title: Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey.
abstract: BACKGROUND
  Large-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV). This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18-54 months in rural Guangxi.
  
  
  METHODS
  Based on quartiles of measles incidence during 2011-2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs) were calculated. Weighted Kaplan-Meier analyses were used to estimate the median delay periods for the first (MCV1) and second (MCV2) doses of the vaccine.
  
  
  RESULTS
  A total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%-62.0%) for MCV1, and 76.9% (95% CI, 73.6%-80.0%) for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%-51.0%). The median delay period was 32 (95% CI, 27-38) days for MCV1, and 159 (95% CI, 118-195) days for MCV2.
  
  
  CONCLUSIONS
  The timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China.
authors.affiliation: Department of Epidemiology & 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. Electronic address: alan.g@psu.ac.th.
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 & 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
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage*; D012424:Rural Population / Q000706:statistics & numerical data*; D013997:Time Factors; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D008458:Measles Vaccine
keywords: Completeness; Measles; Rural children; Timeliness; Vaccination