title: Vaccination Coverage Cluster Surveys in Middle Dreib - Akkar, Lebanon: Comparison of Vaccination Coverage in Children Aged 12-59 Months Pre- and Post-Vaccination Campaign.
abstract: BACKGROUND
  With the high proportion of refugee population throughout Lebanon and continuous population movement, it is sensible to believe that, in particular vulnerable areas, vaccination coverage may not be at an optimal level. Therefore, we assessed the vaccination coverage in children under 5 in a district of the Akkar governorate before and after a vaccination campaign. During the vaccination campaign, conducted in August 2015, 2,509 children were vaccinated.
  
  
  METHODS
  We conducted a pre- and post-vaccination campaign coverage surveys adapting the WHO EPI cluster survey to the Lebanese MoPH vaccination calendar. Percentages of coverage for each dose of each vaccine were calculated for both surveys. Factors associated with complete vaccination were explored.
  
  
  RESULTS
  Comparing the pre- with the post-campaign surveys, coverage for polio vaccine increased from 51.9% to 84.3%, for Pentavalent from 49.0% to 71.9%, for MMR from 36.2% to 61.0%, while the percentage of children with fully updated vaccination calendar increased from 32.9% to 53.8%. While Lebanese children were found to be better covered for some antigens compared to Syrians at the first survey, this difference disappeared at the post-campaign survey. Awareness and logistic obstacles were the primary reported causes of not complete vaccination in both surveys.
  
  
  CONCLUSIONS
  Vaccination campaigns remain a quick and effective approach to increase vaccination coverage in crisis-affected areas. However, campaigns cannot be considered as a replacement of routine vaccination services to maintain a good level of coverage.
authors.affiliation: International Committee of the Red Cross, Health Department, Beirut, Lebanon.
authors.forename: Rodolfo
authors.identifier: http://orcid.org/0000-0001-7761-7162
authors.initials: R
authors.lastname: Rossi
authors.affiliation: Republic of Lebanon, Ministry of Public Health, Primary Health Care services, Halba, Lebanon.
authors.forename: Ramia
authors.initials: R
authors.lastname: Assaad
authors.affiliation: International Committee of the Red Cross, Health Department, Beirut, Lebanon.
authors.forename: Arianna
authors.initials: A
authors.lastname: Rebeschini
authors.affiliation: Republic of Lebanon, Ministry of Public Health, Social Health Service & Primary Health Care Department, Immunization and Essential Drugs Program, Beirut, Lebanon.
authors.forename: Randa
authors.initials: R
authors.lastname: Hamadeh
mesh_terms: D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D007223:Infant; D007861:Lebanon; D008297:Male; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D023321:Poliovirus Vaccines / Q000008:administration & dosage*; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D022542:Measles-Mumps-Rubella Vaccine; D023321:Poliovirus Vaccines; D022243:Rotavirus Vaccines