Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania

Int Health. 2013 Jun;5(2):139-47. doi: 10.1093/inthealth/iht006.


Background: We studied coverage and timeliness of vaccination and risk factors for low and delayed vaccine uptake in children aged <2 years in rural Tanzania.

Methods: We used data from a cluster survey conducted in 2004, which included 1403 children. Risk factors were analysed by log-binomial regression adjusted for the clustering. The analysis was restricted to BCG, first and third dose of Diphtheria-Tetanus-Pertussis vaccines (DTP-1 and DTP-3) and first dose of measles-containing vaccine (MCV-1).

Results: Coverage for BCG, DTP-1, DTP-3 and MCV-1 was 94%, 96%, 90% and 86%, respectively. Delayed vaccination (>1 month after the recommended age) occurred in 398/1205 (33%) children for BCG, 404/1189 (34%) for DTP-1, 683/990 (69%) for DTP-3 and 296/643 (46%) for MCV-1. Coverage was lower for all vaccines except DTP-1 in children living ≥5 km from a healthcare facility. Delayed uptake was associated with poverty. Low and delayed MCV-1 vaccination was associated with low maternal education. Delayed BCG vaccination was associated with ethnicity and rainy season.

Conclusion: Despite reasonably high vaccination coverage, we observed substantial vaccination delays, particularly for DTP-3 and MCV-1. We found specific factors associated with low and/or delayed vaccine uptake. These findings can help to improve strategies to reach children who remain inadequately protected.

Keywords: Children; Coverage; Risk factors; Tanzania; Timeliness; Vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • BCG Vaccine / administration & dosage*
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage*
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage*
  • Educational Status
  • Ethnicity
  • Female
  • Health Care Surveys
  • Health Services Accessibility
  • Humans
  • Infant
  • Male
  • Measles Vaccine / administration & dosage*
  • Mothers
  • Patient Acceptance of Health Care*
  • Poverty
  • Rain
  • Risk Factors
  • Rural Population
  • Seasons
  • Tanzania
  • Vaccination*


  • BCG Vaccine
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Measles Vaccine