September 26, 2016
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Timely vaccinations, improved recordkeeping may reduce mortality rates in India

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Timely and accurately recorded vaccination may help to reduce morbidity and mortality of Indian children from vaccine-preventable diseases, according to published study findings.

“Protection against [vaccine-preventable diseases (VPDs)] requires timely receipt of the recommended number of doses of a given vaccine to develop adequate immunity and minimize susceptibility to disease,” Nijika Shrivastwa, PhD, MHSA, MPH, from the department of epidemiology in the School of Public Health at the University of Michigan, and colleagues wrote. “Delays in vaccine receipt beyond the recommended time frame (ie, untimely vaccination) may unnecessarily expose a child to prolonged risk of disease and contribute to the ongoing transmission of VPDs.”

To provide characteristics of childhood vaccination timeliness and the routine immunization program in India, Shrivastwa and colleagues culled data from India’s Universal Immunization Program (UIP) 2008 survey for children with and without immunization cards. The study included 268,553 children aged up to 5 years during a 1-year observation period. The researchers considered timeliness of bacille Calmette-Guérin (BCG), three doses diphtheria-pertussis-tetanus (DPT3) vaccine and measles-containing vaccine (MCV). The researchers used Turnbull estimation of the cumulative distribution for accurate vaccination coverage estimates at each age.

Analysis demonstrated only 31% of the cohort received timely administration of BCG, 19% received DPT3 at the recommended times, and 34% received MCV in a timely manner. The highest recorded vaccination date percentages for DPT3 vaccination (39%, 38%, 35%) and MCV (31%) occurred in children aged 13 to 24 months. Older children had lower vaccination dates and doses recorded on immunization cards (about 19%), but mothers confirmed vaccination dates in 37% to 63% of children. The researchers observed a plateau in DPT and BCG vaccination at age 24 months; however, they noted an average 5% increase in MCV after age 24 months. Overall, the 5-year immunization coverage in Indian children was 87% for BCG, 63% for DPT3 and 76% for MCV.

“An immunization information system that reliably collects standard childhood immunization records accessible to providers has been shown to reduce missed opportunities,” the researchers wrote. “The need to track childhood vaccination and monitor timeliness will be essential as India adds more vaccines to the UIP, such as rotavirus and a second MCV, and pursues major public health initiatives such as measles elimination.” – by Kate Sherrer

 

Disclosure: The researchers report no relevant financial disclosures.