ArticlePloS one2019
Can vaccination coverage be improved by reducing missed opportunities for vaccination? Findings from assessments in Chad and Malawi using the new WHO methodology.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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43 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of missed opportunities for vaccination (MOV) indicators among children aged 12-23 months in sub-Saharan African countries: An individual-level meta-analysis of DHS and MICS national household data surveys.Human vaccines & immunotherapeutics · 2025Pooled it
- The impact of pharmacist involvement on immunization uptake and other outcomes: An updated systematic review and meta-analysis.Journal of the American Pharmacists Association : JAPhAPooled it
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- Immunization continuity failures and measles vaccine dropout in a fragile urban setting: Evidence from Mogadishu, Somalia.Public health in practice (Oxford, England) · 2026Article
- From trial site to research emerging research hub: mapping Ghana's vaccine research ecosystem, 1977-2025.Health research policy and systems · 2026Review
- Factors associated with uptake of second year of life vaccines among children 24-35 months in Western Region One, The Gambia.BMC public health · 2026Article
- Strategies and challenges for immunisation of children under 5 years in primary health care in different countries: a scoping review.BMC public health · 2025Article
- The Effect of Implementing Advanced Strategies to Improve Immunization Coverage in the Elogbele Health Area.Cureus · 2025Article
- Three in four children age 12-23 months missed opportunities for vaccination in Sub-Saharan African countries: a multilevel mixed effect analysis of demographic health and surveys 2016-2023.BMC public health · 2025Article
- Influencing factors on missed opportunities for vaccination among children aged 0-24 months in hospitals of White Nile State, Sudan: a mixed method study.The Pan African medical journal · 2025Article
- Vaccination opportunity in children up to 6 months old born in 2017 and 2018 in the city of Londrina-PR, Brazil: a population-based survey.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- Inequalities in ownership and availability of home-based vaccination records in 82 low- and middle-income countries.BMJ global health · 2024Article
- Article
- Exploring pre-pandemic patterns of vaccine decision-making with the 5C model: results from representative surveys in 2016 and 2018.BMC public health · 2024Article
- Review
- Article
- Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013-2017.BMJ open · 2024Article
- Contextualising missed opportunities for children's vaccination: A theory-informed qualitative study in primary care settings in Cape Town, South Africa.Human vaccines & immunotherapeutics · 2023Article
- The Role of Adult Vaccines as Part of Antimicrobial Stewardship: A Scoping Review.Antibiotics (Basel, Switzerland) · 2023Article
- Evaluation of a Mobile-Based Immunization Decision Support System for Scheduling Age-Appropriate Vaccine Schedules for Children Younger Than 2 Years in Pakistan and Bangladesh: Lessons From a Multisite, Mixed Methods Study.JMIR pediatrics and parenting · 2023Article
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Abstract
backgroundIn 2015, the World Health Organization (WHO) updated the global methodology for assessing and reducing missed opportunities for vaccination (MOV), when eligible children have contact with the health system but are not vaccinated. This paper presents the results of two pilot assessments conducted in Chad and Malawi.
methodsUsing the ten-step global WHO MOV strategy, we purposively selected districts and health facilities, with non-probabilistic sampling of <24 month old children for exit interviews of caregivers and self-administered knowledge, attitudes, and practices (KAP) surveys of health workers. MOV were calculated based on a child's documented vaccination history (i.e., from a home-based record (HBR) or a health facility vaccination register), including selected vaccines in the national schedule.
resultsRespondents included caregivers of 353 children in Chad and of 580 children in Malawi. Among those with documented vaccination history, 82% (195/238) were eligible for vaccination in Chad and 47% (225/483) in Malawi. Among eligible children, 51% (99/195) in Chad, and 66% (149/225) in Malawi had one or more MOV on the survey date. During non-vaccination visits, 77% (24/31) of children eligible for vaccination in Chad and 92% (119/129) in Malawi had a MOV compared to 46% (75/164) and 31% (30/96) during vaccination visits, respectively. Among health workers, 92% in Chad and 88% in Malawi were unable to correctly identify valid contraindications for vaccination.
conclusionThe new MOV tool was able to characterize the type and potential causes of MOV. In both countries, the findings of the assessments point to two major barriers to full vaccination of eligible children-a lack of coordination between vaccination and curative health services and incomplete vaccination during vaccination visits. National immunization programs should explore tailored efforts to improve health worker practices and to increase vaccine delivery by making better use of existing health service contacts.
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