Vaccination timeliness and delay in low- and middle-income countries: a systematic review of the literature, 2007-2017

Figures & data

Figure 1. Paper selection scheme

Table 1. Summary of included papers, quality assessment, and key details related to vaccine delay

Authors & Year	Quality Score	Country (ies) of Study	Nationally representative	Age Range	Survey Type	Analysis	Antigens	Delay Definition	Predictors
Akmatov, MK, Mikolajczyk RT. 2012.^Citation18	Moderate	Burkina Faso, Burundi, Cameroon, Cote d'Ivoire, Djibouti, Gambia, Ghana, Guinea-Bissau, Malawi, Mauritania, Sierra Leone, Togo, Belarus, Kazakhstan, Albania, Bosnia and Herzegovina, Macedonia, Montenegro, Serbia, Belize, Guyana, Jamaica, Trinidad and Tobago, Bangladesh, Lao People’s Democratic Republic, Thailand, Vietnam, Mongolia, Iraq, Syria, Yemen	Yes	12-59 months	Cross-sectional	Kaplan-Meier	BCG, Polio, DPT, MCV	4.3 weeks, continuous delay	SES, Child Gender, Urban/Rural Environment, Household Size
Akmatov, MK et al. 2008.^Citation19	Moderate	Armenia, Kazakhstan, Kyrgyzstan, Uzbekistan	Yes	12-59 months, 0-35 months	Cross-sectional	Kaplan-Meier, Logistic Regression	DPT, MCV	1 month	Maternal Education, Paternal Education, Child Gender, Urban/Rural, Household Size
Babirye, JN et al. 2012.^Citation20	Good	Uganda	No	10-23 months	Cross-sectional	Kaplan-Meier, Cox Proportional Hazards	BCG, Polio, PENTA, MCV	variable	Birth Setting, Maternal Education, Number of Children, Paternal Age, Maternal Age, Marital Status, SES
Barman, D, Dutta, A. 2013.^Citation21	Moderate	India	No	12-23 months	Cross-sectional	Logistic Regression	BCG, Polio, DPT, MCV, Full Vaccination	within same month, interval	Religion, Birth Setting, Maternal Education, SES, Child Gender, Birth Order, Village Electrified, Equipment in Health Center, Drugs in Health Center…
Barman, M et al. 2015.^Citation22	Good	India	No	12-36 months	Cross-sectional	Kaplan-Meier, Cox Proportional Hazards	BCG, Polio, DPT, MCV	continuous delay	Maternal Education, Paternal Education, Mother's Age, Caste, Child Gender, Maternal Occupation, Paternal Occupation, SES
Bicaba, A et al. 2009.^Citation23	Poor	Burkina Faso	Yes	unclear	Cross-sectional	Cumulative-Age-At-Vaccination Curves	BCG, DTP, MCV, Full Vaccination	interval, continuous delay	Region
Calhoun, LM et al. 2014.^Citation24	Good	Kenya	No	12-23 months	Cross-sectional	Logistic Regression	BCG, Polio, PENTA, MCV, Full Vaccination	within same month	Maternal Education, Paternal Education, Child Gender, Mother's Age, Birth Order, Household Size, Distance to Clinic, Maternal and Paternal Occupation, Mother & Father Alive, Mother with child at interview, Mother looks after Child, Paternal Age, Orphan Status…
Chiabi, A et al. 2017.^Citation25	Good	Cameroon	No	0-11 months	Cross-sectional	Logistic Regression	BCG, Polio, PENTA, MCV, PCV, Rotavirus, Full Vaccination	2 weeks	Religion, Maternal Education, Mother's Age, Marital Status, Distance to the Clinic, Paternal Education, Maternal Occupation, Paternal Occupation
Clark, A, Sanderson C. 2009.^Citation26	Moderate	Bangladesh, Benin, Bolivia, Brazil, Burkina Faso, Cambodia, Cameroon, Chad, Colombia, Comoros, Congo, Côte d’Ivoire, Dominican Rep, Egypt, Eritrea, Gabon, Ghana, Guatemala, Guinea, Haiti, Honduras, India, Kenya, Kyrgyz, Lesotho, Madagascar, Malawi, Mali, Mauritania, Morocco, Mozambique, Namibia, Nicaragua, Niger, Nigeria, Peru, Rwanda, Senegal, Tanzania, Togo, Turkey, Uganda, Uzbekistan, Yemen, Zambia	Yes	0-5 years	Cross-sectional	Cumulative-Age-At-Vaccination Curves	BCG, DPT, MCV	continuous delay	Birth Setting, Maternal Education, Child Gender, Mother's Age, Child Age, Urban/Rural, Birth Order
D’Ardenne, KK et al. 2016.^Citation27	Good	Guatemala and Peru	No	0-5 years	Cross-sectional	Log Binomial Regression, Cumulative-Age-At-Vaccination Curves	PENTA, MMR, Rotavirus	28 days	Maternal Education, Child Gender, Mother's Age, Child Age, Household Size, Food Insecurity, Birth Cohort
Delrieu, I et al. 2015.^Citation28	Moderate	Burkina Faso, Ghana, Kenya, Senegal, Tanzania	Yes	0-5 years	Cross-sectional	Kaplan-Meier	DPT, MCV	continuous delay	N/A
Ettarh, RR et al. 2012.^Citation29	Moderate	Kenya	No	9–59 months	Cross-sectional	Kaplan-Meier, Cox Proportional Hazards	MCV	1 month	Ethnicity, Maternal Education, SES, Child Gender, Village
Fadnes, LT et al. 2011.^Citation30	Good	South Africa	No	0-2 years	Cluster RCT (non-vaccination outcome)	Kaplan-Meier, Cox Proportional Hazards	BCG, Polio, PENTA, Full Vaccination	variable	Birth Setting, Maternal Education, SES, Household Size, Breastfeeding, Peer Counseling, Mother's BMI, Marital Status
Fadnes, LT et al. 2011.^Citation31	Good	Uganda	No	0-2 years	Cluster RCT (non-vaccination outcome)	Kaplan Meier, Cox Proportional Hazards	BCG, Polio, PENTA, MCV	variable	Birth Setting, Maternal Education, SES, Child Gender, Mother's Age, Urban/Rural, Household Size, Mother's BMI, Health Counseling
Fisker, AB et al. 2014.^Citation32	Good	Guinea-Bissau	No	12-23 months	Cohort	Rank Sum Test	BCG, PENTA, Polio, MCV, Full Vaccination	continuous delay	Ethnicity, Maternal Education, Child Gender, Mother's Age, Child Age, Introduction of new Vaccine, Mid-Upper Arm Circumference
Flannery, B et al. 2013.^Citation33	Moderate	Brazil	Yes	unclear	Cross-sectional	N/A	DTP-Hib, Rotavirus	variable	N/A
Gibson, DG et al. 2015.^Citation34	Moderate	Kenya	No	12-23 months	Cross-sectional	Log Binomial Regression	PENTA, MCV, Full Vaccination	1 month	Maternal Education, SES, Child Gender, Mother's Age, Child Age, Marital Status, Previous Child Died, Distance to Clinic,Maternal Literacy, Number of Children <5, Mother's Phone Ownership
Gram, L. et al. 2014.^Citation35	Good	Ghana	No	0-1 year	Cross-sectional	Cox Proportional Hazards	BCG, Polio, PENTA, MCV, Full Vaccination	Variable, continuous delay	Religion, Birth Setting, Maternal Education, SES, Child Gender, Mother's Age, Household Size, Distance to Clinic
