Examining Reasons for Under-vaccination Among Kenyan Children Born Before and During the COVID-19 Pandemic
In collaboration with the Kenyan Ministry of Health and IPA Kenya, researchers assessed the reasons of under-vaccination among children. Under-vaccination of children in Kenya increased during the COVID-19 pandemic, and was associated with person-centeredness of vaccination services, and concerns about vaccine safety.
Routine vaccination is an essential strategy to increase child survival. In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 to accelerate vaccination gains globally by strengthening vaccination service delivery, investing in further research and development, and ensuring continued demand for vaccines. However, vaccination coverage has been stagnating or declining in many countries, and may have been worsened by COVID-19 pandemic-related disruptions, which led to supply shortages and limited people’s access to health services.1 Although vaccination coverage in Kenya is generally high, vaccine confidence may be on the decline.2
In collaboration with the Kenyan Ministry of Health and IPA Kenya, researchers assessed the reasons of under-vaccination among children. To do this, they conducted a survey including 707 mothers of 873 children born between 2017 and 2022 in Nairobi and Kiambu counties in Kenya. Researchers measured indicators including vaccine take-up, access to vaccination services, attitudes toward vaccines, and interactions with health workers.
Among those born before the COVID-19 pandemic (from 2017-2019), 11 percent of newborn children were under-vaccinated (i.e., missed or received a late vaccine dose). This increased to 15.3 percent for children born in 2020 and to 18.5 percent for children born between 2021 and 2022. About half of mothers reported worse attitudes about childhood vaccines now compared to before the COVID-19 pandemic and approximately 75 percent of them perceived that children receive too many vaccines increasing the probability of under-vaccination. The level of person-centered care was the strongest factor associated with vaccine uptake. Mothers who received less person-centered care were more likely to under-vaccinate or miss vaccine doses for their children.3 In contrast, mothers who had greater trust in their health provider were 15 percent less likely to have a child with a missing vaccine dose than mothers who did not trust their providers.
Read the published paper here.
Sources
1 World Health Organization and UNICEF Press Release, "Global childhood immunization levels stalled in 2023, leaving many without life-saving protection," World Health Organization, July 15, 2024.
2 Porth, Julia M., Abram L. Wagner, Cheryl A. Moyer, Martin K. Mutua, and Matthew L. Boulton. "Women's empowerment and child vaccination in Kenya: the modifying role of wealth." American Journal of Preventive Medicine 60, no. 1 (2021): S87-S97.
3 Undervaccination is defined as getting at least a shot of a vaccine but not getting the complete required dosage. Missing vaccine doses is defined as not getting any shot though eligible for the vaccine.
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