The Prevalence of Complete, Timely and Delayed Primary Childhood Vaccination in Malaysia: Insights from the 2022 National Maternal and Child Health Survey
Complete, Timely & Delayed Primary Vaccination
Abstract
An effective primary childhood vaccination programme ensures high vaccine coverage, with vaccinations administered within the recommended timeframe. However, there is a lack of information on the timeliness of these vaccinations. This study aimed to assess the completeness and timeliness of primary childhood vaccinations in Malaysia. Data from a nationwide cross-sectional survey were analysed. Complete vaccination refers to children who received all primary vaccines regardless of the recommended timeframe. Timely vaccination is defined as vaccines administered within the recommended timeframe, while delayed vaccination refers to those given after this period. Immunisation records were verified by trained nurses. A total of 3,523 children aged 12 to 23 months participated in this survey. The prevalence of overall vaccination coverage was 87.1% (95% CI: 84.9, 89.1). Within this cohort, the prevalence of timely vaccination was 51.2% (95% CI: 47.2, 55.2), while the prevalence of delayed vaccination was 35.6% (95% CI: 31.7, 39.7). The prevalence of delayed vaccination particularly evident in the second dose of pneumococcal and measles-mumps-rubella vaccines at 15.0% (95% CI: 12.8, 17.5) and 11.2% (95% CI: 8.1, 15.3), respectively. Urban-rural disparities were evident, with urban areas demonstrating higher delayed vaccination prevalence (39.0%) than rural areas (27.6%). Johor, Selangor, and Kuala Lumpur & Putrajaya had the highest overall delayed vaccination prevalence (45.5%, 43.0%, and 42.5%, respectively). Malaysia demonstrates commendable overall vaccination coverage at 87.1%; however, the timeliness of vaccination remains a concern, with only 51.2% of children receiving vaccinations within the recommended timeframe. Significant disparities exist between urban and rural areas as well as among states in delayed vaccination rates, likely attributed to the presence of urban poor populations who are less exposed to the importance of vaccination and higher levels of vaccine hesitancy among urban parents. This highlights the need for public health interventions to focus on children in urban areas to improve timely vaccination rates and maximise the effectiveness of immunisation programs.
Keywords :
Childhood vaccination; completeness; delayed immunisation; Malaysia; timeliness,
Abstrak
Program immunisasi kanak-kanak yang berkesan akan memastikan liputan vaksin yang tinggi dan pemberian vaksin dalam tempoh yang disarankan. Namun, terdapat kekurangan maklumat mengenai ketepatan masa pemberian vaksin. Kajian ini bertujuan untuk menilai liputan vaksin dan ketepatan masa pemberian vaksin bagi kanak-kanak di Malaysia. Data telah dianalisa daripada tinjauan keratan rentas peringkat nasional. Vaksin lengkap merujuk kepada kanak-kanak yang menerima semua vaksin utama tanpa mengira tempoh yang disarankan. Vaksinasi tepat masa didefinisikan sebagai vaksin yang diberikan dalam tempoh masa yang disarankan, manakala vaksinasi lewat merujuk kepada vaksin yang diberikan selepas tempoh tersebut. Rekod imunisasi semasa pengumpulan data telah disemak oleh jururawat terlatih. Seramai 3,523 kanak-kanak berusia 12 hingga 23 bulan telah menyertai kajian ini. Prevalens keseluruhan liputan vaksin ialah 87.1% (95% CI: 84.9, 89.1). Dalam kohort ini, prevalens vaksin tepat pada masanya ialah 51.2% (95% CI: 47.2, 55.2), manakala prevalens vaksin lewat ialah 35.6% (95% CI: 31.7, 39.7). Pemberian vaksin lewat ketara pada dos kedua vaksin pneumokokal dan measles-mumps-rubella, masing-masing pada kadar 15.0% (95% CI: 12.8, 17.5) dan 11.2% (95% CI: 8.1, 15.3). Perbezaan turut dikesan antara kawasan bandar dan luar bandar, dengan kawasan bandar menunjukkan prevalens vaksin lewat yang lebih tinggi (39.0%) berbanding kawasan luar bandar (27.6%). Negeri Johor, Selangor, dan Kuala Lumpur & Putrajaya mencatatkan prevalens vaksin tidak tepat masa tertinggi (45.5%, 43.0%, dan 42.5%). Malaysia mencatatkan kadar liputan vaksin keseluruhan yang memberangsangkan pada 87.1%; namun, ketepatan masa pemberian vaksin masih menjadi kebimbangan, dengan hanya 51.2% kanak-kanak menerima vaksin dalam waktu yang disarankan. Terdapat perbezaan ketara antara kawasan bandar dan luar bandar serta beberapa negeri bagi dapatan pemberian vaksin tidak mengikut waktu yang disarankan, berkemungkinan disebabkan oleh kewujudan kumpulan miskin bandar yang kurang terdedah kepada kepentingan vaksin serta masalah keraguan vaksin yang tinggi dalam kalangan ibu bapa di bandar. Ini menunjukkan bahawa intervensi kesihatan awam perlu memberi tumpuan kepada kanak-kanak di kawasan bandar, bagi meningkatkan kadar pemberian vaksin dalam tempoh yang dijadualkan dan memaksimumkan keberkesanan program imunisasi.
Kata Kunci :
Kelewatan imunisasi; ketepatan masa; lengkap; Malaysia; vaksinasi kanak-kanak,
Correspondance Address
Norlaila Hamid. Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia.
Tel: +603 33628741 E-mail: norlailahamid@moh.gov.my
