Adjei Michael Rockson, Tweneboah Peter Ofori, Bawa John Tanko, Baafi Janet Vanessa, Kubio Chrysantus, Amponsa-Achiano Kwame, Asiedu-Bekoe Franklin, Kuma-Aboagye Patrick, Grobusch Martin Peter, Ohene Sally-Ann
Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, the Netherlands.
World Health Organization, Country Office, Accra, Ghana.
Heliyon. 2024 Oct 3;10(19):e38858. doi: 10.1016/j.heliyon.2024.e38858. eCollection 2024 Oct 15.
The uptake trend of a new vaccine is unpredictable and may reflect the quality of introduction process and community acceptance. The objective of this study was to conduct a trend analysis of RTS,S malaria vaccine uptake in the seven pilot regions of Ghana from 2019 to 2022. The findings are envisaged to strengthen malaria vaccine introductions in the future.
A retrospective analysis was conducted on routine childhood immunisation data for 2019-2022. Coverages for the first (RTS,S1), second (RTS,S2), third (RTS,S3) and fourth (RTS,S4) doses of malaria vaccine; third dose of diphtheria, tetanus, pertussis-containing vaccine (DTP3/Penta3); first dose measles-rubella (MR1) and second dose measles-rubella (MR2) vaccines were calculated. Dropout rates and uptake gaps were estimated to assess variations in the uptake of consecutive RTS,S schedules; and the differences in the uptake of RTS,S and the comparator vaccines, respectively.
Nationally, the coverages of the first three doses of the RTS,S malaria vaccine rose sharply from 2019 (RTS,S1 = 54.9 %; RTS,S2 = 54.6 %; RTS,S3 = 38.6 %) through 2020 (RTS,S1 = 70.7 %; RTS,S2 = 67.4 %; RTS,S3 = 66.3 %) to peaks in 2021 (RTS,S1 = 76.0 %; RTS,S2 = 73.1 %; RTS,S3 = 74.2 %), and declined marginally in 2022 (RTS,S1 = 74.0 %; RTS,S2 = 69.9 %; RTS,S3 = 71.3 %). For the fourth dose, the low uptake in 2020 (7.5 %) was followed by a steep rise in 2021 (46.9 %) that continued, but at a reduced rate to 50.6% in 2022. The dropout rates and uptake gaps were initially high but declined consistently over the study period. Generally, the trends in vaccination coverages, and dropout rates and uptake gaps at the national level were reflected in the respective regions.
The coverage of RTS,S malaria vaccine improved consistently over the study period despite the low uptake in the early phase of the pilot. While the decreasing dropout rates and uptake gaps may indicate improved community acceptance, strengthening immunisation service delivery is crucial in sustaining the observed trajectory.
新疫苗的接种趋势难以预测，可能反映了引入过程的质量和社区接受度。本研究的目的是对2019年至2022年加纳七个试点地区的RTS,S疟疾疫苗接种情况进行趋势分析。研究结果预计将在未来加强疟疾疫苗的引入。
对2019 - 2022年儿童常规免疫数据进行回顾性分析。计算疟疾疫苗第一剂（RTS,S1）、第二剂（RTS,S2）、第三剂（RTS,S3）和第四剂（RTS,S4）的接种率；白喉、破伤风、含百日咳疫苗第三剂（DTP3/五联疫苗3）；麻疹风疹疫苗第一剂（MR1）和第二剂（MR2）的接种率。估计退出率和接种差距，以评估连续RTS,S接种计划的接种差异；以及RTS,S疫苗与对照疫苗接种情况的差异。
在全国范围内，RTS,S疟疾疫苗前三剂的接种率从2019年（RTS,S1 = 54.9%；RTS,S2 = 54.6%；RTS,S3 = 38.6%）急剧上升，到2020年（RTS,S1 = 70.7%；RTS,S2 = 67.4%；RTS,S3 = 66.3%），并在2021年达到峰值（RTS,S1 = 76.0%；RTS,S2 = 73.1%；RTS,S3 = 74.2%），2022年略有下降（RTS,S1 = 74.0%；RTS,S2 = 69.9%；RTS,S3 = 71.3%）。对于第四剂，2020年接种率较低（7.5%），随后在2021年急剧上升（46.9%），并持续上升，但在2022年降至50.6%。退出率和接种差距最初较高，但在研究期间持续下降。总体而言，国家层面的疫苗接种率、退出率和接种差距趋势在各个地区都有所体现。
尽管在试点早期接种率较低，但在研究期间RTS,S疟疾疫苗的接种率持续提高。虽然退出率和接种差距的下降可能表明社区接受度有所提高，但加强免疫服务提供对于维持观察到的趋势至关重要。