Hu, Y et al. 2013.^Citation36	Moderate	China	No	8-48 months	Cohort	Kaplan-Meier, Logistic Regression	MCV	1 month	Maternal Education, SES, Mother's Age, Household Size, Mother's Occupation
Hu, Y et al. 2014.^Citation37	Good	China	No	2-3 years	Cross-sectional	Kaplan-Meier, Logistic Regression	HepB, Polio, DPT, MCV	Variable, continuous delay	Birth Setting, Maternal Education, SES, Child Gender, Mother's Age, Household Size, Distance to Clinic, Mother's occupation, Resident (migrant) Status, Caregiver Attitude towards Vaccination, Awareness of Immunization, Satisfaction with Immunization Service
Hu, Y et al. 2017.^Citation38	Good	China	No	24-35 months	Cross-sectional	Kaplan Meier, Cox Proportional Hazards	BCG, HepB, Polio, DPT, MCV, Full Vaccination	variable	Birth Setting, Maternal Education, SES, Household Size, Maternal Age, Urban/Rural, Immigration Status
Hughes, MM et al. 2016.^Citation39	Good	Nepal	No	0-6 months	RCT (non-vaccination outcome)	Kaplan Meier, Cox Proportional Hazards	BCG, Polio, PENTA	continuous delay	Ethnicity, SES, Child Gender, Child Age, Birth Order, Household Size, Gestational Age, Birthweight, Breastfeeding, Literacy
Iqbal, W et al. 2015.^Citation40	Moderate	Pakistan	No	0-2 years	Cross-sectional	Chi-Square (unadjusted)	BCG	variable	ANC, Birth Setting, Maternal Education, Paternal Education, SES, Awareness of EPI Schedule, Place of Vaccination
Jadidi, R et al. 2015.^Citation41	Moderate	Iran	No	24-47 months	Cohort	Chi-Square (unadjusted)	MMR	1 week	Maternal Education, Paternal Education, Child Gender, Urban/Rural, Birth Order, Iranian/Non Iranian
Laryea, D et al. 2014.^Citation42	Moderate	Ghana	No	unclear	Cross-sectional	N/A	BCG, Polio, PENTA, MCV	4 weeks	ANC, Birth Setting, Child Gender, Mother's Age, Child Age, Mode of Delivery
Le Polain de Waroux, O et al. 2013.^Citation43	Good	Tanzania	No	12-23 months	Cross-sectional	Log Binomial Regression; Kaplan-Meier	BCG, DPT, MCV	1 month	Ethnicity, Maternal Education, SES, Child Gender, Mother's Age, Child Age, Household Size, Distance to the Clinic, Mother's Occupation, Seasonality
Li, Q et al. 2014.^Citation44	Poor	China	No	1-7 years	Cohort	N/A	BCG, HepB, Polio, DPT, MCV, Full Vaccination	1 month	Immigration Status, Municipality, Birth Cohort
Lin, W et al. 2014.^Citation45	Moderate	China	No	9-24 months	Case-Control	Logistic Regression	MCV	1 month	Child Gender, Household Size, Distance to Clinic, Residential Status, Health Status of Child, Maternal and Paternal Occupation, History of Vaccine Delay, Awareness of Necessity of Timely Vaccination, Waiting Time in EPI Clinic…
Mbengue, MA et al. 2017.^Citation46	Good	Senegal	Yes	12-23 months	Cross-sectional	Kaplan-Meier, Cox Proportional Hazards	BCG, Polio, PENTA, MCV, PCV, Rotavirus, Full Vaccination	4 weeks	Maternal Education, SES, Child Gender, Urban/Rural, Marital Status, Birth Order, ANC
Miyahara, R et al. 2016.^Citation47	Good	Gambia	No	unclear	Cross-sectional	Logistic Regression	BCG, HepB, Polio	variable (1 day, 1 week)	Ethnicity, Maternal Education, SES, Child Gender, Mother's Age, Child Age, Birth Order, Birth Year, Birth Spacing, Birth Season
Moïsi, JC et al. 2010.^Citation48	Moderate	Kenya	No	unclear	Cross-sectional	Kaplan-Meier, Cox Proportional Hazards	BCG, Polio, PENTA, MCV	continuous delay	Ethnicity, Maternal Education, Child Gender, Distance to Clinic, Migration Status
Mokhtari, M 2015.^Citation49	Poor	Iran	No	24-47 months	Cohort	Kaplan-Meier	DPT	continuous delay	Ethnicity, Maternal Education, Paternal Education, Child Gender, Urban/Rural, Birth Order, City Location, Maternal and Paternal Occupation
Montgomery, JP et al. 2015.^Citation50	Good	China	No	8 months - 8 years	Cross-sectional	Logistic Regression	MCV	variable	Child Gender, Urban/Rural, Birth Year
Mutua, MK et al. 2015.^Citation51	Good	Kenya	No	unclear	Cohort	Kaplan-Meier, Cox Proportional Hazards	BCG	continuous delay	Ethnicity, Birth Setting, Maternal Education, Child Gender, Low Birth Weight, Pregnancy Intention, Type of Health Facility, Settlement Area
Mutua, MK et al. 2016.^Citation52	Good	Kenya	No	12-23 months	Cohort	Kaplan-Meier	Full Vaccination	Variable, continuous delay	Ethnicity, Birth Setting, Maternal Education, SES, Child Gender, Study Location
Mvula, H et al. 2016.^Citation53	Good	Malawi	No	>1 year	Cohort	Poisson Regression, Cox Proportional Hazards	MCV, PCV, Rotavirus	variable, continuous delay	Maternal Education, Child Gender, Mother's Age, Child Age, Marital Status, Household Size, Mother's Occupation, Orphanhood, Place of Birth, Distance to Clinic, Vaccination due in Rainy Season
Narváez, J et al. 2017.^Citation54	Good	Colombia	No	0-6 years	Cross-sectional	Mixed Models	BCG, HepB, Polio, DPT, PENTA, MMR, PCV, Rotavirus, Full Vaccination	continuous delay	Ethnicity, Maternal Education, SES, Child Gender, Mother's Age, Child Age, Household Size, Insurance, Displaced by Armed Conflict
Odutola, A et al. 2015.^Citation55	Good	Gambia	No	12-59 months	Cross-sectional	Logistic Regression	BCG, DPT, Polio, MCV	variable, continuous delay	Ethnicity, Birth Setting, Child Gender, Child Age, Marital Status, Birth Order, Family Type: Monogamous/Polygamous/Single Parent
Olusanya BO 2010.^Citation56	Moderate	Nigeria	No	0-3 months	Cross-sectional	Kaplan-Meier, Logistic Regression	BCG	variable	Religion, Ethnicity, ANC, Birth Setting, Maternal Education, SES, Child Gender, Mother's Age, Child Age, Marital Status, Birth Order, Maternal Occupation, Child has Jaundice
Pezzoli, L et al. 2017.^Citation57	Moderate	Wallis and Futuna	No	9-11 years	Cross-sectional	Kaplan-Meier	HepB	variable	N/A
Poorolajal, J. et al. 2012.^Citation58	Moderate	Iran	No	12-24 months	Cross-sectional	Kaplan-Meier	BCG, HepB, Polio, DPT, MMR	variable	ANC, Maternal Education, Child Gender, Urban/Rural, Distance to Clinic, Vaccinator's Education Level
Rainey, JJ. et al. 2012.^Citation59	Poor	Haiti	Yes	12-23 months	Cross-sectional	Rao-Scott (unadjusted)	BCG, Polio, DPT, MR, Full Vaccination	Variable, continuous delay	Vaccine Hesitancy Questions
