RESUMEN
Background: Low immunization and discrepancies in data sources have been a consistent challenge in Afghanistan. The objective of this was to estimate the coverage of immunization status among children of 12-23 months in urban settings of 12 provinces plus Kabul, Afghanistan in 2019. Methods: A cross-sectional survey was conducted in the capital of 12 cities of polio high-risk provinces plus Kabul during October-December 2019. A two-stage cluster sampling was used to approach 30 clusters and interview seven households. The coverage for 13 vaccines against 10 childhood diseases prioritized by the Afghanistan Immunization program was assessed through observation of vaccine cards or by history from caregivers of children. Epi Info v.7.2.5 was used for data management and analysis. Results: Totally, 3382 caregivers of children aged 12-23 months, of whom 50.8% were boys, were interviewed. The literacy of mothers was 35%, and 86.4% were housewives with no formal employment. The average age of children was 17.07 ± 4.05 months. In total, 1261 (37.29%) children were fully vaccinated, 833 (54.2%) were partially vaccinated, and 288 (8.52%) did not receive any dose of routine vaccine. Of total, 71.82% had vaccination cards, 17.24% had lost them, and 11% had no cards. Generally, coverage of immunization by cards and history was 91.70% for BCG, 52% for Penta, 78% for OPV-4, 63% for PCV2, 61% for Rota2, 68.50% for measles 1, and 58% for IPV. Nangarhar and Kunar provinces have the highest and lowest immunization coverage, respectively. Lack of awareness and time was the main factor cited by partially vaccinated individuals, while misconceptions about vaccines were reported among the unvaccinated. Conclusion: Child immunization levels, varying across cities, were suboptimal in the study population. Realistic goal-setting and awareness campaigns are necessary to address the low immunization coverage and fight against barriers in Afghanistan.
Asunto(s)
Programas de Inmunización , Cobertura de Vacunación , Humanos , Afganistán , Femenino , Masculino , Lactante , Estudios Transversales , Programas de Inmunización/estadística & datos numéricos , Cobertura de Vacunación/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Inmunización/estadística & datos numéricos , AdultoRESUMEN
As of August 2021, less than 5% of the total population in Afghanistan has been fully vaccinated against COVID-19. Concerns remain regarding low uptake of the vaccine due to several factors. This study was conducted to understand the perception of the public on COVID-19 and its vaccines in Afghanistan. This was a formative study using qualitative method that included FGDs with vaccination target groups and KIIs, using interview guides in local languages in 12 provinces with 300 participants during May-June 2021. Verbatim transcripts were created, and a deductive thematic analysis was conducted with transcripts after the key themes and sub-themes were developed and reviewed. Totally 24 FGDs with male and female COVID-19 high-risk groups, 12 KIIs with EPI managers, and 12 KIIs with prison heads were conducted. Key themes included awareness and perception about COVID-19, its vaccination, motivators for getting vaccinated, barriers for not getting vaccinated, and sources of information. Awareness about the COVID-19 was high in urban areas compared to rural areas. Almost 60% of the participants considered the COVID-19 vaccine effective. However, participants expressed their concerns regarding rumors and misconceptions on content, source, effectiveness, and side effects of the vaccine in their communities. Based on the study results, many participants expressed accurate knowledge about the COVID-19 disease and its vaccines. Significant barriers including misinformation, conspiracy theories, and fear of side effects persist. Collaboration between stakeholders and increasing awareness and engagement of communities about the benefits and effectiveness of the vaccines should be considered crucial.