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Abstract

Background

Childhood vaccination schedules recommend vaccine doses at predefined ages.

Aim

We evaluated vaccination completeness and timeliness in Jerusalem, a district with recurrent vaccine-preventable disease outbreaks.

Methods

Vaccination coverage was monitored by the up-to-date method (vaccination completeness at age 2 years). Timeliness of vaccination was assessed in children (n = 3,098, born in 2009, followed to age 48 months, re-evaluated at age 7 years) by the age-appropriate method (vaccine dose timeliness according to recommended schedule). Vaccines included: hepatitis B (HBV: birth, 1 month and 6 months); diphtheria, tetanus, acellular pertussis, polio, b (DTaP-IPV-Hib: 2, 4, 6 and 12 months); pneumococcal conjugate (PCV: 2, 4 and 12 months); measles-mumps-rubella/measles-mumps-rubella-varicella (MMR/MMRV: 12 months) and hepatitis A (HAV: 18 and 24 months).

Results

Overall vaccination coverage (2014 cohort evaluated at age 2 years) was 95% and 86% for MMR/MMRV and DTaP-IPV-Hib4, respectively. Most children (94%, 91%, 79%, 95%, 92% and 82%) were up-to-date for HBV3, DTaP-IPV-Hib4, PCV3, MMR/MMRV1, HAV1 and HAV2 vaccines at 48 months, but only 32%, 28%, 38%, 58%, 49% and 20% were vaccinated timely (age-appropriate). At age 7 years, the median increase in vaccination coverage was 2.4%. Vaccination delay was associated with: high birth order, ethnicity (higher among Jews vs Arabs), birth in winter, delayed acceptance of first dose of DTaP-IPV-Hib and multiple-dose vaccines (vs MMR/MMRV). Jewish ultra-Orthodox communities had low vaccination coverage.

Conclusions

Considerable vaccination delay should be addressed within the vaccine hesitancy spectrum. Delays may induce susceptibility to vaccine-preventable disease outbreaks; tailored programmes to improve timeliness are required.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2019-02-07
2025-07-19
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Timeliness and completeness of routine childhood vaccinations in young children residing in a district with recurrent vaccine-preventable disease outbreaks, Jerusalem, Israel
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Chen+Stein-Zamir&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stein-Zamir Chen</a>, <a href="/search?value1=Avi+Israeli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Israeli Avi</a></span>. Timeliness and completeness of routine childhood vaccinations in young children residing in a district with recurrent vaccine-preventable disease outbreaks, Jerusalem, Israel. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(6):pii=1800004. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.6.1800004" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.6.1800004</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 23 Dec 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 26 Nov 2018 </span> </p>
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