Rejali, M et al. 2015.^Citation60	Moderate	Iran	No	24-47 months	Cross-sectional	Logistic Regression	BCG, HepB, Polio, DPT, MMR	variable	Maternal Education, Paternal Education, Child Gender, Urban/Rural, Birth Order, City, Nationality, Maternal and Paternal Occupation
Sadoh, EA, Eregie OC. 2009.^Citation61	Moderate	Nigeria	No	unclear	Cross-sectional	N/A	Full Vaccination	4 weeks, continuous delay	Child Gender, Mother's Age, Paternal Age
Sadoh, EA et al. 2016.^Citation62	Moderate	Nigeria	No	unclear	Cohort	Kaplan-Meier, Cox Proportional Hazards	BCG, DPT, PENTA	continuous delay	Birth Setting, Maternal Education, Child Gender, Mother's Age, Introduction of New Vaccine, Paternal Age
Sanchez, D et al. 2015.^Citation63	Moderate	Venezuela	No	0-6 years	Cross-sectional	Hazard-based estimator (unadjusted)	BCG, HepB, Polio, PENTA, MMR, Rotavirus, Full Vaccination	continuous delay	N/A
Sartori, AL et al. 2017.^Citation64	Good	Brazil	No	0-23 months	Cohort	Log Binomial Regression	PCV	28 days, continuous delay	ANC, Maternal Education, Mother's Age, Child Birthweight
Schoeps, A. et al. 2013.^Citation65	Good	Burkina Faso	No	12-23 months	Cross-sectional	Logistic Regression	BCG, PENTA, MCV, Full Vaccination	28 days	Religion, Ethnicity, Maternal Education, SES, Child Gender, Mother's Age, Urban/Rural, Household Size, Season of Birth
Scott, S et al. 2014.^Citation66	Moderate	Gambia	Yes	12-23 months; 9-60 months	Cross-sectional	Kaplan Meier, Cox Proportional Hazards	BCG, DPT, MCV, Full Vaccination	variable, continuous delay	Ethnicity, Region, Previous Vaccine Delay
Senessie, C et al. 2007.^Citation67	Moderate	Sierra Leone	No	0-35 months	Cross-sectional	Chi-Square (unadjusted)	Full Vaccination	variable	Child Age, Time Relative to Civil Conflicts
Shrivastwa, N. et al. 2016.^Citation68	Moderate	India	Yes	0-60 months	Cross-sectional	Turnbull Estimator	BCG, DPT, MCV	continuous delay	N/A
Suárez-Castaneda, E et al. 2014.^Citation69	Good	El Salvador	Yes	23-59 months	Cross-sectional	Logistic Regression, Cox Proportional Hazards	BCG, Polio, PENTA, MMR, Rotavirus, Full Vaccination	variable	Ethnicity, Maternal Education, Paternal Education, Child Gender, Urban/Rural, Marital Status, Household Size, Distance to Clinic, Parental Occupation, Region, Birth Year
Suárez-Castaneda, E et al. 2015.^Citation70	Good	El Salvador	Yes	24-59 months	Cross-sectional	Logistic Regression, Cumulative-Age-At-Vaccination Curves	PENTA, Rotavirus	continuous delay	Parental Education, Child Gender, Urban/Rural, Marital Status, Household Size, Distance to Clinic, Parental Occupation, Primary Mode of Transportation, Presence of Organized Crime, Region
Tang, X et al. 2016.^Citation71	Good	China	No	18-54 months	Cross-sectional	Kaplan-Meier, Logistic Regression	MCV	variable	Ethnicity, Maternal Education, SES, Child Gender, Mother's Age, Child Age, Household Registration, Guardian Occupation, Average Duration of Time Father (and Mother) is Away from Home, Residential Status of Mother, Measles Vaccination Status of Mother
Tang, X et al. 2017.^Citation72	Good	China	No	18-54 months	Cross-sectional	Kaplan Meier, Cox Proportional Hazards	MCV	continuous delay	Ethnicity, Child Gender, Child Age
Tippins, A et al. 2017.^Citation73	Moderate	Federated States of Micronesia	No	24-35 months	Cross-sectional	Kaplan Meier, TSEIR model	TDaP, MMR	1 month, interval	Household Size
Toikilik, S et al. 2010.^Citation74	Moderate	Papua New Guinea	Yes	12-23 months	Cross-sectional	N/A	BCG, HepB, Polio, DPT, MCV	variable	Birth Setting, Urban/Rural, Vaccine Hesitancy Questions
Vasudevan, L et al. 2014.^Citation75	Moderate	Bangladesh	No	11-18 weeks	Cohort	Logistic Regression	Full Vaccination	Fixed time point	ANC, Maternal Education, SES, Child Gender, Mother's Age, Urban/Rural, Size of Infant at Birth, Infant Sickness
Wagner, AL et al. 2014.^Citation76	Moderate	China	No	8 months - 6 years	Cross-sectional	Wilcoxon/Kruskall-Wallis (unadjusted)	MCV	variable, continuous delay	Child Gender, Resident District, Birth Year
Wagner, AL et al. 2014.^Citation77	Moderate	China	No	2-7 years	Cohort	Binomial Regression, Cumulative Age-At-Vaccination Curve	Hib, PCV	variable	Child Gender, Urban/Rural, Birth Year
Wagner, AL et al. 2016.^Citation78	Good	China	No	9 months - 14 years	Cross-sectional	Logistic Regression	MCV, PCV	variable	Child Gender, Child Age, Urban/Rural, Birth Year, Township factors
Wallace, AS et al. 2012.^Citation79	Good	Philippines	No	5-7 months	Cross-sectional	Chi-Square (unadjusted)	HepB	variable	Child Gender, Introduction of New Vaccine Schedule, Provider Size, Provider Type
Wu, JN et al. 2015.^Citation80	Good	China	No	1-14 years	Cross-sectional	Logistic Regression	HepB	variable	Ethnicity, Birth Setting, Child Gender, Urban/Rural, HBC Serum Biomarker
Yadav, K et al. 2012.^Citation81	Moderate	India	No	unclear	Cross-sectional	Chi-Square (unadjusted)	BCG, Polio, DPT, MCV	variable, continuous delay	Hard to reach areas, Lower priority, Family Refusal, Lack of Knowledge
Zaidi, SM et al. 2014.^Citation82	Moderate	Pakistan	Yes	0-5 years	Cross-sectional	Logistic Regression	BCG, Polio, DPT, MCV	1 month	Ethnicity, ANC, Birth Setting, Maternal Education, SES, Child Gender, Child Age, Urban/Rural, Household Size, Telephone Connection, Male Household Head, Breastfeeding Duration, Maternal Tetanus Vaccine
Zhou, Y et al. 2009.^Citation83	Moderate	China	No	unclear	Cross-sectional	Logistic Regression	HepB	1 day	Ethnicity, Birth Setting, Maternal Education, Paternal Education, Child Gender, Urban/Rural, Possession of EPI Card, Knowledge of Birth Dose of HepB, Migrant Status
Zivich, PN et al. 2017.^Citation84	Moderate	Democratic Republic of Congo	No	0-6 months	Cohort	Logistic Regression	BCG, Polio, DPT, PCV	variable, interval	ANC, Maternal Education, SES, Mother's Age, Marital Status, Birth Order, Previous Child Died, Pregnancy Intention, Clinic

