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ABSTRACT
Vaccination coverage studies are important in determining a population's vaccination status and strategically adjusting national immunization programs. This study assessed full and timely vaccination coverage of preschool children aged 2–3 y attending nurseries-kindergartens (N-K) nationwide at the socioeconomic crisis onset. Geographically stratified cluster sampling was implemented considering prefectures as strata and N-K as clusters. The N-K were selected by simple random sampling from the sampling frame while their number was proportional to the stratum size. In total, 185 N-K (response rate 93.9%) and 2539 children (response rate 81.5%) participated. Coverage with traditional vaccines for diphtheria-tetanus-pertussis, polio and measles-mumps-rubella was very high (>95%), followed by Haemophilus influenzae type b and varicella vaccines. Despite very high final coverage, delayed vaccination was observed for hepatitis B (48.3% completed by 12 months). Significant delay was observed for the booster dose of pneumococcal conjugate vaccines (PCV) and meningococcal C conjugate vaccines (MCC). Of the total population studied, 82.3% received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months and 76.2% by 30 months. However, 89.6% received at least one MCC dose over 12 months. Timely vaccinated for hepatitis A with 2 doses by 24 months were 6.1%. Coverage was significantly low for Rotavirus (<20%) and influenza (23.1% one dose). High vaccination coverage is maintained for most vaccines at the beginning of the crisis in Greece. Coverage and timeliness show an increasing trend compared to previous studies. Sustained efforts are needed to support the preventive medicine system as socioeconomic instability continues.
Abbreviations
| CHB | = | child health booklet |
| CI | = | confidence interval |
| DTaP | = | diptheria-tetanus-acellular pertussis vaccine |
| Hib | = | Haemophilus Influenzae type b vaccine |
| HepA | = | hepatitis A vaccine |
| HepB | = | hepatitis B vaccine |
| IIV | = | inactivated influenza vaccine |
| IPV | = | inactivated polio vaccine |
| MCC | = | meningococcal serogroup C conjugate vaccine |
| MMR | = | measles-mumps-rubella vaccine |
| N-K | = | nurseries-kindergartens |
| NIP | = | National Immunization Program |
| PCV | = | pneumococcal conjugate vaccine |
| RV | = | rotavirus vaccine |
| SD | = | standard deviation |
| VAR | = | varicella vaccine |
| WHO | = | World Health Organization |
Disclosure of potential conflicts of interest
The authors declare no potential conflicts of interest in preparing this article.
Acknowledgments
The authors would like to thank the parents of all children that participated in the study and provided their CHB as well as the headteachers and teachers of participating N-K for their contribution in collecting the data. We would also like to address special thanks to Alexandra Vernardaki for the administrative support of the study and data entry, Efthimia Paza, Filippos Markotsis, Panagiotis Katsaounos and Pandelis Mavraganis for the data entry.
Authors' contributions
TG and JK conceived the study and all authors contributed to the design. TG and CH coordinated the study and all authors contributed to the analysis and interpretation of the data.
TG, DM and AK drafted the manuscript and MT, JK and CH critically edited it. All authors read and approved the final manuscript.
