Preprint Article Version 2 Preserved in Portico This version is not peer-reviewed

Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria

Version 1 : Received: 25 September 2020 / Approved: 26 September 2020 / Online: 26 September 2020 (15:13:26 CEST)
Version 2 : Received: 17 November 2020 / Approved: 18 November 2020 / Online: 18 November 2020 (12:18:02 CET)

How to cite: Wagai, J.N.; Rhoda, D.A.; Prier, M.L.; Trimner, M.K.; Clary, C.B.; Oteri, J.; Okposen, B.; Adeniran, A.; Danovaro-Holliday, M.C.; Cutts, F.T. Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria. Preprints 2020, 2020090645 (doi: 10.20944/preprints202009.0645.v2). Wagai, J.N.; Rhoda, D.A.; Prier, M.L.; Trimner, M.K.; Clary, C.B.; Oteri, J.; Okposen, B.; Adeniran, A.; Danovaro-Holliday, M.C.; Cutts, F.T. Implementing WHO Guidance on Conducting and Analysing Vaccination Coverage Cluster Surveys: Two Examples from Nigeria. Preprints 2020, 2020090645 (doi: 10.20944/preprints202009.0645.v2).

Abstract

In 2015, the World Health Organization substantially revised its guidance for vaccination coverage cluster surveys (revisions were finalized in 2018) and has since developed a set of accompanying resources, including definitions for standardized coverage indicators and software (named the Vaccination Coverage Quality Indicators - VCQI) to calculate them. The current WHO vaccination coverage survey manual was used to design and conduct two nationally representative vaccination coverage surveys in Nigeria – one to assess routine immunization and one to measure post-measles campaign coverage. The primary analysis for both surveys was conducted using VCQI. In this paper, we describe those surveys and highlight some of the analyses that are facilitated by the new resources. In addition to calculating coverage of each vaccine-dose by age group, VCQI analyses provide insight into several indicators of program quality such as crude coverage versus valid doses, vaccination timeliness, missed opportunities for simultaneous vaccination, and, where relevant, vaccination campaign coverage stratified by several parameters, including the number of previous doses received. The VCQI software furnishes several helpful ways to visualize survey results. We show that routine coverage of all vaccines is far below targets in Nigeria and especially low in northeast and northwest zones, which also have highest rates of dropout and missed opportunities for vaccination. Coverage in the 2017 measles campaign was higher and showed less geospatial variation than routine coverage. Nonetheless, substantial improvement in both routine program performance and campaign implementation will be needed to achieve disease control goals.

Subject Areas

survey; vaccination coverage; WHO; Nigeria

Comments (1)

Comment 1
Received: 18 November 2020
Commenter: Caitlin B. Clary
Commenter's Conflict of Interests: Author
Comment: The revised paper includes a description of the vaccination coverage quality indicators (VCQI) software, adds detail to discussions of challenges in implementing high-quality household surveys and of the causes of missed opportunities for vaccination, and discusses ethical considerations in the collection of survey data. The abstract of the paper has also been revised to highlight the purpose of the study and action areas. Some figure titles have been edited for length, and notes in the manuscript have been added to guide reader interpretation of some figures.
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