title: Assessment of delay in age-appropriate vaccination using survival analysis.
abstract: Assessment of delay in age-appropriate vaccination provides more information about timeliness of vaccination than up-to-date vaccination coverage. The authors applied survival analysis methods to data from a vaccination coverage survey among children aged 13-59 months conducted in Argentina in 2002. By age 19 months, 43% of children (95% confidence interval (CI): 40, 46) were vaccinated with the fourth dose of diphtheria, tetanus, and pertussis (DTP4). By age 13 months, 55% of children (95% CI: 52, 57) were vaccinated with measles-containing vaccine. By age 7 months, 33% of children (95% CI: 27, 40) were vaccinated with the third dose of hepatitis B. Compared with firstborn children, third children were more likely to be delayed for DTP4 (relative risk (RR) = 1.41, 95% CI: 1.22, 1.62), measles-containing vaccine (RR = 1.54, 95% CI: 1.32, 1.78), and the third dose of hepatitis B (RR = 1.31, 95% CI: 1.03, 1.67). Children whose caregivers had completed secondary school were less likely to be delayed for DTP4 (RR = 0.68, 95% CI: 0.52, 0.90) compared with those whose caregivers had not completed primary school. Survival analysis methods were helpful in measuring vaccine uptake and should be considered in future surveys when assessing delay in age-appropriate vaccination.
authors.affiliation: Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-61, Atlanta, GA 30333, USA. gdayan@cdc.gov
authors.forename: Gustavo H
authors.initials: GH
authors.lastname: Dayan
authors.forename: Kate M
authors.initials: KM
authors.lastname: Shaw
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Baughman
authors.forename: Liliana C
authors.initials: LC
authors.lastname: Orellana
authors.forename: Raúl
authors.initials: R
authors.lastname: Forlenza
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ellis
authors.forename: Jorge
authors.initials: J
authors.lastname: Chaui
authors.forename: Silvia
authors.initials: S
authors.lastname: Kaplan
authors.forename: Peter
authors.initials: P
authors.lastname: Strebel
mesh_terms: D000367:Age Factors; D001118:Argentina / Q000453:epidemiology; D002662:Child Health Services / Q000592:standards / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003141:Communicable Diseases / Q000401:mortality*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D012306:Risk; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D014611:Vaccination / Q000592:standards / Q000706:statistics & numerical data*