title: Geographic analysis of vaccine uptake in a cluster-randomized controlled trial in Hue, Vietnam.
abstract: 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.
authors.affiliation: International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea. mali@ivi.int
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ali
authors.forename: Vu Dinh
authors.initials: VD
authors.lastname: Thiem
authors.forename: Jin-Kyung
authors.initials: JK
authors.lastname: Park
authors.forename: Rion Leon
authors.initials: RL
authors.lastname: Ochiai
authors.forename: Do Gia
authors.initials: DG
authors.lastname: Canh
authors.forename: M Carolina
authors.initials: MC
authors.lastname: Danovaro-Holliday
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kaljee
authors.forename: John D
authors.initials: JD
authors.lastname: Clemens
authors.forename: Camilo J
authors.initials: CJ
authors.lastname: Acosta
mesh_terms: 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
chemical_list: D022362:Hepatitis A Vaccines; D014436:Typhoid-Paratyphoid Vaccines