Format

Send to

Choose Destination
Euro Surveill. 2019 Feb;24(6). doi: 10.2807/1560-7917.ES.2019.24.6.1800004.

Timeliness and completeness of routine childhood vaccinations in young children residing in a district with recurrent vaccine-preventable disease outbreaks, Jerusalem, Israel.

Author information

1
Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel.
2
The Hebrew University of Jerusalem, Faculty of medicine, the Hebrew University and Hadassah Braun School of Public health and Community Medicine, Jerusalem, Israel.
3
Chief Scientist, Ministry of Health, Jerusalem, Israel.
4
The Hebrew University of Jerusalem, Faculty of medicine, the Hebrew University and Hadassah Braun School of Public health and Community Medicine, Department of Health Policy and Management, Jerusalem, Israel.

Abstract

BackgroundChildhood vaccination schedules recommend vaccine doses at predefined ages.AimWe evaluated vaccination completeness and timeliness in Jerusalem, a district with recurrent vaccine-preventable disease outbreaks.MethodsVaccination coverage was monitored by the up-to-date method (vaccination completeness at age 2 years). Timeliness of vaccination was assessed in children (n = 3,098, born in 2009, followed to age 48 months, re-evaluated at age 7 years) by the age-appropriate method (vaccine dose timeliness according to recommended schedule). Vaccines included: hepatitis B (HBV: birth, 1 month and 6 months); diphtheria, tetanus, acellular pertussis, polio, Haemophilus influenzae b (DTaP-IPV-Hib: 2, 4, 6 and 12 months); pneumococcal conjugate (PCV: 2, 4 and 12 months); measles-mumps-rubella/measles-mumps-rubella-varicella (MMR/MMRV: 12 months) and hepatitis A (HAV: 18 and 24 months).ResultsOverall vaccination coverage (2014 cohort evaluated at age 2 years) was 95% and 86% for MMR/MMRV and DTaP-IPV-Hib4, respectively. Most children (94%, 91%, 79%, 95%, 92% and 82%) were up-to-date for HBV3, DTaP-IPV-Hib4, PCV3, MMR/MMRV1, HAV1 and HAV2 vaccines at 48 months, but only 32%, 28%, 38%, 58%, 49% and 20% were vaccinated timely (age-appropriate). At age 7 years, the median increase in vaccination coverage was 2.4%. Vaccination delay was associated with: high birth order, ethnicity (higher among Jews vs Arabs), birth in winter, delayed acceptance of first dose of DTaP-IPV-Hib and multiple-dose vaccines (vs MMR/MMRV). Jewish ultra-Orthodox communities had low vaccination coverage.ConclusionsConsiderable vaccination delay should be addressed within the vaccine hesitancy spectrum. Delays may induce susceptibility to vaccine-preventable disease outbreaks; tailored programmes to improve timeliness are required.

KEYWORDS:

childhood vaccination; children; infants; measles; routine vaccinations; toddlers; vaccination completeness; vaccination coverage; vaccination schedules; vaccination timeliness; vaccines and immunisation

Supplemental Content

Full text links

Icon for Ingenta plc Icon for PubMed Central
Loading ...
Support Center