Table 2. Number of papers by WHO region

WHO Region	Number of Papers
African Region	29
Western Pacific Region	19
Region of the Americas	10
South East Asian Region	8
Eastern Mediterranean Region	8
European Region	3

Table 3. Number of included papers by country of study

Country	Number of Papers
China	13
Kenya	8
Burkina Faso, Ghana, India	5
Gambia, Iran, Nigeria	4
Bangladesh, Brazil, Cameroon, Malawi, Senegal, Tanzania, Uganda	3
Colombia, Cote d’Ivoire, Democratic Republic of Congo, El Salvador, Guatemala, Guinea-Bissau, Haiti, Kazakhstan, Kyrgyzstan, Mauritania, Pakistan, Peru, Sierra Leone, Togo, Uzbekistan, Yemen	2
Albania, Armenia, Belarus, Belize, Benin, Bolivia, Bosnia and Herzegovina, Burundi, Cambodia, Chad, Comoros, Djibouti, Dominican Republic, Egypt, Eritrea, Federated States of Micronesia, Gabon, Guinea, Guyana, Honduras, Iraq, Jamaica, Laos, Lesotho, Macedonia, Madagascar, Mali, Mongolia, Montenegro, Morocco, Mozambique, Namibia, Nepal, Nicaragua, Niger, Papua New Guinea, Philippines, Rwanda, Serbia, South Africa, Syria, Thailand, Trinidad and Tobago, Turkey, Venezuela, Vietnam, Wallis and Futuna, Zambia	1

