Objectives: Many developing countries achieved high coverage for childhood vaccinations. However,
research has shown that vaccinations are sometimes administered with substantial delays.
We aimed to examine the extent of delays in childhood vaccinations and to examine
factors associated with delayed and missing vaccinations. Methods: We used the recent available MICS3 data in 34 countries conducted in 2005 and 2006
(n=113,570). Surveys were conducted among women aged between 15 and 49 years, only
information on childhood vaccinations from child health cards was used. The Kaplan-Meier
method was used to examine age-appropriate vaccinations and delays in vaccinations.
Factors associated with delayed and missing vaccinations were assessed by using multilevel
logistic regression analysis. Results: The median fraction of timely administered vaccination across all countries was 65%
(Interquartile range, IQR 51.6–71.6) for BCG, 65% (53.8–70.7) for DTP1, 41% (27.1–51.5)
for DTP3 and 51% (42.7–62.5) for MCV. The median of the median delays across all countries
for BCG was 2.3 weeks (IQR 0.7–5.6), 2.6 weeks (0.7–6.6) for DTP1; 6.4 weeks (2.3–17.3)
for DTP3; and 4.2 weeks (1.0–14.0) for MCV. Boys, those living in families with a
higher number of children, children living in rural areas and from poorer families
were more likely to be vaccinated with delays for DTP vaccine compared to timely vaccinated
children. Similar pattern of association was observed for MCV vaccine (except gender
and place of residence). A lower economic status was also associated with a higher
risk of missing DTP and MCV vaccinations. Conclusions: Vaccinations were often administered with substantial delays. An inclusion of the
new indicator „Age-appropriate vaccination“ into the monitoring systems of vaccination
services may help to identify delayed vaccinations and therefore, undertake necessary
interventions. Further research is needed to examine more deeply factors contributing
to delayed vaccination.
