Masemola Natasha M, Burnett Rosemary J, Makamba-Mutevedzi Portia C, Schönfeldt Marione, Bamford Lesley J, Ismail Zeenat, Madhi Shabir A, Meyer Johanna C
Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa; South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South Africa.; Department of Virology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Vaccine. 2025 Jan 25;45:126583. doi: 10.1016/j.vaccine.2024.126583. Epub 2024 Dec 9.
In 2019 the National Department of Health (NDoH) conducted a national immunisation coverage survey of caregivers of children aged 24-35 months in all 52 districts of South Africa, and reported a national fully immunised under one year-old coverage of 83.9 %, and 76.8 % coverage for all vaccines scheduled up to 18 months of age. This retrospective, descriptive study was a secondary data analysis of 3576 validated Microsoft Excel® records containing the reasons for missed vaccinations collected by field workers during the 2019 national survey. The reason "vaccine out of stock" had been captured by field workers from children's vaccination cards, while other reasons given by caregivers had been captured either as pre-defined codes or free text. Free text reasons were analysed and additional codes created, and all reasons were categorised. In total, 3576 caregivers gave 8116 reasons for 8056 doses that had been missed by their children. Reasons related to health facility obstacles (HFOs) (67.9 %; 2429/3576) and personal obstacles (34.6 %; 1237/3576) constituted the major categories of reasons for missed vaccinations. Of all vaccines missed because of HFO-related reasons, 57.8 % (1403/2429) were missed because of vaccine stock-outs, affecting 39.2 % (1403/3576) of children. Other important HFOs included lack of access to vaccination services (24.5 %; 595/2429); and information about missed vaccinations and the need to return for catch-up not being shared with caregivers (17.1 %; 416/2429). These results were stratified by district and shared with the NDoH, who have initiated several projects in collaboration with other stakeholders, focusing mainly on building capacity for effective vaccine management to prevent vaccine stock-outs, and ensuring that all children are able to access vaccination services. The results of this study can be used as a baseline against which the success of future interventions emanating from these projects can be measured.
2019年，南非国家卫生部（NDoH）在全国52个区对24至35个月大儿童的看护人进行了全国免疫接种覆盖率调查，报告显示一岁以下儿童的全国全程免疫接种覆盖率为83.9%，18个月龄前所有计划疫苗的接种覆盖率为76.8%。这项回顾性描述性研究是对3576条经验证的Microsoft Excel®记录进行的二次数据分析，这些记录包含了现场工作人员在2019年全国调查期间收集的漏种疫苗原因。“疫苗缺货”这一原因是现场工作人员从儿童预防接种证上获取的，而看护人给出的其他原因则以预定义代码或自由文本形式记录。对自由文本原因进行了分析并创建了额外的代码，所有原因都进行了分类。共有3576名看护人给出了其子女漏种8056剂疫苗的8116条原因。与卫生机构障碍（HFOs）相关的原因（67.9%；2429/3576）和个人障碍相关的原因（34.6%；1237/3576）构成了漏种疫苗的主要原因类别。在所有因HFO相关原因漏种的疫苗中，57.8%（1403/2429）是由于疫苗缺货导致的，影响了39.2%（1403/3576）的儿童。其他重要的HFOs包括无法获得预防接种服务（24.5%；595/2429）；以及未向看护人告知漏种疫苗情况及补种必要性（17.1%；416/2429）。这些结果按地区进行了分层，并与南非国家卫生部进行了分享，该部门已与其他利益相关方合作启动了多个项目，主要侧重于建设有效疫苗管理能力以防止疫苗缺货，并确保所有儿童都能获得预防接种服务。本研究结果可作为一个基线，用以衡量这些项目未来干预措施的成效。
