Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan
Background/Objectives: Full immunization coverage in Pakistan remains suboptimal at 66%. An in-depth assessment is needed to understand the long-term trends in immunization and identify the extent of defaulters and associated risk factors of them being left uncovered by the immunization system. Meth...
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MDPI AG
2024-11-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/12/12/1327 |
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| author | Fatima Miraj Sundus Iftikhar Muhammad Siddique Vijay Kumar Dharma Mubarak Taighoon Shah Danya Arif Siddiqi Subhash Chandir |
| author_facet | Fatima Miraj Sundus Iftikhar Muhammad Siddique Vijay Kumar Dharma Mubarak Taighoon Shah Danya Arif Siddiqi Subhash Chandir |
| author_sort | Fatima Miraj |
| collection | DOAJ |
| description | Background/Objectives: Full immunization coverage in Pakistan remains suboptimal at 66%. An in-depth assessment is needed to understand the long-term trends in immunization and identify the extent of defaulters and associated risk factors of them being left uncovered by the immunization system. Methods: We conducted a 5-year analysis using the Government’s Provincial Electronic Immunization Registry data for the 2018–2023 birth cohorts in Sindh province. We analyzed 8,792,392 child-level immunization records from 1 January 2018 to 31 May 2024 to examine trends in immunization coverage, timeliness, defaulter rates, and associated risk factors; Results: Our findings indicate gradual improvements in immunization coverage, with full immunization rates increasing by 23.2% (from 47.5% to 70.7%) from 2018 to 2022. While timeliness declined from 2018 to 2021, it recovered in 2022 and 2023. Over the 5-year study period, >90% of children defaulted on vaccinations, with 34.8% fully covered and 9.1% uncovered. Children from urban areas (OR = 1.54; 95% CI = 1.52, 1.56; <i>p</i>-value < 0.001) and those enrolled through fixed immunization sites (OR = 2.11; 95% CI = 2.08, 2.15; <i>p</i>-value < 0.001) and mobile immunization vans (OR = 1.13; 95% CI = 1.13, 1.77; <i>p</i>-value = 0.003) were at higher risk of being uncovered defaulters. Conclusions: This study demonstrates improvements in immunization coverage in Sindh while highlighting the challenge of low timeliness and high default rates. Our findings provide insights to strengthen immunization access and timeliness, particularly in high-default areas, and can guide policies in similar low-income settings for more equitable and comprehensive immunization coverage. |
| format | Article |
| id | doaj-art-3d053b229d40434d897dbc84de8d2859 |
| institution | OA Journals |
| issn | 2076-393X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Vaccines |
| spelling | doaj-art-3d053b229d40434d897dbc84de8d28592025-08-20T02:01:19ZengMDPI AGVaccines2076-393X2024-11-011212132710.3390/vaccines12121327Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, PakistanFatima Miraj0Sundus Iftikhar1Muhammad Siddique2Vijay Kumar Dharma3Mubarak Taighoon Shah4Danya Arif Siddiqi5Subhash Chandir6Maternal & Child Health, IRD Pakistan, Karachi 75190, PakistanMaternal & Child Health, IRD Pakistan, Karachi 75190, PakistanMaternal & Child Health, IRD Pakistan, Karachi 75190, PakistanMaternal & Child Health, IRD Pakistan, Karachi 75190, PakistanIRD Global, 16 Raffles Quay, Singapore 049145, SingaporeIRD Global, 16 Raffles Quay, Singapore 049145, SingaporeIRD Global, 16 Raffles Quay, Singapore 049145, SingaporeBackground/Objectives: Full immunization coverage in Pakistan remains suboptimal at 66%. An in-depth assessment is needed to understand the long-term trends in immunization and identify the extent of defaulters and associated risk factors of them being left uncovered by the immunization system. Methods: We conducted a 5-year analysis using the Government’s Provincial Electronic Immunization Registry data for the 2018–2023 birth cohorts in Sindh province. We analyzed 8,792,392 child-level immunization records from 1 January 2018 to 31 May 2024 to examine trends in immunization coverage, timeliness, defaulter rates, and associated risk factors; Results: Our findings indicate gradual improvements in immunization coverage, with full immunization rates increasing by 23.2% (from 47.5% to 70.7%) from 2018 to 2022. While timeliness declined from 2018 to 2021, it recovered in 2022 and 2023. Over the 5-year study period, >90% of children defaulted on vaccinations, with 34.8% fully covered and 9.1% uncovered. Children from urban areas (OR = 1.54; 95% CI = 1.52, 1.56; <i>p</i>-value < 0.001) and those enrolled through fixed immunization sites (OR = 2.11; 95% CI = 2.08, 2.15; <i>p</i>-value < 0.001) and mobile immunization vans (OR = 1.13; 95% CI = 1.13, 1.77; <i>p</i>-value = 0.003) were at higher risk of being uncovered defaulters. Conclusions: This study demonstrates improvements in immunization coverage in Sindh while highlighting the challenge of low timeliness and high default rates. Our findings provide insights to strengthen immunization access and timeliness, particularly in high-default areas, and can guide policies in similar low-income settings for more equitable and comprehensive immunization coverage.https://www.mdpi.com/2076-393X/12/12/1327full immunization coverageimmunization defaultervaccine timelinessantigen-wise coverageimmunization outreach activitiesCOVID-19 pandemic |
| spellingShingle | Fatima Miraj Sundus Iftikhar Muhammad Siddique Vijay Kumar Dharma Mubarak Taighoon Shah Danya Arif Siddiqi Subhash Chandir Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan Vaccines full immunization coverage immunization defaulter vaccine timeliness antigen-wise coverage immunization outreach activities COVID-19 pandemic |
| title | Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan |
| title_full | Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan |
| title_fullStr | Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan |
| title_full_unstemmed | Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan |
| title_short | Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan |
| title_sort | leveraging data from a provincial electronic immunization registry to analyze immunization coverage timeliness and defaulters among 8 8 million children from the 2018 to 2023 birth cohorts in sindh province pakistan |
| topic | full immunization coverage immunization defaulter vaccine timeliness antigen-wise coverage immunization outreach activities COVID-19 pandemic |
| url | https://www.mdpi.com/2076-393X/12/12/1327 |
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