By Tabora Bojang
A study conducted by the Medical Research Council Gambia, MRCG, examining the burden and the spatial pattern of untimely childhood vaccination in The Gambia, has revealed significant subnational inequalities in delayed vaccination throughout the country.
The study was unveiled Thursday at the Ocean Bay Hotel in Bakau.
Timely vaccination is the vaccination received within the recommended window in an age-appropriate manner.
The researchers used the birth dose of hepatitis B vaccine (HepB0), the third dose of pentavalent vaccine (PENTA3), and first dose of the measles- containing vaccine (MCV1) as case studies.
The report pointed out that too early or delayed vaccination could increase children’s exposure to suboptimal immune responses and diseases like measles.
It affirms that although Gambia have attained persistently high vaccination coverage, it must now explore the quality dimensions and ensure that children across all subpopulations receive vaccination in a timely, age-appropriate manner.
“Despite achieving consistently high coverage of measles-containing vaccine MCV1, Gambia experienced a significant six-fold increase in measles cases by mid-2022 compared to the numbers recorded in 2020.
The study highlighted that trend may be owing to postponed measles campaigns and stagnating MCV1 coverage since 2017 along with potential impacts of delayed vaccination.
The research further identified districts with a combination of high estimated prevalence and a significant population of affected infants.
Results
According to the study, the highest pockets of predicted delayed vaccination were located in central and eastern ends while the coastal areas generally exhibited lowest pockets of delays.
The predicted prevalence vaccination of delayed hepatitis B vaccination at districts exhibited significant variation ranging from 66.4 percent to 95.0 percent. Among the 49 districts 17 (34.7) had a HepB0 vaccination delay of 90 percent surpassing the national average.
On vaccination of the pentavalent vaccine (PENTA3) predicted prevalence at district level ranged from 25.7 percent to 54.1 percent. Among the seven districts with a delay of 50 percent or more 4 were located in Basse, 2 in Jangjangbureh and 1 in Banjul.
Districts and wards with lowest prevalence of delayed PENTA 3 vaccination are in coastal areas.
While the predicted prevalence of measles- containing vaccine (MCV1) vaccination at the district level ranged from 22.7 percent to 40.2 percent.
Of the 10 districts with delayed MCV1 vaccinations, 50 percent were located in Basse, 40 percent in Jangjangbureh and 10 percent in the Kuntaur local government area.
Meanwhile, in the Basse local government area, all the districts expect one fell within the highest tertile of delayed vaccination for the 3 vaccines.
“These findings suggest that these districts may have peculiar health system or other issues,” the report added.
This research is part of the EDCTP2 programme supported by the European and Developing countries Clinical Trials partnership.
Dr Oghenebrume Wariri, a research fellow and paediatrician at the MRCG, expressed optimism that the study will help policy makers, communities and health care personnel to rally in ensuring Gambia does not only further strengthen vaccine coverage but also timeliness.
The program manager Expanded Program on Immunization (EPI) Gambia, Sidat Fofana, said the Covid-19 pandemic has contributed to vaccine hesitancy and timelines of vaccination resulting in implication on morbidity and mortality in children.
“Studies like this will definitely help point our attention to the fact that timeliness of vaccination is important. If you have a high coverage in the absence of timeliness it will still come with a very little effect,” he warned.
