 12 percentage point falls, respectively) before recovering partially in the second half of 2022, with decreases 1.5–2.3 percentage points greater in Indigenous than non-Indigenous children, from an already close to 10 percentage points lower pre-pandemic baseline. Adolescents: Of adolescents turning 15 years in 2022, a total of 85.3% of girls and 83.1% of boys (83.0% and 78.1% of Indigenous girls and boys) had received at least one dose of human papillomavirus (HPV) vaccine by their fifteenth birthday, 0.9–1.3 percentage points lower than in 2021 (2.5–3.1 percentage points for Indigenous adolescents), also reflecting pandemic impacts. It will be important to monitor coverage with the single-dose HPV vaccine schedule – which was implemented from February 2023 – to ensure that it is sustained (ideally, increasing) and equitable, given that coverage in 2022 was 5–6 percentage points lower in adolescents in socioeconomically disadvantaged and remote areas. By 31 December 2022, coverage for an adolescent dose of diphtheria-tetanus-acellular pertussis vaccine in adolescents turning 15 years in 2022 was 86.9% (82.6% for Indigenous adolescents) and coverage for an adolescent dose of meningococcal ACWY vaccine in those turning 17 years was 75.9% (65.6% for Indigenous adolescents). Ongoing adolescent coverage gaps warrant tailored strategies to achieve higher vaccine uptake. Adults: Zoster vaccination coverage in 2022 was 41.3% in adults turning 71 years (37.7% in Indigenous adults), 2.6 (3.6) percentage points higher than in 2021, and was highest in adults turning 75 years (54.6% and 54.0%), reflecting a combination of vaccination at 70 years and catch-up at older ages. Coverage of 13-valent pneumococcal conjugate vaccine (13vPCV) was 33.8% in adults turning 70 years in 2022 (37.7% in Indigenous adults), 9.9 (12.6) percentage points higher than in 2021. These increases may be partly due to more complete reporting following the introduction of mandatory reporting to the AIR in mid-2021. Influenza vaccination coverage in adults in 2022 increased with increasing age, reaching 73.0% in the ≥ 75 years age group. Coverage was higher in 2022 than in 2021 across all adult age groups, with the proportionate increase since 2019 four- to five-fold higher in those aged < 65 years than in those aged ≥ 65 years. This likely reflects increased completeness due to mandatory reporting, with coverage previously substantially underestimated in younger adults. Conclusions: Vaccination coverage in children and adolescents decreased modestly in 2022, reflecting impacts of the COVID-19 pandemic, but remained relatively high in global terms. The decrease in coverage was greater in Indigenous children and adolescents, with timeliness of vaccination an ongoing issue exacerbated by the pandemic. While adult coverage increased in 2022 – likely, in part, due to the introduction of mandatory reporting to AIR resulting in more accurate estimates – it remains suboptimal. Limited evidence suggests the lower coverage in children and adolescents is due to a combination of acceptance and access factors. Particularly given the evidence that these modest declines in coverage have continued into the first half of 2023, further exploration is needed to better understand these factors and to inform approaches to effectively address barriers and increase vaccine uptake.
Immunisation remains one of the most effective public health interventions, yet in Nigeria, significant gaps in coverage persist, leaving millions vulnerable to preventable diseases. This chapter examines the current state of immunisation in Nigeria, highlighting the challenges that hinder widespread coverage, including cultural, economic, and geographical barriers. It explores strategies for reaching zerodose children, emphasising the importance of integrating immunisation efforts with other health services. Additionally, the chapter discusses the role of disease surveillance and early detection systems in preventing outbreaks. By analysing success stories and best practices, this chapter offers insights into overcoming the barriers to achieving high immunisation coverage in Nigeria and other developing nations.
We analysed Australian Immunisation Register (AIR) data as at 31 March 2021 for children, adolescents and adults. This is the first time that adolescent and adult coverage data from the AIR have been included in our annual coverage report.
This 9th annual immunisation coverage report shows data for 2015 derived from the Australian Childhood Immunisation Register and the National Human Papillomavirus (HPV) Vaccination Program Register. This report includes coverage data for ‘fully immunised’ and by individual vaccines at standard age milestones and timeliness of receipt at earlier ages according to Indigenous status. Overall, ‘fully immunised’ coverage has been mostly stable at the 12- and 24-month age milestones since late 2003, but at 60 months of age, coverage reached its highest ever level of 93% during 2015. As in previous years, coverage for ‘fully immunised’ at 12 and 24 months of age among Indigenous children was 3.4% and 3.3% lower than for non-Indigenous children overall, respectively. In 2015, 77.8% of Australian females aged 15 years had 3 documented doses of HPV vaccine (jurisdictional range 68.0–85.6%), and 86.2% had at least one dose, compared to 73.4% and 82.7%, respectively, in 2014. The differential of on-time vaccination between Indigenous and non-Indigenous children in 2015 diminished progressively from 18.4% for vaccines due at 12 months to 15.7% for those due at 24 months of age. In 2015, the proportion of children whose parents had registered an objection to vaccination was 1.2% at the national level, with large regional variations. This was a marked decrease from 1.8% in 2014 and the lowest rate of registered vaccination objection nationally since 2007 when it was 1.1%. Medical contraindication exemptions for Australia were more than double in 2015 compared with the previous year (635 to 1,401).
