Maternal determinants of timely vaccination coverage among infants in rural Bangladesh

Research output: Contribution to journalArticle

Abstract

Background: Timely vaccination, i.e., the receipt of all scheduled vaccinations in an age-appropriate fashion, is critical for the prevention of deadly diseases in infants and achievement of the UN Millennium Development Goal to reduce infant mortality. Infants, especially in rural or underprivileged settings often receive delayed vaccinations leaving them susceptible to vaccine-preventable illnesses early in the first year of life. In this study, we examined rates of timely vaccination among 24,435 infants born in Gaibandha and Rangpur rural districts of Bangladesh from 2001 to 2007. Methods: Vaccinations due by 14 weeks of age and administered through routine government immunization services were assessed using interviews with enrolled mothers between 11 and 18 weeks postpartum. We created a Timely Vaccination (TV) score to classify infants as vaccinated fully and on schedule (TV = 1) or not (TV = 0), and used multivariable logistic regression to identify maternal characteristics associated with infant's timely vaccination status. Results: Our results suggest that only 19% of infants in this cohort received scheduled vaccinations on time by 11-18 weeks postpartum. Mothers' engagement in paid employment [OR = 1.13, 95% CI: 1.03-1.23], receipt of tetanus toxoid vaccination [OR = 1.24, 95% CI: 1.11-1.38], history of antenatal care [OR = 1.22, 95% CI: 1.12-1.32], or higher socioeconomic status [OR = 1.07, 95% CI: 1.03-1.11] were positively associated with timely vaccination of their infants. Mother's perception of small infant size at birth was negatively associated with timely vaccination [OR = 0.89, 95% CI: 0.82-0.97]. Conclusion: Timely vaccination coverage of infants in rural Gaibandha and Rangpur districts is extremely low. This analysis identifies important shortcomings associated with the 1-year vaccination benchmark of routine immunization performance and suggests the need for specific interventions based on potential maternal determinants as well as known system and programmatic barriers of timely vaccination among infants in rural Bangladesh.

Original languageEnglish (US)
Pages (from-to)5514-5519
Number of pages6
JournalVaccine
Volume32
Issue number42
DOIs
StatePublished - 2014

Fingerprint

Bangladesh
Vaccination
vaccination
Mothers
Postpartum Period
Immunization
immunization
prenatal care
infant mortality
Benchmarking
Tetanus Toxoid
toxoids
Prenatal Care
United Nations
tetanus
Infant Mortality
socioeconomic status
Social Class

Keywords

  • Antenatal care
  • Bangladesh
  • Crude vaccination
  • Expanded Program on Immunization (EPI)
  • Maternal determinants
  • Tetanus toxoid vaccination
  • Timely vaccination
  • Timely vaccination score

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • veterinary(all)
  • Molecular Medicine
  • Medicine(all)

Cite this

@article{aa1c62873e894ac096d3ce6eb554d7d8,
title = "Maternal determinants of timely vaccination coverage among infants in rural Bangladesh",
abstract = "Background: Timely vaccination, i.e., the receipt of all scheduled vaccinations in an age-appropriate fashion, is critical for the prevention of deadly diseases in infants and achievement of the UN Millennium Development Goal to reduce infant mortality. Infants, especially in rural or underprivileged settings often receive delayed vaccinations leaving them susceptible to vaccine-preventable illnesses early in the first year of life. In this study, we examined rates of timely vaccination among 24,435 infants born in Gaibandha and Rangpur rural districts of Bangladesh from 2001 to 2007. Methods: Vaccinations due by 14 weeks of age and administered through routine government immunization services were assessed using interviews with enrolled mothers between 11 and 18 weeks postpartum. We created a Timely Vaccination (TV) score to classify infants as vaccinated fully and on schedule (TV = 1) or not (TV = 0), and used multivariable logistic regression to identify maternal characteristics associated with infant's timely vaccination status. Results: Our results suggest that only 19{\%} of infants in this cohort received scheduled vaccinations on time by 11-18 weeks postpartum. Mothers' engagement in paid employment [OR = 1.13, 95{\%} CI: 1.03-1.23], receipt of tetanus toxoid vaccination [OR = 1.24, 95{\%} CI: 1.11-1.38], history of antenatal care [OR = 1.22, 95{\%} CI: 1.12-1.32], or higher socioeconomic status [OR = 1.07, 95{\%} CI: 1.03-1.11] were positively associated with timely vaccination of their infants. Mother's perception of small infant size at birth was negatively associated with timely vaccination [OR = 0.89, 95{\%} CI: 0.82-0.97]. Conclusion: Timely vaccination coverage of infants in rural Gaibandha and Rangpur districts is extremely low. This analysis identifies important shortcomings associated with the 1-year vaccination benchmark of routine immunization performance and suggests the need for specific interventions based on potential maternal determinants as well as known system and programmatic barriers of timely vaccination among infants in rural Bangladesh.",
keywords = "Antenatal care, Bangladesh, Crude vaccination, Expanded Program on Immunization (EPI), Maternal determinants, Tetanus toxoid vaccination, Timely vaccination, Timely vaccination score",
author = "Lavanya Vasudevan and Labrique, {Alain B} and Sucheta Mehra and Wu, {Lee Shu Fune} and Orin Levine and Daniel Feikin and Rolf Klemm and Christian, {Parul S} and Keith West",
year = "2014",
doi = "10.1016/j.vaccine.2014.06.092",
language = "English (US)",
volume = "32",
pages = "5514--5519",
journal = "Vaccine",
issn = "0264-410X",
publisher = "Elsevier BV",
number = "42",

