Determinants of vaccination coverage and adherence to the Greek national immunization program among infants aged 2-24 months at the beginning of the economic crisis (2009-2011)

BMC Public Health

Kafetzis Dimitris¹  Tsolia Maria¹  Achilleas Attilakos⁴  Zellos Aglaia²  Klinaki Eleni³  Vintila Artemis¹  Koutsoumbari Ioanna¹  Papaevangelou Vassiliki⁴ 

[1] Second Pediatric Department, National and Kapodistrian University of Athens Medical School, “P&A Kyriakou” Childrens Hospital, Thivon & Livadias, Goudi 11527, Greece;First Pediatric Department, National and Kapodistrian University of Athens Medical School, “Agia Sophia” Childrens Hospital, Thivon & Livadias, Goudi 11527, Greece;Hellenic Health Foundation, Athens, Greece;Third Pediatric Department, National and Kapodistrian University of Athens Medical School, University General Hospital “ATTIKON”, Rimini 1, Chaidari 12462, Greece

关键词: Socio economic factors;    Economic crisis;    Immigrants;    Coverage;    Vaccination;   

Others  :  1122928
DOI  :  10.1186/1471-2458-14-1192

 received in 2014-07-17, accepted in 2014-11-10,  发布年份 2014

【 摘 要 】

Background

Childhood immunization has significantly reduced the incidence of vaccine preventable diseases. Parental mistrust over vaccine safety has been associated with vaccine refusal creating barriers on vaccine coverage. Recently, economic crisis has imposed additional impediment.

Methods

Study aim was to evaluate vaccine coverage among infants 2-24 months old in the Athens metropolitan area at the beginning of the economic crisis (2009-2011).

Results

Overall, 1,667 infants were enrolled (mean age 13 months). Less than 5% of parents admitted omitting or postponing vaccination secondary to their beliefs. Although vaccination coverage was acceptable for most vaccines, lower rates of immunization were found for some newer vaccines such as hepatitis A and rotavirus. Multiple regression analysis indicated that parental age, occupational, educational statuses and family size were independently associated with immunization coverage at 6 and 12 months. Interestingly, lack of insurance was not associated with missed vaccine doses.

Conclusion

Incomplete vaccination coverage was associated with socioeconomic factors. It becomes apparent, that reassessing vaccination priorities under the current economic situation may be needed.

