Vaccine coverage estimation using a computerized vaccination registry with potential underreporting and a seroprevalence study.
OBJECTIVE
To develop a method to estimate vaccination coverage using both a computerized vaccine registry with an unknown underreporting rate and a seroprevalence study. A real example of a meningococcal C conjugate vaccine (MCCV) coverage estimation is studied to illustrate the proposed methodology.


METHODS
We reviewed the Vaccine Information System of Valencia (Sistema de Información Vacunal, SIV) for the MCCV status of 1430 subjects aged 3-29 years as part of a seroprevalence study. When MCCV was not registered in SIV, subjects were classified into three groups (MCCV non-registered, no vaccination records and missing information) depending on the registry of other vaccines. A Bayesian model was developed to ascertain the percentage of MCCV-vaccinated subjects based on the meningococcal C seroprotection levels from the seroprevalence study.


RESULTS
The seroprotection levels in subjects with no MCCV registered in SIV (358) were similar to those in subjects with MCCV registered (1072). This indicated a large proportion of vaccinated subjects with no MCCV registered. The estimated vaccine coverage was over 80% in all age groups, except >22 years, where it was 67.6% (95% CI: [54.0-80.4]), which corresponded to those aged over 13 years at the time of the catch-up campaign. An underreporting rate of 23.5-73.4%, depending on the age group, was estimated in those vaccinated in the 2002 catch-up campaign.


CONCLUSIONS
The Bayesian model allowed for a more realistic estimation of MCCV uptake. In this example, we quantified the underreporting of a vaccine registry, especially occurring during a catch-up campaign that occurred at the establishment of the registry.
Vaccine Research, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region FISABIO - Public Health, Avenida Cataluña 21, CP 46020 Valencia, Spain.
Lina Pérez
LP
Breva
Vaccine Research, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region FISABIO - Public Health, Avenida Cataluña 21, CP 46020 Valencia, Spain. Electronic address: diez_jav@gva.es.
Javier Díez
JD
Domingo
Health inequalities, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region FISABIO - Public Health, Avenida Cataluña 21, CP 46020 Valencia, Spain.
Miguel Ángel
MÁ
Martínez Beneito
Vaccine Research, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region FISABIO - Public Health, Avenida Cataluña 21, CP 46020 Valencia, Spain.
Joan Puig
JP
Barberà
D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D008297:Male; D022401:Meningococcal Vaccines / Q000276:immunology; D038542:Neisseria meningitidis, Serogroup C / Q000276:immunology*; D012042:Registries; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
D000907:Antibodies, Bacterial; D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine
Bayesian model; Electronic immunization registries; Meningococcal C conjugate vaccine; Seroprevalence studies; Underreporting; Vaccination coverage; Validation studies