Figure 2. Number of papers included by year of publication, 2007–2017 (n = 67)

Figure 3. Number of papers assessing the timeliness of different antigens as primary or secondary outcome measures (n = 67)

Figure 4. Number of papers reporting different variables used as predictors of vaccine timeliness in multivariable regression (n = 67)

Figure 5. Number of papers reporting different age-ranges (n = 67)

Akmatov MK, Mikolajczyk RT. Timeliness of childhood vaccinations in 31 low and middle-income countries. J Epidemiol Community Health. 2012;66:e14. doi:10.1136/jech.2010.124651.

 PubMed Web of Science ®Google Scholar

Akmatov MK, Kretzschmar M, Krämer A, Mikolajczyk RT. Timeliness of vaccination and its effects on fraction of vaccinated population. Vaccine. 2008;26:3805–11. doi:10.1016/j.vaccine.2008.05.031.

 PubMed Web of Science ®Google Scholar

Babirye JN, Engebretsen IMS, Makumbi F, Fadnes LT, Wamani H, Tylleskar T, Nuwaha F. Timeliness of childhood vaccinations in kampala uganda: A community-based cross-sectional study. PLoS One. 2012;7:1–6. doi:10.1371/journal.pone.0035432.

 Web of Science ®Google Scholar

Barman D, Dutta A. Access and barriers to immunization in West Bengal, India: quality matters. J Health Popul Nutr. 2013;31:510–22.

 PubMed Web of Science ®Google Scholar

Barman MP, Nath K, Hazarika J. Factors affecting timeliness of immunization coverage among children of Assam, India. J Health Manag. 2015;17:274–84. doi:10.1177/0972063415589243.

 Web of Science ®Google Scholar

Bicaba A, Haddad S, Kabore M, Taminy E, Feletto M, Fournier P. Monitoring the performance of the expanded program on immunization: the case of Burkina Faso. BMC Int Health Hum Rights. 2009;9(Suppl 1):S12. doi:10.1186/1472-698X-9-S1-S12.

 PubMed Web of Science ®Google Scholar

Calhoun LM, Van Eijk AM, Lindblade KA, Odhiambo FO, Wilson ML, Winterbauer E, Slutsker L, Hamel MJ. Determinants and coverage of vaccination in children in western Kenya from a 2003 cross-sectional survey. Am J Trop Med Hyg. 2014;90:234–41. doi:10.4269/ajtmh.13-0127.

 PubMed Web of Science ®Google Scholar

Chiabi A, Nguefack FD, Njapndounke F, Kobela M, Kenfack K, Nguefack S, Mah E, Nguefack-Tsague G, Angwafo F. Vaccination of infants aged 0 to 11 months at the Yaounde Gynaeco-obstetric and pediatric hospital in Cameroon: how complete and how timely? BMC Pediatr. 2017;17:206. doi: 10.1186/s12887-017-0954-1.

 PubMed Web of Science ®Google Scholar

Clark A, Sanderson C. Timing of children’s vaccinations in 45 low-income and middle-income countries: an analysis of survey data. Lancet. 2009;373:1543–49. doi:10.1016/S0140-6736(09)60317-2.

 PubMed Web of Science ®Google Scholar

D’Ardenne KK, Darrow J, Furniss A, Chavez C, Hernandez H, Berman S, Asturias EJ. Use of rapid needs assessment as a tool to identify vaccination delays in Guatemala and Peru. Vaccine. 2016;34:1719–25. doi: 10.1016/j.vaccine.2016.01.060.

 PubMed Web of Science ®Google Scholar

Delrieu I, Gessner BD, Baril L, Roset Bahmanyar E. From current vaccine recommendations to everyday practices: an analysis in five sub-Saharan African countries. Vaccine. 2015;33:7290–98. doi:10.1016/j.vaccine.2015.10.107.

 PubMed Web of Science ®Google Scholar

Ettarh RR, Mutua MK, Kyobutungi C. Ethnicity and delay in measles vaccination in a Nairobi slum. Trop Med Health. 2012;40:59–62. doi:10.2149/tmh.2012-09s.

 PubMedGoogle Scholar

Fadnes LT, Jackson D, Engebretsen IMS, Zembe W, Sanders D, Sommerfelt H, Tylleskär T. Vaccination coverage and timeliness in three South African areas: a prospective study. BMC Public Health. 2011;11:404. doi:10.1186/1471-2458-11-404.

 PubMed Web of Science ®Google Scholar

Fadnes LT, Nankabirwa V, Sommerfelt H, Tylleskär T, Tumwine JK, Engebretsen IMS. Is vaccination coverage a good indicator of age-appropriate vaccination? A prospective study from Uganda. Vaccine. 2011;29:3564–70. doi:10.1016/j.vaccine.2011.02.093.

 PubMed Web of Science ®Google Scholar

Fisker AB, Hornshøj L, Rodrigues A, Balde I, Fernandes M, Benn CS, Aaby P. Effects of the introduction of new vaccines in Guinea-Bissau on vaccine coverage, vaccine timeliness, and child survival: an observational study. Lancet Glob Health. 2014;2:478–87. doi:10.1016/S2214-109X(14)70274-8.

 Web of Science ®Google Scholar

Flannery B, Samad S, Tate JE, Danovaro-Holliday C, Rainey JJ, States U, Program I, States U, Cássio J, Moraes D, et al. Uptake of oral rotavirus vaccine and timeliness of routine immunization in Brazil’s national immunization program. Vaccine. 2013;31:1523–28. doi:10.1016/j.vaccine.2013.01.004.