【 授权许可】

   
2014 Vassiliki et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Hinman AR, Orenstein WA, Schuchat A, Centers for Disease Control and Prevention (CDC): Vaccine-preventable diseases, immunizations, and MMWR--1961-2011. MMWR 2011, 60 Suppl 4:49-57. Surveill Summ
• [2]Panagiotopoulos T, Papamichael D, Stavrou D, Laggas D, Gavana M, Salonikioti A, Gogoglou B, Theocharopoulos G, Koutentakis K, Benos A, Giannakopoulos S, Georgakopoulou T, Golfinopoulou K, Detsis M, Keramarou M, Leivaditi B, Mellou K, Danis K, Panteli J, Pervanidou D, Sideroglou T, Tsana M: National Immunization coverage study in Greek children 2012. 2012. http://www.nsph.gr/files/011_Ygeias_Paidiou/Ereunes/ekthesi_emvolia_2012.pdf webcite (last accessed 30/05/2014)
• [3]Centers for Disease Control and Prevention (CDC): Vaccination coverage among children in kindergarten--United States, 2012-13 school year. MMWR 2013, 62:607-612.
• [4]Blumberg S, Enanoria WT, Lloyd-Smith JO, Lietman TM, Porco TC: Identifying post elimination trends for the introduction and transmissibility of measles in the United States. Am J Epidemiol. 2014, 179:1375-1382.
• [5]Omer SB, Richards JL, Ward M, Bednarczyk RA: Vaccination policies and rates of exemption from immunization, 2005–2011. N Engl J Med 2012, 367:1170-1171.
• [6]De Serres G, Gay NJ, Farrington CP: Epidemiology of transmissible disease after elimination. Am J Epidemiol 2000, 151:1039-1048.
• [7]Omer SB, Salmon DA, Orenstein WA, de Hart MP, Halsey N: Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N Engl J Med 2009, 360:1981-1988.
• [8]Gottret P, Gupta V, Sparkes S, Tandon A, Moran V, Berman P: Protecting pro-poor health services during financial crises: lessons from experience. Adv Health Econ Health Serv Res 2009, 21:23-53. Review
• [9]Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, Mackenbach JP, McKee M: Financial crisis, austerity, and health in Europe. Lancet 2013, 381:1323-1331.
• [10]Centers for Disease Control and Prevention: National, State, and Local area vaccination coverage among children aged 19–35 Months — United States, 2012. MMWR 2013, 62:733-740.
• [11]Rousounidis A, Papaevangelou V, Hadjipanayis A, Panagakou S, Theodoridou M, Syrogiannopoulos G, Hadjichristodoulou C: Descriptive study on parents' knowledge, attitudes and practices on antibiotic use and misuse in children with upper respiratory tract infections in Cyprus. Int J Environ Res Public Health 2011, 8:3246-3262.
• [12]Danis K, Georgakopoulou T, Stavrou T, Laggas D, Panagiotopoulos T: Socioeconomic factors play a more important role in childhood vaccination coverage than parental perceptions: a cross-sectional study in Greece. Vaccine 2010, 28:1861-1869.
• [13]Grivea IN, Priftis KN, Giotas A, Kotzia D, Tsantouli AG, Douros K, Michoula AN, Syrogiannopoulos GA: Dynamics of pneumococcal carriage among day-care center attendees during the transition from the 7-valent to the higher-valent pneumococcal conjugate vaccines in Greece. Vaccine 2014. [epub ahead of print]
• [14]Pavlopoulou ID, Michail KA, Samoli E, Tsiftis G, Tsoumakas K: Immunization coverage and predictive factors for complete and age-appropriate vaccination among preschoolers in Athens, Greece: a cross–sectional study. BMC Public Health 2013, 13:908. BioMed Central Full Text
• [15]Fonteneau L, Urcun JM, Guthmann JP, Collet M, Neulat N, Bristol-Gauzy P, Guignon N, Lévy-Bruhl D, Herbet JB: Vaccination coverage in 6-year-old preschool children, France, 2005-2006. Arch Pediatr 2013, 20:241-247.
• [16]Yusuf HR, Daniels D, Smith P, Coronado V, Rodewald L: Association between administration of hepatitis B vaccine at birth and completion of the hepatitis B and 4:3:1:3 vaccine series. JAMA 2000, 284:978-983.
• [17]Baldo V, Bonanni P, Castro M, Gabutti G, Franco E, Marchetti F, Prato R, Vitale F: Combined hexavalent diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Hemophilus influenzae type b vaccine; Infanrix™ hexa: Twelve years of experience in Italy. Hum Vaccin Immunother 2014, 10:129-137.
• [18]Prislin R, Dyer JA, Blakely CH, Johnson CD: Immunization status and sociodemographic characteristics: the mediating role of beliefs, attitudes, and perceived control. Am J Public Health 1988, 88:1821-1826.
• [19]Kentikelenis A, Karanikolos M, Papanicolas I, Basu S, McKee M, Stuckler D: Health effects of financial crisis: omens of a Greek tragedy. Lancet 2011, 378:1457-1458.
• [20]McKee M, Karanikolos M, Belcher P, Stuckler D: Austerity: a failed experiment on the people of Europe. Clin Med 2012, 12:346-350.
• [21]Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M: Migration and health in an increasingly diverse Europe. Lancet 2013, 381:1235-1245.
• [22]Wolfe I, Thompson M, Gill P, Tamburlini G, Blair M, van den Bruel A, Ehrich J, Pettoello-Mantovani M, Janson S, Karanikolos M, McKee M: Health services for children in Western Europe. Lancet 2013, 381:1224-1234.