title: Vaccine receipt and vaccine card availability among children of the apostolic faith: analysis from the 2010-2011 Zimbabwe demographic and health survey.
abstract: BACKGROUND
  Vaccine hesitancy and refusal continue to be a global challenge to reaching immunization targets, especially among those in traditional or fundamentalist religions. The apostolic faith in Zimbabwe has been historically associated with objection to most medical interventions, including immunization.
  
  
  METHODS
  We conducted a descriptive analysis of socio-demographic characteristics and vaccine coverage among apostolic and non-apostolic adults aged 15-49 years and children aged 12-23 months using the Demographic and Health Survey conducted in Zimbabwe during 2010-2011. We used logistic regression models to estimate associations between the apostolic religion and receipt of all four basic childhood vaccinations in the Expanded Program on Immunization, receipt of no vaccinations, and availability of child vaccination card.
  
  
  RESULTS
  Among children aged 12-23 months, 64% had received all doses of the four basic vaccinations, and 12% had received none of the recommended vaccines. A vaccination card was available for 68% of children. There was no significant association between Apostolic faith and completion of all basic vaccinations (aOR = 0.90, 95% CI: 0.69-1.17), but apostolic children were almost twice as likely to have received no basic vaccinations (aOR = 1.83, 95% CI: 1.22-2.77) than non-Apostolic children, and they were 32% less likely to have a vaccination card that was available and seen by the interviewer (aOR = 0.68, 95% CI: 0.52-0.89).
  
  
  CONCLUSIONS
  Disparities in childhood vaccination coverage and availability of vaccination cards persist for apostolic in Zimbabwe. Continued collaboration with apostolic leaders and additional research to better understand vaccine hesitancy and refine interventions and messaging strategies are needed.
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Jennifer Lara
authors.initials: JL
authors.lastname: Kriss
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Goodson
authors.affiliation: InterCountry Support Team East and Southern Africa, Regional Office for Africa, World Health Organization, Harare, Zimbabwe.
authors.forename: Zorodzai
authors.initials: Z
authors.lastname: Machekanyanga
authors.affiliation: InterCountry Support Team East and Southern Africa, Regional Office for Africa, World Health Organization, Harare, Zimbabwe.
authors.forename: Messeret Eshetu
authors.initials: ME
authors.lastname: Shibeshi
authors.affiliation: InterCountry Support Team East and Southern Africa, Regional Office for Africa, World Health Organization, Harare, Zimbabwe.
authors.forename: Fussum
authors.initials: F
authors.lastname: Daniel
authors.affiliation: Immunization and Vaccines Development Programme, Regional Office for Africa, World Health Organization, Brazzaville, Republic of the Congo.
authors.forename: Balcha
authors.initials: B
authors.lastname: Masresha
authors.affiliation: InterCountry Support Team East and Southern Africa, Regional Office for Africa, World Health Organization, Harare, Zimbabwe.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kaiser
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012068:Religion and Medicine; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage*; D055815:Young Adult; D015030:Zimbabwe
chemical_list: D014612:Vaccines
keywords: Vaccines; apostolic faith; immunization; vaccine hesitancy; vaccine refusal