Determinants of basic childhood vaccination coverage in European and OECD countries
Vaccination coverage varies between countries and over time. Using official databases, we extracted data on 50 national-level immunization, socio-economic, demographic, healthcare, and cultural factors, and the uptake of the third dose of diphtheria toxoid, tetanus toxoid, and pertussis vaccines (DT...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-11-01
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| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/21645515.2022.2123883 |
| _version_ | 1797673101603897344 |
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| author | Vladimira Varbanova Frederik Verelst Niel Hens Philippe Beutels |
| author_facet | Vladimira Varbanova Frederik Verelst Niel Hens Philippe Beutels |
| author_sort | Vladimira Varbanova |
| collection | DOAJ |
| description | Vaccination coverage varies between countries and over time. Using official databases, we extracted data on 50 national-level immunization, socio-economic, demographic, healthcare, and cultural factors, and the uptake of the third dose of diphtheria toxoid, tetanus toxoid, and pertussis vaccines (DTP3) and the first dose of measles-containing vaccines (MCV1) for 61 countries between 1990 and 2019. The main branch of the analysis included all covariates, while a secondary branch excluded life-expectancy and child mortality. The statistical analysis was completed in three stages: a variable-selection stage via random forests; multilevel multiple imputation for missing data in the reduced dataset; and generalized estimating equations (GEE) over all imputed datasets with pooled results. Less than 20 covariates were retained after variable-selection. Among a relatively small number of statistically significant (p-value <.05) effects in the pooled GEE results of our main branch, under-5 mortality and long-term orientation culture showed negative associations with both uptake outcomes and GDP per capita a positive association. For MCV1, whether a second dose was integrated into routine immunization appeared as the overall strongest negative correlate. In the secondary analytical branch, results were largely consistent, with a few additional statistically significant effects emerging, mainly related to immunization and healthcare system characteristics. These insights improve our understanding of the main factors influencing vaccine uptake, some of which are broadly contextual (e.g., GDP, socio-cultural factors), requiring bespoke vaccine program approaches, in order to maximize childhood vaccine uptake over time. |
| first_indexed | 2024-03-11T21:40:37Z |
| format | Article |
| id | doaj.art-5a8aa9ead1264c74bcbc0b3e9089805c |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T21:40:37Z |
| publishDate | 2022-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-5a8aa9ead1264c74bcbc0b3e9089805c2023-09-26T13:19:09ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2022-11-0118610.1080/21645515.2022.21238832123883Determinants of basic childhood vaccination coverage in European and OECD countriesVladimira Varbanova0Frederik Verelst1Niel Hens2Philippe Beutels3University of AntwerpUniversity of AntwerpUniversity of AntwerpUniversity of AntwerpVaccination coverage varies between countries and over time. Using official databases, we extracted data on 50 national-level immunization, socio-economic, demographic, healthcare, and cultural factors, and the uptake of the third dose of diphtheria toxoid, tetanus toxoid, and pertussis vaccines (DTP3) and the first dose of measles-containing vaccines (MCV1) for 61 countries between 1990 and 2019. The main branch of the analysis included all covariates, while a secondary branch excluded life-expectancy and child mortality. The statistical analysis was completed in three stages: a variable-selection stage via random forests; multilevel multiple imputation for missing data in the reduced dataset; and generalized estimating equations (GEE) over all imputed datasets with pooled results. Less than 20 covariates were retained after variable-selection. Among a relatively small number of statistically significant (p-value <.05) effects in the pooled GEE results of our main branch, under-5 mortality and long-term orientation culture showed negative associations with both uptake outcomes and GDP per capita a positive association. For MCV1, whether a second dose was integrated into routine immunization appeared as the overall strongest negative correlate. In the secondary analytical branch, results were largely consistent, with a few additional statistically significant effects emerging, mainly related to immunization and healthcare system characteristics. These insights improve our understanding of the main factors influencing vaccine uptake, some of which are broadly contextual (e.g., GDP, socio-cultural factors), requiring bespoke vaccine program approaches, in order to maximize childhood vaccine uptake over time.http://dx.doi.org/10.1080/21645515.2022.2123883vaccinationimmunizationdiphtheria toxoid, tetanus toxoid and pertussis vaccines (dtp)measles-containing vaccines (mcv)longitudinalmulti-country |
| spellingShingle | Vladimira Varbanova Frederik Verelst Niel Hens Philippe Beutels Determinants of basic childhood vaccination coverage in European and OECD countries Human Vaccines & Immunotherapeutics vaccination immunization diphtheria toxoid, tetanus toxoid and pertussis vaccines (dtp) measles-containing vaccines (mcv) longitudinal multi-country |
| title | Determinants of basic childhood vaccination coverage in European and OECD countries |
| title_full | Determinants of basic childhood vaccination coverage in European and OECD countries |
| title_fullStr | Determinants of basic childhood vaccination coverage in European and OECD countries |
| title_full_unstemmed | Determinants of basic childhood vaccination coverage in European and OECD countries |
| title_short | Determinants of basic childhood vaccination coverage in European and OECD countries |
| title_sort | determinants of basic childhood vaccination coverage in european and oecd countries |
| topic | vaccination immunization diphtheria toxoid, tetanus toxoid and pertussis vaccines (dtp) measles-containing vaccines (mcv) longitudinal multi-country |
| url | http://dx.doi.org/10.1080/21645515.2022.2123883 |
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