Geographic analysis of vaccine uptake in a cluster-randomized controlled trial in Hue, Vietnam.
This paper identifies spatial patterns and predictors of vaccine uptake in a cluster-randomized controlled trial in Hue, Vietnam. Data for this study result from the integration of demographic surveillance, vaccine record, and geographic data of the study area. A multi-level cross-classified (non-hierarchical) model was used for analyzing the non-nested nature of individual's ecological data. Vaccine uptake was unevenly distributed in space and there was spatial variability among predictors of vaccine uptake. Vaccine uptake was higher among students with younger, male, or not literate family heads. Students from households with higher per-capita income were less likely to participate in the trial. Residency south of the river or further from a hospital/polyclinic was associated with higher vaccine uptake. Younger students were more likely to be vaccinated than older students in high- or low-risk areas, but not in the entire study area. The findings are important for the management of vaccine campaigns during a trial and for interpretation of disease patterns during vaccine-efficacy evaluation.
Ali
Mohammad
M
International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea. mali@ivi.int
Thiem
Vu Dinh
VD
Park
Jin-Kyung
JK
Ochiai
Rion Leon
RL
Canh
Do Gia
DG
Danovaro-Holliday
M Carolina
MC
Kaljee
Linda M
LM
Clemens
John D
JD
Acosta
Camilo J
CJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D040362:Geographic Information Systems; D005843:Geography; D022362:Hepatitis A Vaccines / Q000191:economics / Q000600:supply & distribution; D006801:Humans; D008297:Male; D032541:Mass Vaccination / Q000191:economics / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance; D012111:Residence Characteristics; D012572:School Health Services / Q000706:statistics & numerical data*; D014435:Typhoid Fever / Q000453:epidemiology / Q000517:prevention & control*; D014436:Typhoid-Paratyphoid Vaccines / Q000191:economics / Q000600:supply & distribution*; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data*; D014744:Vietnam / Q000453:epidemiology
D022362:Hepatitis A Vaccines; D014436:Typhoid-Paratyphoid Vaccines