 PubMed Web of Science ®Google Scholar

Gibson DG, Ochieng B, Kagucia EW, Obor D, Odhiambo F, O’Brien KL, Feikin DR. Individual level determinants for not receiving immunization, receiving immunization with delay, and being severely underimmunized among rural western Kenyan children. Vaccine. 2015;33:6778–85. doi:10.1016/j.vaccine.2015.10.021.

 PubMed Web of Science ®Google Scholar

Gram L, Soremekun S, Ten Asbroek A, Manu A, O’Leary M, Hill Z, Danso S, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR. Socio-economic determinants and inequities in coverage and timeliness of early childhood immunisation in rural Ghana. Trop Med Int Health. 2014;19:802–11. doi: 10.1111/tmi.12324.

 PubMed Web of Science ®Google Scholar

Hu Y, Li Q, Luo S, Lou L, Qi X, Xie S. Timeliness vaccination of measles containing vaccine and barriers to vaccination among migrant children in east China. PLoS One. 2013;8:1–7.

 Web of Science ®Google Scholar

Hu Y, Chen Y, Guo J, Tang X, Shen L. Completeness and timeliness of vaccination and determinants for low and late uptake among young children in eastern China. Hum Vaccin Immunother. 2014;10:1408–15. doi:10.4161/hv.28054.

 PubMed Web of Science ®Google Scholar

Hu Y, Li Q, Chen Y. Timeliness of childhood primary immunization and risk factors related with delays: evidence from the 2014 Zhejiang Provincial vaccination coverage survey. Int J Environ Res Public Health. 2017;14:1086. doi:10.3390/ijerph14091086.

 Web of Science ®Google Scholar

Hughes MM, Katz J, Englund JA, Khatry SK, Shrestha L, LeClerq SC, Steinhoff M, Tielsch JM. Infant vaccination timing: beyond traditional coverage metrics for maximizing impact of vaccine programs, an example from southern Nepal. Vaccine. 2016;34:933–41. doi: 10.1016/j.vaccine.2015.12.061.

 PubMed Web of Science ®Google Scholar

Iqbal W, Danish SH, Ahmad F. Factors responsible for non-compliance of timely administration of BCG vaccine in district Jhelum Pakistan. Pak J Public Health. 2015;5:22–27.

 Google Scholar

Jadidi R, Mohammadbeigi A, Mohammadsalehi N, Ansari H, Ghaderi E. Inequity in timeliness of MMR vaccination in children living in the suburbs of Iranian cities. Int J Biomed Sci. 2015;11:93–98.

 PubMedGoogle Scholar

Laryea DO, Abbeyquaye Parbie E, Frimpong E. Timeliness of childhood vaccine uptake among children attending a tertiary health service facility-based immunisation clinic in Ghana. BMC Public Health. 2014;14:90. doi:10.1186/1471-2458-14-90.

 PubMed Web of Science ®Google Scholar

Le Polain de Waroux O, Schellenberg JRA, Manzi F, Mrisho M, Shirima K, Mshinda H, Alonso P, Tanner M, Schellenberg DM. Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania. Int Health. 2013;5:139–47. doi:10.1093/inthealth/iht006.

 PubMed Web of Science ®Google Scholar

Li Q, Hu Y, Zhong Y, Chen Y, Tang X, Guo J, Shen L. Using the immunization information system to determine vaccination coverage rates among children aged 1–7 years: A report from Zhejiang province, China. Int J Environ Res Public Health. 2014;11:2713–28. doi: 10.3390/ijerph110302713.

 PubMed Web of Science ®Google Scholar

Lin W, Xiong Y, Tang H, Chen B, Ni J. Factors associated with delayed measles vaccination among children in Shenzhen, China: a case-control study. Hum Vaccin Immunother. 2014;10:3601–06. doi:10.4161/21645515.2014.979687.

 PubMed Web of Science ®Google Scholar

Mbengue MAS, Mboup A, Ly ID, Faye A, Niang FB, Thiam M, Ndiaye BP, Dieye TN, Mboup S. Vaccination coverage and immunization timeliness among children aged 12–23 months in Senegal: a Kaplan-Meier and Cox regression analysis approach. Pan Afr Med J. 2017;27:8.

 PubMedGoogle Scholar

Miyahara R, Jasseh M, Gomez P, Shimakawa Y, Greenwood B, Keita K, Ceesay S, D’Alessandro U, Roca A. Barriers to timely administration of birth dose vaccines in The Gambia, West Africa. Vaccine. 2016;34:3335–41. doi: 10.1016/j.vaccine.2016.05.017.

 PubMed Web of Science ®Google Scholar

Moïsi JC, Kabuka J, Mitingi D, Levine OS, Scott JAG. Spatial and socio-demographic predictors of time-to-immunization in a rural area in Kenya: is equity attainable? Vaccine. 2010;28:5725–30. doi:10.1016/j.vaccine.2010.06.011.

 PubMed Web of Science ®Google Scholar

Mokhtari M, Rezaeimanesh M, Mohammadbeigi A, Zahraei SM, Mohammadsalehi N, Ansari H. Risk factors of delay proportional probability in Diphtheria?Tetanus? Pertussis vaccination of Iranian children; life table approach analysis. J Glob Infect Dis. 2015;7:165–69. doi:10.4103/0974-777X.170503.

 PubMed Web of Science ®Google Scholar

Montgomery JP, Zhang Y, Carlson B, Ewing S, Wang X, Boulton ML. Measles vaccine coverage and series completion among children 0–8 years of age in Tianjin, China. Pediatr Infect Dis J. 2015;34:289–95. doi:10.1097/INF.0000000000000562.

