title: Parental migration and children's timely measles vaccination in rural China: a cross-sectional study.
abstract: With the rapid economic development in China, millions of rural residents are migrating to the cities to gain employment, resulting in numerous left-behind children (LBC). Simultaneously, outbreaks of measles continue to occur, yet the effect of parental migration on children's vaccination status is largely unknown. This study aimed to evaluate the association between parental migration and children's timely measles vaccination in rural China, after adjusting for family socio-economic status (SES) indicators.
  
  
  
  We conducted a cross-sectional survey using multistage sampling among children aged 18-54 months in rural Guangxi of China. Information on measles vaccination status was obtained from the child's vaccination certificate, and data on SES were collected by interviewing the child's primary guardian. Family SES and vaccination coverage were compared between LBC and non-left-behind children (NLBC) using weighted logistic regression, while the delay in vaccination was compared using Kaplan-Meier survival analysis.
  
  
  
  Of the 1216 study children, 46% were LBC and 54% were NLBC. Compared to NLBC, the coverage of timely measles vaccination was significantly lower, and the median delay period was longer among LBC. After adjusting for SES indicators, LBC were significantly more likely to have an untimely vaccination for their first dose of measles vaccine than NLBC (OR = 1.33, 95% CI = 1.02-1.75).
  
  
  
  Due to the negative effect of parental migration and family SES, LBC were more likely to encounter serious delays of measles vaccination in rural China. Optimising vaccination policies could facilitate timely vaccination among LBC in rural China.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, China.|Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
authors.forename: Xianyan
authors.initials: X
authors.lastname: Tang
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
authors.forename: Edward
authors.initials: E
authors.lastname: McNeil
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Institute of Vaccination, Guangxi Center for Disease Control and Prevention, Guangxi Zhuang Autonomous Region, China.
authors.forename: Qiuyun
authors.initials: Q
authors.lastname: Deng
authors.affiliation: Institute of Vaccination, Guangxi Center for Disease Control and Prevention, Guangxi Zhuang Autonomous Region, China.
authors.forename: Aihu
authors.initials: A
authors.lastname: Dong
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Li
mesh_terms: D000328:Adult; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D016015:Logistic Models; D008297:Male; D008457:Measles / Q000517:prevention & control*; D008458:Measles Vaccine; D008875:Middle Aged; D016017:Odds Ratio; D010290:Parents; D012424:Rural Population; D012923:Social Class; D014171:Transients and Migrants; D014611:Vaccination
chemical_list: D008458:Measles Vaccine
keywords: enfants laissés derrière; estatus socioeconómico; left-behind children; migración parental; migration parentale; niños abandonados; oportunidad; opportunité; parental migration; socio-economic status; statut socioéconomique; timeliness; vaccination; vacunación