Mapping vaccination coverage to explore the effects of delivery mechanisms and inform vaccination strategies
Mapping vaccination coverage to explore the effects of delivery mechanisms and inform vaccination strategies
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DOI：
10.1038/s41467-019-09611-1
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发表时间：
2019-04-09
影响因子：
16.6
通讯作者：
Tatem, Andrew J.
中科院分区：
文献类型：
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作者：
Utazi, C. Edson;Thorley, Julia;Tatem, Andrew J.
疫苗接种计划的成功在很大程度上取决于疫苗接种中使用的机制。国家免疫规划通过卫生系统内的固定和外展服务提供儿童疫苗，并经常开展额外的补充免疫活动以填补空白并提高覆盖率。在这里，我们绘制了五个低收入和中等收入国家1 x 1 km空间分辨率的预测覆盖率，以确定使用人口与健康调查数据通过每种接种方法接种疫苗不足的地区。我们比较了第三剂白喉-破伤风-百日咳三联疫苗（DTP 3）的覆盖率估计值，该疫苗通常通过常规免疫接种（RI）提供，而麻疹疫苗（MCV）也进行了SIAs。我们发现，SIAs提高了MCV覆盖率在某些地方，但在其他地方，特别是在RI一直不足，如DTP覆盖率所示。这里概述的建模方法可以帮助指导地理优先次序和战略设计。
The success of vaccination programs depends largely on the mechanisms used in vaccine delivery. National immunization programs offer childhood vaccines through fixed and out-reach services within the health system and often, additional supplementary immunization activities (SIAs) are undertaken to fill gaps and boost coverage. Here, we map predicted coverage at 1 x 1 km spatial resolution in five low-and middle-income countries to identify areas that are under-vaccinated via each delivery method using Demographic and Health Surveys data. We compare estimates of the coverage of the third dose of diphtheria-tetanus-pertussis-containing vaccine (DTP3), which is typically delivered through routine immunization (RI), with those of measles-containing vaccine (MCV) for which SIAs are also undertaken. We find that SIAs have boosted MCV coverage in some places, but not in others, particularly where RI had been deficient, as depicted by DTP coverage. The modelling approaches outlined here can help to guide geographical prioritization and strategy design.