In contrast to non-Somalis, family wealth did not significantly affect the likelihood of being fully vaccinated among Somali refugee children living in Kenya. This may point to systemic barriers to vaccination that cut across all socio-economic levels of the Somali refugee population.
Africa
Nigerian children of mothers with less education are less likely to be vaccinated compared to those with educated mothers
Children born to mothers in Southwest Nigeria who had no formal education were four times more likely to be unvaccinated or partially vaccinated than those born to mothers who completed primary school and were six times more likely to be partially vaccinated or unvaccinated than children whose mothers completed a post-secondary education.
Children from the poorest households in Nigeria are less likely to be immunized than those from wealthier households
In a Southwest state of Nigeria, children in the poorest category (quintile) of households were 14 times more likely to be partially immunized or not immunized, and those in the next poorest category were eight times more likely to be partially immunized or not immunized than children in the wealthiest group, after adjusting for factors such as education, religion, and ethnicity.
Educating women can help increase infant immunization rates in Kenya
Data from the Kenya Demographic and Health Survey show that women with a primary school education were 2 to 5 times more likely to have their infants vaccinated (depending on the vaccine) and women with a secondary school education were 2.5 to 9 times more likely to have their infants vaccinated than mothers with less than a primary education or no education [after adjusting for wealth, age, religion and other variables].
PCV-10 vaccine reduced rates of pneumococcal pneumonia in adults in Kenya, including those with HIV
The introduction of PCV-10, along with a “catch-up” campaign for 1-4 year olds, led to dramatic reductions in the rates of pneumococcal pneumonia in adults (≥18 years old) in a rural area of Kenya with high rates of both adult pneumococcal pneumonia and HIV. Over five years following the vaccine introduction, the incidence rates among adults were 47-94% lower each year than in the pre-vaccine period, with similar declines for HIV-infected and HIV-uninfected adults.
Immunization with PCV reduced the risk of pneumococcal pneumonia in HIV-positive adults in Kenya
Prior to the introduction of PCV, adults with HIV in a rural area of Kenya were nearly five times more likely to have pneumococcal pneumonia than non-infected adults, and the majority of cases with bacteremia (blood infection) occurred in HIV positive individuals.
High measles vaccination coverage in Ethiopia linked to lower rates of acute malnutrition in children
An analysis conducted in areas of Ethiopia with high proportions of refugees found that high measles vaccination coverage was linked to lower rates of acute malnutrition (wasting) in children under five. For each percentage point increase in measles vaccination coverage, there was a 0.65% decrease in the rate of acute malnutrition in these areas.
Even in hard-to-reach areas measles vaccination is cost-effective and beneficial for public health
An outreach strategy in Kenya to vaccinate children against measles in hard-to-reach areas (e.g., beyond 5 km from a vaccination post) would be highly cost-effective, despite the higher cost per child to reach these children. The estimated cost per DALY averted ranged from US$122 (if 50% of these children receive the first dose and one-half of them the second dose) to US$274 (if 100% receive the first dose) — considerably less than the country’s GDP per capita of US$1,865 used as the threshold of cost-effectiveness.
Fear of Ebola in West Africa caused financial losses and staff shortages in Nigerian hospitals
Fear of Ebola during the 2014-2016 epidemic in 3 West African countries had a major impact on the health sector in neighboring Nigeria, where hospitals some hospitals also turned away febrile patients to prevent being associated with Ebola while staff in other hospitals abandoned their posts.
Efforts to eradicate polio have also led to improved access to other vaccines
The expertise and assets gained through efforts to eradicate polio at least partially explain the improvement between 2013 and 2015 in vaccination coverage of DPT3 in six out of ten “focus” countries of the Polio Eradication Endgame strategic plan. This includes substantial increases in vaccination rates in India, Nigeria, and Ethiopia, which, combined, reduced the number of children not fully vaccinated with DPT by 2 million in 2 years.