Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination

Trop Med Int Health. 2014 Sep;19(9):1105-15. doi: 10.1111/tmi.12335. Epub 2014 Jul 16.

Abstract

Objectives: We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1-9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA).

Methods: Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince, North, Centre, South and West), 40 clusters were randomly selected in each region, and 35 households were selected per cluster.

Results: Among the 7000 visited households, 75.8% had at least one child aged 1-9 years; of these, 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled, 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA, and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA, the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1-4 years had significantly lower MR SIA coverage than those aged 5-9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8-9.1%). Awareness, educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001).

Conclusions: The 2012 SIA successfully increased MR coverage; however, to maintain measles and rubella elimination, coverage needs to be further increased among children aged 1-4 years and in regions with lower coverage.

Keywords: Estudio de cobertura; Haiti; Haití; Haïti; Rubeola; actividades suplementarias de inmunización; activité de vaccination supplémentaire; coverage survey; measles; rougeole; rubella; rubéole; sarampión; supplementary immunisation activity; surveillance de la couverture.

MeSH terms

  • Child
  • Child, Preschool
  • Family Characteristics
  • Female
  • Haiti
  • Health Care Surveys
  • Humans
  • Immunization Programs / statistics & numerical data*
  • Infant
  • Male
  • Measles / prevention & control*
  • Measles Vaccine*
  • Rubella / prevention & control*
  • Rubella Vaccine*
  • Vaccination / statistics & numerical data*

Substances

  • Measles Vaccine
  • Rubella Vaccine