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Nat Commun. 2019 Apr 9;10(1):1633. doi: 10.1038/s41467-019-09611-1.

Mapping vaccination coverage to explore the effects of delivery mechanisms and inform vaccination strategies.

Author information

1
WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK. c.e.utazi@soton.ac.uk.
2
Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, SO17 1BJ, UK. c.e.utazi@soton.ac.uk.
3
WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK.
4
Flowminder Foundation, Stockholm SE, 11355, Sweden.
5
Center for Infectious Disease Dynamics, The Pennsylvania State University, State College, PA, 16802, USA.
6
Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, 08544, USA.
7
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
8
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.

Abstract

The success of vaccination programs depends largely on the mechanisms used in vaccine delivery. National immunization programs offer childhood vaccines through fixed and outreach services within the health system and often, additional supplementary immunization activities (SIAs) are undertaken to fill gaps and boost coverage. Here, we map predicted coverage at 1 × 1 km spatial resolution in five low- and middle-income countries to identify areas that are under-vaccinated via each delivery method using Demographic and Health Surveys data. We compare estimates of the coverage of the third dose of diphtheria-tetanus-pertussis-containing vaccine (DTP3), which is typically delivered through routine immunization (RI), with those of measles-containing vaccine (MCV) for which SIAs are also undertaken. We find that SIAs have boosted MCV coverage in some places, but not in others, particularly where RI had been deficient, as depicted by DTP coverage. The modelling approaches outlined here can help to guide geographical prioritization and strategy design.

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