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
. 2022 Nov 11;12(11):e050211.
doi: 10.1136/bmjopen-2021-050211.

Spatial distribution, determinants and trends of full vaccination coverage in children aged 12-59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

Ali Al-Kassab-Córdova  1 , Claudia Silva-Perez  1 , Jorge L Maguiña  2
Affiliations

Spatial distribution, determinants and trends of full vaccination coverage in children aged 12-59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

Ali Al-Kassab-Córdova et al. BMJ Open. .

Abstract

Objective: To assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12-59 months between 2010 and 2019 in Peru.

Design, setting and analysis: A cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran's I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic.

Outcome measure: FVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age.

Participants: A total of 5 751 and 14 144 children aged 12-59 months from 2010 and 2019 DHSs, respectively, were included.

Results: FVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified.

Conclusions: Although FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.

Keywords: Community child health; Epidemiology; Geographical mapping; Paediatric infectious disease & immunisation; Public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Vaccination coverage by type of vaccine in children aged 12–59 months in Peru, 2010 and 2019 Footnote: DPT, Diphtheria, pertussis, tetanus; MMR, measles, mumps, rubella.
Figure 2
Figure 2
Time trend of full vaccination coverage in children aged 12–59 months in Peru, 2010–2019. P trend p<0.0001.
Figure 3
Figure 3
(A) Choropleth map at the departmental level of the full vaccination coverage in children aged 12–59 months in Peru, 2019 (B). Kriging interpolation of full vaccination coverage in children aged 12–59 months in Peru, 2019 (C). Spatial clustering of areas with incomplete vaccination coverage in children aged 12–59 months in Peru, 2019.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. WHO . Vaccines and diseases, 2019. Available: http://www.who.int/immunization/diseases/en/ [Accessed 20 June 2020].
    1. Ng SS, Hutubessy R, Chaiyakunapruk N. Systematic review of cost-effectiveness studies of human papillomavirus (HPV) vaccination: 9-valent vaccine, gender-neutral and multiple age cohort vaccination. Vaccine 2018;36:2529–44. 10.1016/j.vaccine.2018.03.024 - DOI - PubMed
    1. Dilokthornsakul P, Kengkla K, Saokaew S, et al. . An updated cost-effectiveness analysis of pneumococcal conjugate vaccine among children in Thailand. Vaccine 2019;37:4551–60. 10.1016/j.vaccine.2019.06.015 - DOI - PubMed
    1. Ning G, Yin Z, Li Y, et al. . Cost-Effectiveness of the Haemophilus influenzae type B vaccine for infants in mainland China. Hum Vaccin Immunother 2018;14:36–44. 10.1080/21645515.2017.1385687 - DOI - PMC - PubMed
    1. Andre F, Booy R, Bock HL. Who vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ 2011. 10.2471/blt.07.040089 - DOI - PMC - PubMed

Substances

LinkOut - more resources