Vaccination Rates and Risk Factors Associated with Vaccine Compliance in Apartadó, Colombia Open Access

Abstract

Vaccinations are one of the most-cost effective and impactful public health interventions created; however, 1.6 million children die every year from vaccine-preventable diseases (VPDs). Low- and middle-income countries like Colombia have a higher-than-average burden of VPDs because of barriers to vaccine access, lack of trust in healthcare, and belief in alternative medicine remedies. The goal of this study was to evaluate the factors for vaccine adherence as it relates to children under 5 in Apartadó, Colombia by determining their vaccination status, compliance with recommended schedule, the duration of delay in vaccination, and risk factors for vaccine compliance. By conducting a secondary data analysis, this study evaluated vaccination status and compliance for 10 of the 12 vaccines recommended by the World Health Organization and the Colombian Ministry of Health. Multivariate logistic regression models were used to evaluate the socio-demographic risk factors that may be associated with vaccine compliance for each individual vaccine and overall vaccine compliance, where age-appropriate children were compliant if they received all 10 vaccines on-time. The vaccines that had the highest percentage who had received all of their age-appropriate doses were Bacillus Calmette-Guérin (BCG) (99%), hepatitis B (97%), and rotavirus (97%). Similarly, the vaccines that had the highest percentage of all age-appropriate doses received on-time were hepatitis B (96%), BCG (94%), and pneumococcal (92%). When determining the vaccines with the shortest duration for delay in vaccination, the first doses for the pentavalent and polio vaccines had the shortest time delay at 0.19 months each. None of the socio-economic demographics for caregivers had a strong association with overall vaccine compliance. Apartadó, Colombia has strong rates for vaccination status and vaccine compliance; however, public health researchers need to increase the number of children who receive all of their age-appropriate vaccines on-time.

Table of Contents

Chapter 1: Literature Review……………………………………………………...…………1

Global burden of Vaccine-Preventable Diseases……………………………………………1

Vaccine-Preventable Disease and Children Under 5……………………………………….1

Vaccine Adherence……………………………………………………………………………..2

Risk Factors and Vaccine Adherence………………………………………………………...4

Vaccine Compliance and COVID-19………………………………………………………….6

Colombia Vaccination Rates…………………………………………………………………...7

Apartadó, Colombia Characteristics…………………………………………………………..8

Conclusion & Significance……………………………………………………………………..9

Chapter 2: Methods……………………………………………………………...…………..11

Introduction……………………………………………………………………………………..11

Study Approval and Location…………………………………………………………………11

Population and Sample……………………………………………………………………….11

Data Collection Procedures………………………………………………………………….12

Data Entry Procedures…………………………………………………………………….….13

Data Analysis: Methodology………………………………………………………………….13

Data Analysis: Logistic Regression Models………………………………………..……….16

Chapter 3: Results………………………………………………..………………………….18

Characteristics of Children and Caregivers…………………………………………………18

Vaccination Status of Children……………………………………………………………….20

Compliance with Recommended Vaccine Schedule……………………………………....21

Risk Factors Associated with Individual Vaccine Compliance……………………………23

Risk Factors Associated with Overall Vaccine Compliance………………………………27

Duration of Delay in Vaccination……………………………………………………………..28

Chapter 4: Discussion……………………………………………………………………….30

Introduction and Findings…….……………………………………………………………….30

Vaccination Status….………………………………………………………………………….31

Compliance with Recommended Vaccine Schedule….………………………...…………32

Duration in Delay of Vaccination….……………………….…………………………………33

Strengths and Limitations….…………………………………….……………………………34

Implications….………………………………………….………………………………………34

Conclusion….……………………………………………………..……………………………35

Chapter 5: Public Health Implications…..………………………………………………..36

 

List of Tables

Table 1: Colombian Vaccination Schedule….……………………………………………...14

Table 2: Characteristics of Children and Caregivers in Apartadó, Colombia………...…19

Table 3: Vaccination Status According to Doses and Vaccines………………………….21

Table 4: Compliance with Recommended Schedules by Dose…………………………..23

Table 5: Risk Factors Associated with Compliance for Each Vaccine…………………..25

Table 6: Risk Factors Associated with Compliance Across All Vaccines……………….27

Table 7: Average Duration between On-Time Vaccinations and Actual Vaccinations…29

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Global Health Epidemiology Colombia Vaccine
Committee Chair / Thesis Advisor	Dr. Juan S. Leon, Emory University

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