ArticleBMJ open2022
How did the adoption of wP-pentavalent affect the global paediatric vaccine coverage rate? A multicountry panel data analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- 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
- Further analysis of determinants of Pentavalent and Measles immunizations dropouts among children under five years of age in Ethiopia from Mini-EDHS 2019.BMC health services research · 2024Article
- Introduction of a hexavalent vaccine containing acellular pertussis into the national immunization program for infants in Peru: a cost-consequence analysis of vaccination coverage.BMC health services research · 2024Article
- Promoting higher-valent pediatric combination vaccines in China: challenges and recommendations for action.Infectious diseases of poverty · 2024Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSeveral studies have highlighted the effects of combination vaccines on immunisation coverage at the national or subnational level. This study examined the effects globally. Worldwide introduction of whole-cell pertussis pentavalent (wP-pentavalent) allowed estimation of incremental coverage effects of combination vaccines on the third doses of diphtheria, tetanus, pertussis (DTP3); hepatitis B (HepB3) and
designMulticountry panel data analysis. DATA SOURCES: Country-level vaccine coverage data of WHO/UNICEF for the years 1980-2018.
methodsLinear mixed models were used to estimate the effects of wP-pentavalent introduction by incorporating proxy variables to control for time trend and other time-dependent changes in the immunisation programmes.
resultsIntroduction of combination vaccines may have improved the coverage of DTP3 by 3percentage points(95% CI 2.5% to 3.6%) globally compared with the coverage in the pre-combination vaccine era. The comparison of coverage rates of HepB3 and Hib3 in before and after wP-pentavalent periods indicates that the introduction of combination vaccines improved the coverage by 10.1 percentage points (95% CI 8.4% to 11.7%) for HepB3 and 9.9 (95% CI 7.1% to 12.7%) for Hib3 in countries that introduced those antigens prior to adoption of wP-pentavalent. Even though the incremental coverage increase of DTP3 appears quite modest, it is still a significant result, especially because DTP vaccine has been in the national immunisation programmes of all countries for about 24 years prior to the introduction of wP-pentavalent. Additionally, the introduction of pentavalent also allowed inclusion of Hib and HepB in the vaccine schedule for a large number of countries (85 and 37, respectively, of the 102 countries included in our analysis).
conclusionThe findings suggest that development of combination vaccines with additional antigens is likely to help sustain and improve coverage of existing as well as new childhood vaccines.
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