Introduction of inactivated poliovirus vaccine in the Philippines: Effect on health care provider and infant caregiver attitudes and practices. Issue 48 (19th November 2018)

• Record Type: Journal Article
• Authors: Lopez, Anna Lena; Harris, Jennifer B.; Raguindin, Peter Francis; Aldaba, Josephine; Morales, Merrylle; Sylim, Patrick; Wannemuehler, Kathleen; Wallace, Aaron; Ehlman, Daniel C.; Hyde, Terri B.; Fox, Kimberley K.; Nyambat, Batmunkh; Ducusin, Maria Joyce; Hampton, Lee M.
• Is Part Of: Vaccine. Volume 36:Issue 48(2018)
• Page Start: 7399
• Page End: 7407
• Publication Date: 2018-11-19
• Subjects: Multiple vaccine injections -- Vaccine acceptance -- Vaccine hesitancy -- PHILIPPINES -- IPV; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2018.09.028
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: IPV introduction added a third injectable vaccine to the 14-week vaccination visit. After IPV introduction, most children received all three vaccines at the same visit. Proportion of children receiving all vaccines at same visit varied by region and health center. When children did not receive all vaccines, many caregivers reported not being offered all of them. Most caregivers and providers supported administration of three injections at one visit. Abstract: Background: The introduction of inactivated poliovirus vaccine (IPV) to the Philippines' national immunization schedule meant the addition of a third injectable vaccine at a child's 14-week immunization visit. Although previous studies have shown that providing multiple vaccines at the same time affected neither the risk of severe adverse events nor vaccine efficacy, concerns were raised that providing three injections at a single visit, with two injections in one leg, might be unacceptable to health care providers (HCP) and infant caregivers. Methods: We conducted pre- and post-IPV introduction surveys on the acceptance and acceptability of the additional injectable vaccine in three of the Philippines' 17 administrative regions. Regions 3 and 6 were included in the pre-introduction phase and Regions 3, 6 and 10 were included in the post-introduction phase. Thirty public health centers (PHCs) were randomly sampled from each region. HCPs and infant caregivers were interviewed. In addition, vaccination records from a minimum of 20 eligible children pre-introduction and 10 children post-introduction per PHC were reviewed. Results and discussion: We interviewed 89 HCPs and 286 infant caregivers during the pre-introduction phase and 137 HCPs and 455 caregivers during the post-introduction phase. Among 986 vaccination records reviewed post-introduction, 84% (n = 826) of children received all three recommended injections at one visit, with a range from 61% (209/342) in Region 10 to 100% (328/328) in Region 3. The proportion of HCPs reporting that they had administered three or more injectable vaccines and the proportion of caregivers that would be comfortable with their child receiving three or more injectable vaccines at one visit increased from pre- to post-introduction (p < 0.0001 for both). Eighty-seven percent of HCPs that had administered three or more injectable vaccines post-introduction reported being comfortable or very comfortable with the number of vaccines they had administered.