Factors associated with low vaccination coverage among children in the Former Soviet countries: An example of Kyrgyzstan

Background

Factors associated with low vaccination coverage were extensively investigated both in developing and developed countries. It is not clear which factors affect vaccination coverage in former Soviet countries which experience intensive economic and health care system transition process.

Methods

We conducted a cross-sectional study among parents of first-year school children (n=934) from eight primary schools in the capital of, Bishkek in September 2006 using a self-administered questionnaire. The questionnaire included three major dimensions (parents’ attitudes towards vaccine safety and knowledge about vaccination, access to health care facilities and socio-demographic factors) which may have potential effects on vaccination coverage. Multilevel logistic regression analysis was conducted to identify factors independently associated with child’s vaccination status against hepatitis B and measles (in separate models) using PROC GLIMMIX in SAS 9.1.3.  

Results

The coverage with vaccine against hepatitis B was 81.3% and against measles - 88.7%. After adjusting for sex of the child, age of the respondent, socio-economic status, education level and other factors, children whose parents had positive attitudes towards vaccine safety (OR 0.47 (95% CI: 0.31-0.70)) and children born in the capital (OR 0.58 (0.37-0.91)) were less likely to be unvaccinated with hepatitis B vaccine. Children whose parents reported no sources of information about vaccinations were more likely to be unvaccinated with hepatitis B vaccine (OR 3.39 (1.64-6.99)) as compared to those whose parents had more than one source. Access to health care facilities and socio-demographic factors played no significant role. The same pattern of risk factors was observed for vaccination against measles.

Conclusion

We identified that parental attitudes towards and knowledge about vaccinations were strongly associated with a poor vaccination status of children. These findings should be taken into account by policy makers even in society with a compulsory vaccination program.