 PubMed Web of Science ®Google Scholar

Mutua MK, Ochako R, Ettarh R, Ravn H, Echoka E, Mwaniki P. Effects of low birth weight on time to BCG vaccination in an urban poor settlement in Nairobi, Kenya: an observational cohort study. BMC Pediatr. 2015;15:45. doi:10.1186/s12887-015-0360-5.

 PubMed Web of Science ®Google Scholar

Mutua MK, Kimani-Murage E, Ngomi N, Ravn H, Mwaniki P, Echoka E. Fully immunized child: coverage, timing and sequencing of routine immunization in an urban poor settlement in Nairobi, Kenya. Trop Med Health. 2016;44:13. doi:10.1186/s41182-016-0013-x.

 PubMedGoogle Scholar

Mvula H, Heinsbroek E, Chihana M, Crampin AC, Kabuluzi S, Chirwa G, Mwansambo C, Costello A, Cunliffe NA, Heyderman RS, et al. Predictors of uptake and timeliness of newly introduced pneumococcal and rotavirus vaccines, and of measles vaccine in rural Malawi: A population cohort study. PLoS One. 2016;11:1–15. doi:10.1371/journal.pone.0154997.

 Web of Science ®Google Scholar

Narváez J, Osorio MB, Castañeda-Orjuela C, Alvis Zakzuk N, Cediel N, Chocontá-Piraquive LÁ, de La Hoz-Restrepo F. Is Colombia reaching the goals on infant immunization coverage? A quantitative survey from 80 municipalities. Vaccine. 2017;35:1501–08. doi:10.1016/j.vaccine.2017.01.073.

 PubMed Web of Science ®Google Scholar

Odutola A, Afolabi MO, Ogundare EO, Lowe-Jallow YN, Worwui A, Okebe J, Ota MO, Heiniger U, Clark A, Sanderson C, et al. Risk factors for delay in age-appropriate vaccinations among Gambian children. BMC Health Serv Res. 2015;15:346. doi: 10.1186/s12913-015-1015-9.

 PubMed Web of Science ®Google Scholar

Olusanya BO. Pattern and determinants of BCG immunisation delays in a sub-Saharan African community. Health Res Policy Syst. 2010;8:1. doi:10.1186/1478-4505-8-1.

 PubMed Web of Science ®Google Scholar

Pezzoli L, Mathelin JP, Hennessey K, Eswara-Aratchige P, Valiakolleri J, Kim SH. Low level of hepatitis B virus infection in children 20 years after initiation of infant vaccination program in Wallis and Futuna. Am J Trop Med Hyg. 2017;16–0596.

 Web of Science ®Google Scholar

Poorolajal J, Khazaei S, Kousehlou Z, Bathaei SJ, Zahiri A. Delayed vaccination and related predictors among infants. Iran J Public Health. 2012;41:65–71.

 PubMed Web of Science ®Google Scholar

Rainey JJ, Lacapère F, Danovaro-Holliday MC, Mung K, Magloire R, Kananda G, Cadet JR, Lee CE, Chamouillet H, Luman ET. Vaccination coverage in Haiti: results from the 2009 national survey. Vaccine. 2012;30:1746–51. doi:10.1016/j.vaccine.2011.12.015.

 PubMed Web of Science ®Google Scholar

Rejali M, Mohammadbeigi A, Mokhtari M, Zahraei SM, Eshrati B. Timing and delay in children vaccination; evaluation of expanded program of immunization in outskirt of Iranian cities. J Res Health Sci. 2015;15:54–58.

 PubMed Web of Science ®Google Scholar

Sadoh AE, Eregie CO. Timeliness and Completion Rate of Immunization among Nigerian Children Attending a Clinic-based Immunization Service on JSTOR. J Heal Popul Nutr 2009; 27:391–395.

 Google Scholar

Sadoh AE, Nwaneri DU, Ogboghodo BC, Sadoh WE. Effect of introduction of pentavalent vaccine as replacement for diphtheria-tetanus-pertussis and hepatitis B vaccines on vaccination uptake in a health facility in Nigeria. Vaccine. 2016;34:2722–28. doi: 10.1016/j.vaccine.2016.04.026.

 PubMed Web of Science ®Google Scholar

Sanchez D, Sodha SV, Kurtis HJ, Ghisays G, Wannemuehler KA, Danovaro-Holliday MC, Ropero-Alvarez AM. Vaccination week in the Americas, 2011: an opportunity to assess the routine vaccination program in the Bolivarian Republic of Venezuela. BMC Public Health. 2015;15:395. doi:10.1186/s12889-015-1723-4.

 PubMed Web of Science ®Google Scholar

Sartori AL, Minamisava R, Afonso ET, Policena GM, Pessoni GC, Bierrenbach AL, Andrade AL. Timeliness and risk factors associated with delay for pneumococcal conjugate 10-valent routine immunization in Brazilian children. Vaccine. 2017;35:1030–36. doi:10.1016/j.vaccine.2017.01.012.

 PubMed Web of Science ®Google Scholar

Schoeps A, Ouédraogo N, Kagoné M, Sié A, Müller O, Becher H. Socio-demographic determinants of timely adherence to BCG, Penta3, measles, and complete vaccination schedule in Burkina Faso. Vaccine. 2013;32:96–102. doi: 10.1016/j.vaccine.2013.10.063.

 PubMed Web of Science ®Google Scholar

Scott S, Odutola A, Mackenzie G, Fulford T, Afolabi MO, Jallow YL, Jasseh M, Jeffries D, Dondeh BL, Howie SRC, et al. Coverage and timing of children’s vaccination: an evaluation of the expanded programme on immunisation in the Gambia. PLoS One. 2014;9:1–9. doi:10.1371/journal.pone.0107280.

 Web of Science ®Google Scholar

Senessie C, Gage GN, von Elm E. Delays in childhood immunization in a conflict area : a study from Sierra Leone during civil war. Confl Health. 2007;1:14. doi:10.1186/1752-1505-1-14.

