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Arch Hellen Med, 22(4), July-August 2005, 358-369


Adequacy of vaccination coverage at school-entry:
Cross-sectional study in schoolchildren of an urban population

Laboratory of Hygiene, Aristotle University of Thessaloniki, Thessaloniki, Greece

OBJECTIVE The valid and accurate estimation of vaccination coverage in children enrolled in the first grade of primary school, in order to evaluate the completeness of the pre-school vaccination schedule.

METHOD Information was gathered from the official vaccination cards of children enrolled in all primary schools of the three municipalities that comprise the northern part of Thessaloniki metropolitan area. Specially designed report cards were completed by appropriate trained health professionals and teachers. Data concerning 972 of 1,250 children (77.76%) were analysed for this study. Results were assessed according to the method proposed by the Institute of Child Health during the panhellenic vaccination coverage research.

RESULTS The proportion of fully vaccinated children was only 23.3% (CI95%: 20.8-26.1%). Vaccination coverage of children under the age of 2 years, with 4 doses for diphtheria-tetanus, pertussis and poliomyelitis was respectively 71.6%, 67.4% and 74.3%; 5 doses of these vaccines had been given in 83.2%, 48.5% and 84.6% of the children respectively. By the age of 2 years a proportion of 75.7%, 71.2% and 71.5% had been vaccinated against measles, rubella and mumps, but the revaccinated percentages were only 38.5%, 33.4% and 33.9% respectively of the children older than 6 years. Finally, 74% of the children were covered by the hepatitis B vaccine, while 47.8% of the children were vaccinated against infection from Haemophilus influenzae.

CONCLUSIONS Comparing data from this study and the panhellenic vaccination coverage studies of 1998 and 2001, it could be concluded that our research population has a similar vaccination coverage, although timely vaccination coverage is gravely below the WHO vaccination targets. Surveillance of immunization through periodic reporting held in schools by the primary health services appears to provide an effective and accurate estimation of vaccination coverage. Motivation of the public health services and the school community can play a very important role in achieving effective herd immunity status and eliminating cases of vaccine preventable diseases.

Key words: Immunization, Primary health care, Schoolchildren, Vaccination coverage.

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