Socioeconomic characteristics associated with the introduction of new vaccines and full childhood vaccination in Ghana, 2014

Elizabeth B Moran; Abram L Wagner; Franklin Asiedu-Bekoe; Abass Abdul-Karim; Lee F Schroeder; Matthew L Boulton

doi:10.1016/j.vaccine.2020.02.065

Socioeconomic characteristics associated with the introduction of new vaccines and full childhood vaccination in Ghana, 2014

Vaccine. 2020 Mar 23;38(14):2937-2942. doi: 10.1016/j.vaccine.2020.02.065. Epub 2020 Mar 2.

Authors

Elizabeth B Moran¹, Abram L Wagner², Franklin Asiedu-Bekoe³, Abass Abdul-Karim⁴, Lee F Schroeder⁵, Matthew L Boulton⁶

Affiliations

¹ Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. Electronic address: ebmoran@umich.edu.
² Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. Electronic address: awag@umich.edu.
³ Ghana Health Service, Accra, Ghana. Electronic address: kofi2711@gmail.com.
⁴ Zonal Public Health Laboratory, Tamale, Ghana. Electronic address: abass.komei@yahoo.com.
⁵ Department of Pathology, Michigan Medicine, Ann Arbor, MI, USA. Electronic address: leeschro@med.umich.edu.
⁶ Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Internal Medicine, Division of Infectious Disease, Michigan Medicine, Ann Arbor, MI, USA. Electronic address: mboulton@umich.edu.

PMID: 32139314
DOI: 10.1016/j.vaccine.2020.02.065

Abstract

Background: Childhood vaccination in Ghana has historically been high, but the impact of recently introduced vaccines on coverage is unknown. We calculate vaccine coverage of Ghanaian children- contrasting newly introduced vaccines and those long available - and describe associations between sociodemographic indicators and full vaccination.

Methods: Data from the 2014 Ghana Demographic and Health Survey was used to calculate full vaccination, defined as receipt of one dose bacillus Calmette-Guérin (BCG); two doses of rotavirus vaccine; 3 doses of pentavalent vaccine, oral polio vaccine (OPV), and pneumococcal conjugate vaccine (PCV); and one dose of measles-rubella vaccine and yellow fever vaccine, among children age 12-24 months. Logistic regression with survey procedures was used to estimate odds ratios for socioeconomic factors' association with full vaccination.

Results: The sample comprised a total of 1107 children 12-24 months. Full vaccination coverage was 70.8%. Vaccination coverage was higher for vaccines administered at younger ages (e.g., birth dose of BCG was 97.0%) than at older ages (e.g., yellow fever at 9 months was 88.2%). Newly introduced vaccines had lower coverage: at 10 weeks, pentavalent 2 was 95.4%, versus 91.2% for PCV 2 and 88.8% for rotavirus 2. Living outside of Greater Accra, home delivery, younger maternal age, urban residence, and more than one child under five in the home were all associated with decreased odds of full vaccination in the adjusted analysis whereas sex of the child, wealth, religion, and maternal education were not associated with full vaccination status.

Conclusion: Ghana has high overall vaccination rates although disparities in full vaccination by sociodemographic status exist. As vaccine recommendations are revised, it will be important to insure equitable access to vaccination for all children regardless of demographic and socioeconomic background.

Keywords: BCG vaccine; Health surveys; Rotavirus vaccines; Socioeconomic factors; Yellow fever vaccine.

MeSH terms

Ghana / epidemiology
Humans
Immunization Programs*
Infant
Socioeconomic Factors*
Vaccination / statistics & numerical data*