 PubMedGoogle Scholar

Shrivastwa N, Gillespie BW, Lepkowski JM, Boulton ML. Vaccination timeliness in children under India’s universal immunization program. Pediatr Infect Dis J. 2016;35:955–60. doi:10.1097/INF.0000000000001223.

 PubMed Web of Science ®Google Scholar

Suárez-Castaneda E, Pezzoli L, Elas M, Baltrons R, Crespin-Elías EO, Pleitez OAR, de Campos MIQ, Danovaro-Holliday MC. Routine childhood vaccination programme coverage, El Salvador, 2011-In search of timeliness. Vaccine. 2014;32:437–44. doi:10.1016/j.vaccine.2013.11.072.

 PubMed Web of Science ®Google Scholar

Suarez-Castaneda E, Burnett E, Elas M, Baltrons R, Flannery B, Kleinbaum D, Oliveira LH D, Danovaro-Holliday MC. Catching-up with pentavalent vaccine: exploring reasons behind lower rotavirus vaccine coverage in El Salvador. Vaccine. 2015;33:6865–70. doi:10.1016/j.vaccine.2015.07.092.

 PubMed Web of Science ®Google Scholar

Tang X, Geater A, McNeil E, Zhou H, Deng Q, Dong A, Li Q. Parental migration and children’s timely measles vaccination in rural China: a cross-sectional study. Trop Med Int Health. 2016;21:886–94. doi:10.1111/tmi.12719.

 PubMed Web of Science ®Google Scholar

Tang X, Geater A, McNeil E, Zhou H, Deng Q, Dong A. Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey. J Epidemiol. 2017;27:317–24. doi:10.1016/j.je.2016.08.006.

 PubMed Web of Science ®Google Scholar

Tippins A, Leidner AJ, Meghani M, Griffin A, Nyaku M, Underwood JM. Timeliness of childhood vaccination in the federated states of micronesia. Vaccine. 2017;35:6404–11. doi:10.1016/j.vaccine.2017.10.001.

 PubMed Web of Science ®Google Scholar

Toikilik S, Tuges G, Lagani J, Wafiware E, Posanai E, Coghlan B, Morgan C, Sweeney R, Miller N, Abramov A, et al. Are hard-to-reach populations being reached with immunization services? Findings from the 2005 Papua New Guinea national immunization coverage survey. Vaccine. 2010;28:4673–79. doi:10.1016/j.vaccine.2010.04.063.

 PubMed Web of Science ®Google Scholar

Vasudevan L, Labrique AB, Mehra S, Wu L, Levine O, Feikin D, Klemm R, Christian P, West KP. Maternal determinants of timely vaccination coverage among infants in rural Bangladesh. Vaccine. 2014;32:5514–19. doi:10.1016/j.vaccine.2014.06.092.

 PubMed Web of Science ®Google Scholar

Wagner AL, Zhang Y, Montgomery JP, Ding Y, Carlson BF, Boulton ML. Timely measles vaccination in Tianjin, China: a cross-sectional study of immunization records and mothers. BMC Public Health. 2014;14:888. doi:10.1186/1471-2458-14-888.

 PubMed Web of Science ®Google Scholar

Wagner AL, Sun X, Montgomery JP, Huang Z, Boulton ML. The impact of residency and urbanicity on Haemophilus influenzae type b and pneumococcal immunization in Shanghai children: A retrospective cohort study. PLoS One. 2014;9:1–7. doi:10.1371/journal.pone.0097800.

 Web of Science ®Google Scholar

Wagner AL, Sun X, Huang Z, Ren J, Mukherjee B, Wells EV, Boulton ML, On-Time M. Pneumococcal vaccination of shanghai children: the impact of individual- and neighborhood-level factors. Pediatr Infect Dis J. 2016;35:1–34. doi:10.1097/INF.0000000000001267.

 PubMed Web of Science ®Google Scholar

Wallace AS, Sobel H, Ryman TK, Mantaring JB, Silvestre M, Thorley M, Ducusin J, Nyunt-U S. Timing of hepatitis B vaccination and impact of non-simultaneous vaccination with DTP vaccine following introduction of a hepatitis B birth dose in the Philippines. J Public Health Policy. 2012;33:368–81. doi: 10.1111/jvh.12359.

 PubMed Web of Science ®Google Scholar

Wu JN, Wen XZ, Zhou Y, Lin D, Zhang SY, Yan YS. Impact of the free-vaccine policy on timely initiation and completion of hepatitis B vaccination in Fujian, China. J Viral Hepat. 2015;22:551–60. doi:10.1111/jvh.12359.

 PubMed Web of Science ®Google Scholar

Yadav K, Srivastava R, Kumar R, Chinnakal P, Rai SK, Krishnan A. Significant vaccination delay can occur even in a community with very high vaccination coverage: evidence from Ballabgarh, India. J Trop Pediatr. 2012;58:133–38. doi:10.1093/tropej/fmr059.

 PubMed Web of Science ®Google Scholar

Zaidi SMA, Khowaja S, Dharma VK, Khan AJ, Chandir S. Coverage, timeliness, and determinants of immunization completion in Pakistan: evidence from the demographic and health survey (2006–07). Hum Vaccin Immunother. 2014;10:1712–20. doi:10.4161/hv.28621.

 PubMed Web of Science ®Google Scholar

Zhou Y, Wang H, Zheng J, Zhu X, Xia W, Hipgrave DB. Coverage of and influences on timely administration of hepatitis B vaccine birth dose in remote rural areas of the People’s Republic of China. Am J Trop Med Hyg. 2009;81:869–74. doi:10.4269/ajtmh.2009.09-0238.

 PubMed Web of Science ®Google Scholar

Zivich PN, Kiketa L, Kawende B, Lapika B, Yotebieng M. Vaccination coverage and timelines among children 0–6 months in kinshasa, the democratic Republic of Congo: a prospective cohort study. Matern Child Health J. 2017; 5:1055–1064.

 Web of Science ®Google Scholar