Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination.

Vaccination coverage surveys - Publication

abstract: OBJECTIVES: We conducted a nationwide survey to assess

measles containing vaccine (MCV) coverage among children aged 1-9

years in Haiti and identify factors associated with vaccination

before and during the 2012 nationwide supplementary immunisation

activities (SIA). METHODS: Haiti was stratified into five

geographic regions (Metropolitan Port-au-Prince, North, Centre,

South and West), 40 clusters were randomly selected in each region,

and 35 households were selected per cluster. RESULTS: Among the

7000 visited households, 75.8% had at least one child aged 1-9

years; of these, 5279 (99.5%) households consented to participate

in the survey. Of 9883 children enrolled, 91% received MCV before

and/or during the SIA; 31% received MR for the first time during

the SIA, and 50.7% received two doses of MCV (one before and one

during the 2012 SIA). Among the 1685 unvaccinated children during

the SIA, the primary reason of non-vaccination was caregivers not

being aware of the SIA (31.0%). Children aged 1-4 years had

significantly lower MR SIA coverage than those aged 5-9 years

(79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children

living in the West (12.3%) and Centre (11.2%) regions had never

been vaccinated than in other regions (4.8-9.1%). Awareness,

educational level of the mother and region were significantly

associated with MR vaccination during and before the SIA (P <

0.001). CONCLUSIONS: The 2012 SIA successfully increased MR

coverage; however, to maintain measles and rubella elimination,

coverage needs to be further increased among children aged 1-4

years and in regions with lower coverage.