}

TY - JOUR

T1 - Maternal determinants of timely vaccination coverage among infants in rural Bangladesh

AU - Vasudevan, Lavanya

AU - Labrique, Alain B

AU - Mehra, Sucheta

AU - Wu, Lee Shu Fune

AU - Levine, Orin

AU - Feikin, Daniel

AU - Klemm, Rolf

AU - Christian, Parul S

AU - West, Keith

PY - 2014

Y1 - 2014

N2 - Background: Timely vaccination, i.e., the receipt of all scheduled vaccinations in an age-appropriate fashion, is critical for the prevention of deadly diseases in infants and achievement of the UN Millennium Development Goal to reduce infant mortality. Infants, especially in rural or underprivileged settings often receive delayed vaccinations leaving them susceptible to vaccine-preventable illnesses early in the first year of life. In this study, we examined rates of timely vaccination among 24,435 infants born in Gaibandha and Rangpur rural districts of Bangladesh from 2001 to 2007. Methods: Vaccinations due by 14 weeks of age and administered through routine government immunization services were assessed using interviews with enrolled mothers between 11 and 18 weeks postpartum. We created a Timely Vaccination (TV) score to classify infants as vaccinated fully and on schedule (TV = 1) or not (TV = 0), and used multivariable logistic regression to identify maternal characteristics associated with infant's timely vaccination status. Results: Our results suggest that only 19% of infants in this cohort received scheduled vaccinations on time by 11-18 weeks postpartum. Mothers' engagement in paid employment [OR = 1.13, 95% CI: 1.03-1.23], receipt of tetanus toxoid vaccination [OR = 1.24, 95% CI: 1.11-1.38], history of antenatal care [OR = 1.22, 95% CI: 1.12-1.32], or higher socioeconomic status [OR = 1.07, 95% CI: 1.03-1.11] were positively associated with timely vaccination of their infants. Mother's perception of small infant size at birth was negatively associated with timely vaccination [OR = 0.89, 95% CI: 0.82-0.97]. Conclusion: Timely vaccination coverage of infants in rural Gaibandha and Rangpur districts is extremely low. This analysis identifies important shortcomings associated with the 1-year vaccination benchmark of routine immunization performance and suggests the need for specific interventions based on potential maternal determinants as well as known system and programmatic barriers of timely vaccination among infants in rural Bangladesh.

AB - Background: Timely vaccination, i.e., the receipt of all scheduled vaccinations in an age-appropriate fashion, is critical for the prevention of deadly diseases in infants and achievement of the UN Millennium Development Goal to reduce infant mortality. Infants, especially in rural or underprivileged settings often receive delayed vaccinations leaving them susceptible to vaccine-preventable illnesses early in the first year of life. In this study, we examined rates of timely vaccination among 24,435 infants born in Gaibandha and Rangpur rural districts of Bangladesh from 2001 to 2007. Methods: Vaccinations due by 14 weeks of age and administered through routine government immunization services were assessed using interviews with enrolled mothers between 11 and 18 weeks postpartum. We created a Timely Vaccination (TV) score to classify infants as vaccinated fully and on schedule (TV = 1) or not (TV = 0), and used multivariable logistic regression to identify maternal characteristics associated with infant's timely vaccination status. Results: Our results suggest that only 19% of infants in this cohort received scheduled vaccinations on time by 11-18 weeks postpartum. Mothers' engagement in paid employment [OR = 1.13, 95% CI: 1.03-1.23], receipt of tetanus toxoid vaccination [OR = 1.24, 95% CI: 1.11-1.38], history of antenatal care [OR = 1.22, 95% CI: 1.12-1.32], or higher socioeconomic status [OR = 1.07, 95% CI: 1.03-1.11] were positively associated with timely vaccination of their infants. Mother's perception of small infant size at birth was negatively associated with timely vaccination [OR = 0.89, 95% CI: 0.82-0.97]. Conclusion: Timely vaccination coverage of infants in rural Gaibandha and Rangpur districts is extremely low. This analysis identifies important shortcomings associated with the 1-year vaccination benchmark of routine immunization performance and suggests the need for specific interventions based on potential maternal determinants as well as known system and programmatic barriers of timely vaccination among infants in rural Bangladesh.

KW - Antenatal care

KW - Bangladesh

KW - Crude vaccination

KW - Expanded Program on Immunization (EPI)

KW - Maternal determinants

KW - Tetanus toxoid vaccination

KW - Timely vaccination

KW - Timely vaccination score

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U2 - 10.1016/j.vaccine.2014.06.092

DO - 10.1016/j.vaccine.2014.06.092

M3 - Article

C2 - 25132336

AN - SCOPUS:84922401063

VL - 32

SP - 5514

EP - 5519

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 42

ER -