Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 10;21(1):2063.
doi: 10.1186/s12889-021-11841-2.

Age-appropriate vaccination coverage and its determinants in children aged 12-36 months in Nepal: a national and subnational assessment

Santosh Kumar Rauniyar  1 , Yoko Iwaki  2 , Daisuke Yoneoka  3   4 , Masahiro Hashizume  3 , Shuhei Nomura  3   5
Affiliations

Age-appropriate vaccination coverage and its determinants in children aged 12-36 months in Nepal: a national and subnational assessment

Santosh Kumar Rauniyar et al. BMC Public Health. .

Abstract

Background: Vaccination is one of the effective ways to develop immunity against potential life-threatening diseases in children in early age. This study is focused on analysing the age-appropriate vaccination coverage at national and subnational levels and identify the factors associated with age-appropriate coverage in Nepal.

Methods: 460 children aged 12-36 months were included in the study. The data was obtained from Nepal Demographic and Health Survey (NDHS) 2016-17. Age-appropriate coverage of Bacillus Calmette-Guerin vaccine (BCG), oral polio vaccine (OPV) doses 1-3, pentavalent vaccine (PE) doses 1-3, and first dose of measles, mumps, and rubella vaccine (MMR) were estimated using Kaplan Meier method. Multilevel logistic regression with random intercept was used to identify the factors associated with age-appropriate vaccination.

Results: The crude coverage of the vaccines included in the study ranged from 91.5% (95% CI, 88.5-93.7) for PE3 to 97.8% (95.8-98.7) for BCG. Although the crude coverage of all the vaccines was above 90%, the age-appropriate coverage was significantly low, ranging from 41.5% (36.5-46.6) for PE3 to 73.9% (69.2-78.1) for PE1. Furthermore, high disparity in timely vaccination coverage was observed at regional level. Compared to the age-appropriate vaccination coverage in other provinces, Province 2 had the lowest coverage of all, followed by that in Province 6. The timeliness of vaccination was significantly associated with subnational regions i.e., provinces and the season of childbirth.

Conclusion: Although the immunization program in Nepal has achieved the target of 90% crude coverage of all the childhood vaccines, the age-appropriate coverage is significantly low which undermines the effectiveness of the vaccines administered. Thus, along with crude coverage, timeliness of the vaccines administered should be taken into consideration and thoroughly monitored at national and subnational levels. Provincial government should formulate tailored strategies to ensure the timely administration of the childhood vaccines.

Keywords: Delay; Immunization; Timeliness; Vaccination; Vaccine coverage.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig. 1
Fig. 1
Age-appropriate coverage of BCG and MMR1 vaccines at national level in Nepal, 2016. A. A Bacillus-Calmette-Guerin (BCG) vaccine. B. Measles, Mumps, and Rubella vaccine, 1st dose (MMR1). Note: BCG-Bacillus Calmette-Guerin vaccine; MMR1-Measles, Mumps, and Rubella vaccine, 1st dose. CI-Confidence interval. * The red lines in the figure indicate the age-appropriate time range for the vaccine to be administered
Fig. 2
Fig. 2
Age-appropriate coverage of BCG and MMR vaccines l at regional level in Nepal, 2016. A. Bacillus-Calmette-Guerin (BCG) vaccine. B. Measles, Mumps, and Rubella vaccine (MMR) 1st dose. Note: 1,2,3,4,5,6 and 7 are the respective provinces in Nepal. Note: BCG-Bacillus Calmette-Guerin vaccine; MMR1-Measles, Mumps, and Rubella vaccine, 1st dose. CI-Confidence interval
Fig. 3
Fig. 3
Age-appropriate coverage of OPV and PE vaccines at national level in Nepal, 2016. A. Oral polio vaccine (OPV) 1–3 doses. B. Pentavalent vaccine doses (Penta) 1–3 doses. Note: OPV-Oral Polio vaccine; Penta1, Penta2, Penta3- Pentavalent vaccines doses 1–3 (DTP-Diphtheria, Tetanus, and Pertussis vaccine; Hep B- Hepatitis B vaccine; Hib-Hemophilus influenzae type b vaccine); CI-Confidence interval. * The blue, red, and green lines in the figure indicate the age-appropriate time range for the vaccine to be administered
Fig. 4
Fig. 4
Age-appropriate coverage of Oral polio vaccines doses 1–3 at regional level in Nepal, 2016. A. Oral polio vaccine 1st dose (OPV1). B. Oral polio vaccine 2nd dose (OPV2). C. Oral polio vaccine 3rd dose (OPV3). Note: 1,2,3,4,5,6 and 7 are the respective provinces in Nepal
Fig. 5
Fig. 5
Age-appropriate coverage of Pentavalent vaccines doses 1–3 at regional level in Nepal, 2016. A. Pentavalent 1st dose (Penta1). B. Pentavalent 2nd dose (Penta2). C. Pentavalent 3rd dose (Penta3). Note: 1,2,3,4,5,6 and 7 are the respective provinces in Nepal
See this image and copyright information in PMC

References

    1. National Center for Immunization and Respiratory Diseases, CDC. Vaccines and Prevantable Diseases. 2016. https://www.cdc.gov/vaccines/vpd/index.html (accessed August 2020).
    1. Andre FE, Booy R, Bock HL, Clemens J, Datta SK, John TJ, Lee BW, Lolekha S, Peltola H, Ruff TA, Santosham M, Schmitt HJ. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ. 2008;86(2):140–146. doi: 10.2471/BLT.07.040089. - DOI - PMC - PubMed
    1. Reid M, Fleck F. The immunization programme that saved millions of lives. Bull World Health Organ. 2014;92(5):314–315. doi: 10.2471/BLT.14.020514. - DOI - PMC - PubMed
    1. Keja K, Chan C, Hayden G, Henderson RH. Expanded programme on immunization. World Health Stat Q. 1988;41(2):59–63. - PubMed
    1. World Health Organization. Immunization Coverage 2020. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage (accessed 10 September, 2020).

Publication types

Substances

LinkOut - more resources