ArticleVaccine2018
Coverage and timeliness of vaccination and the validity of routine estimates: Insights from a vaccine registry in Kenya.
Article in Vaccine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 63 citations in OpenAlex.
- Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia.JMIR mHealth and uHealth · 2021Trial
- Vaccination coverage and timeliness among children in Ethiopia.BMJ global health · 2026Article
- Variations in Routine Childhood Vaccination Gaps: A Decomposition Analysis Across 80 Low- and Middle-Income Countries.Vaccines · 2025Article
- Modelling the relative contribution of infection, routine vaccination and supplementary immunisation activities to measles seroconversion in Kenyan Children.PLoS computational biology · 2025Article
- Article
- Routine immunization status of nomadic children aged five years and below in Volta Region, Ghana in the post-COVID-19 pandemic era: a cross-sectional study.BMC public health · 2025Article
- Concordance of coverage estimates from routine and survey data of measles second dose vaccine in Western Kenya.Frontiers in epidemiology · 2025Article
- The impact of 10-valent pneumococcal conjugate vaccine on the incidence of admissions to hospital with hypoxaemic and non-hypoxaemic pneumonia in Kenyan children.PLOS global public health · 2025Article
- Determinants of Access to the Pentavalent 3 Vaccine Among Children Aged 0-23 months in Cameroon Based on the Demographic and Health Survey 2018.Pediatric health, medicine and therapeutics · 2025Article
- Addressing the challenges of estimating the target population in calculation of routine infant immunization coverage in Kenya.PLOS global public health · 2025Article
- Timeliness of 24 childhood immunisations and evolution of vaccination delay: Analysis of data from 54 low- and middle-income countries.PLOS global public health · 2024Article
- Predictors of timeliness of vaccination among children of age 12-23 months in Boricha district, Sidama region Ethiopia, in 2019.BMC pediatrics · 2023Article
- The impact of introduction of the 10-valent pneumococcal conjugate vaccine on pneumococcal carriage in Nigeria.Nature communications · 2023Article
- The impact of the COVID-19 pandemic on vaccine coverage in Kilifi, Kenya: A retrospective cohort study.Vaccine · 2023Article
- Changes in on-time vaccination following the introduction of an electronic immunization registry, Tanzania 2016-2018: interrupted time-series analysis.BMC health services research · 2022Article
- Beyond coverage: Rural-urban disparities in the timeliness of childhood vaccinations in Tanzania.Vaccine · 2022Article
- Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa.Vaccine: X · 2022Article
- Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978-2021: A scoping review to map measurement and methodological gaps.PLOS global public health · 2022Article
- Inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and place of birth characteristics in Kenya.BMC infectious diseases · 2021Article
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Corrections and comments
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Authors and funding
15 authors at 3 institutions in 4 countries.
Funding
Abstract
backgroundThe benefits of childhood vaccines are critically dependent on vaccination coverage. We used a vaccine registry (as gold standard) in Kenya to quantify errors in routine coverage methods (surveys and administrative reports), to estimate the magnitude of survivor bias, contrast coverage with timeliness and use both measures to estimate population immunity.
methodsVaccination records of children in the Kilifi Health and Demographic Surveillance System (KHDSS), Kenya were combined with births, deaths, migration and residence data from 2010 to 17. Using inverse survival curves, we estimated up-to-date and age-appropriate vaccination coverage, calculated mean vaccination coverage in infancy as the area under the inverse survival curves, and estimated the proportion of fully immunised children (FIC). Results were compared with published coverage estimates. Risk factors for vaccination were assessed using Cox regression models.
resultsWe analysed data for 49,090 infants and 48,025 children aged 12-23 months in 6 birth cohorts and 6 cross-sectional surveys respectively, and found 2nd year of life surveys overestimated coverage by 2% compared to birth cohorts. Compared to mean coverage in infants, static coverage at 12 months was exaggerated by 7-8% for third doses of oral polio, pentavalent (Penta3) and pneumococcal conjugate vaccines, and by 24% for the measles vaccine. Surveys and administrative coverage also underestimated the proportion of the fully immunised child by 10-14%. For BCG, Penta3 and measles, timeliness was 23-44% higher in children born in a health facility but 20-37% lower in those who first attended during vaccine stock outs.
conclusionsStandard coverage surveys in 12-23 month old children overestimate protection by ignoring timeliness, and survivor and recall biases. Where delayed vaccination is common, up-to-date coverage will give biased estimates of population immunity. Surveys and administrative methods also underestimate FIC prevalence. Better measurement of coverage and more sophisticated analyses are required to control vaccine preventable diseases.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.