This eleventh national annual immunisation coverage report focuses on data for the calendar year 2017 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. This is the first report to include data on HPV vaccine course completion in Aboriginal and Torres Strait Islander (Indigenous) adolescents. ‘Fully immunised’ vaccination coverage in 2017 increased at the 12-month assessment age reaching 93.8% in December 2017, and at the 60-month assessment age reaching 94.5%. ‘Fully immunised’ coverage at the 24-month assessment age decreased slightly to 89.8% in December 2017, following amendment in December 2016 to require the fourth DTPa vaccine dose at 18 months. ‘Fully immunised’ coverage at 12 and 60 months of age in Indigenous children reached the highest ever recorded levels of 93.2% and 96.9% in December 2017. Catch-up vaccination activity for the second dose of measles-mumps-rubella-containing vaccine was considerably higher in 2017 for Indigenous compared to non-Indigenous adolescents aged 10–19 years (20.3% vs. 6.4%, respectively, of those who had not previously received that dose). In 2017, 80.2% of females and 75.9% of males aged 15 years had received a full course of three doses of human papillomavirus (HPV) vaccine. Of those who received dose one, 79% and 77% respectively of Indigenous girls and boys aged 15 years in 2017 completed three doses, compared to 91% and 90% of non-Indigenous girls and boys, respectively. A separate future report is planned to present adult AIR data and to assess completeness of reporting.
Australian Immunisation Register data have been analysed for children aged < 5 years, focusing on changes in coverage at key milestone ages (12, 24 and 60 months) between 2017 and 2018, while also documenting longer term trends. Fully vaccinated coverage increased at the 12- and 60-months milestones to 93.9% and 94.0%, respectively, but, in the context of additional antigens required, decreased to 90.1% at 24 months. Following the move to a two-dose rotavirus vaccine schedule across Australia from mid-2017, rotavirus vaccine coverage increased from 86.8% to 90.9%. In 2018, most jurisdictions funded influenza vaccine for non-Indigenous children aged 6 months to < 5 years; the National Immunisation Program has funded influenza vaccine for Aboriginal and Torres Strait Islander children and medically at-risk children since 2015 and 2010, respectively. Recorded influenza vaccine coverage in Aboriginal and Torres Strait Islander children doubled from 14.9% to 31.4%, and increased fivefold in non-Indigenous children from 5.0% to 25.9% in 2018. The timeliness of fully vaccinated coverage was also examined at earlier milestones (3 months after due date of last scheduled vaccine) of 9, 15, 21 and 51 months, by area of residence. For all children, coverage among those living in the least advantaged residential area quintile was 3–4% lower than that for those in the most advantaged quintile at the 9-, 15- and 21-month milestones. Importantly, although Aboriginal and Torres Strait Islander children had lower coverage for the second dose of measles-mumps-rubella vaccine at 24 months (91.8% versus 93.1% for non-Indigenous), coverage increased to 98.5% at 60 months; coverage was also high in non-Indigenous children at 96.2%, above the 95% target critical to measles control. These data demonstrate continuing improvements in immunisation coverage and suggest potential new coverage targets for earlier protection in the first two years of life.
This tenth annual immunisation coverage report shows data for the calendar year 2016 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. After a decade of being largely stable at around 90%, ‘fully immunised’ coverage at the 12-month assessment age increased in 2016 to reach 93.7% for the age assessment quarterly data point in December 2016, similar to the 93.4% for the age assessment quarterly data point in December 2016 for 60 months of age. Implementation of the ‘No Jab No Pay’ policy may have contributed to these increases. While ‘fully immunised’ coverage at the 24-month age assessment milestone decreased marginally from 90.8%, in December 2015, to 89.6% for the age assessment quarterly data point in December 2016, this was likely due to the assessment algorithm being amended in December 2016 to include four doses of DTPa vaccine instead of three, following reintroduction of the 18-month booster dose. Among Indigenous children, the gap in coverage assessed at 12 months of age decreased fourfold, from 6.7 percentage points in March 2013 to only 1.7 percentage points lower than non-Indigenous children in December 2016. Since late 2012, ‘fully immunised’ coverage among Indigenous children at 60 months of age has been higher than for non-Indigenous children. Vaccine coverage for the nationally funded seasonal influenza vaccine program for Indigenous children aged 6 months to <5 years, which commenced in 2015, remained suboptimal nationally in 2016 at 11.6%. Changes in MMR coverage in adolescents were evaluated for the first time. Of the 411,157 ten- to nineteen-year-olds who were not recorded as receiving a second dose of MMR vaccine by 31 December 2015, 43,103 (10.5%) of them had received it by the end of 2016. Many of these catch-up doses are likely to have been administered as a result of the introduction on 1 January 2016 of the Australian Government’s ‘No Jab No Pay’ policy. In 2016, 78.6% of girls aged 15 years had three documented doses of HPV vaccine (jurisdictional range 67.8–82.9%), whereas 72.9% of boys (up from 67.1 % in 2015) had received three doses.
