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Open AccessArticle

Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh

Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Sarani, Dhaka 1212, Bangladesh
School of Health and Social Development, Deakin University, Melbourne, Burwood, VIC 3125, Australia
School of Commerce, University of Southern Queensland, Toowoomba, QLD 4350, Australia
Laboratory Sciences & Services Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
Department of Management Science, University of Strathclyde, Glasgow G4 0QU, UK
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2018, 3(3), 72;
Received: 8 May 2018 / Revised: 19 June 2018 / Accepted: 20 June 2018 / Published: 25 June 2018
Immunization has become one of the major contributors to public health globally as it prevents communicable disease, particularly in children. The objective of this study was to estimate the extent of timely immunization coverage and to investigate the determinants of incomplete and untimely vaccination. Methods: The study used data from the latest Bangladesh Demographic Health Survey (BDHS) 2014. A total sample of 1631 children aged 12–23 months who had an Expanded Program on Immunization (EPI) card and immunization history were analyzed. Multivariable logistic regression models were used to determine the significant influencing factors on untimely vaccination (BCG, pentavalent vaccine/OPV, and measles) and incomplete vaccination. The results were presented in terms of adjusted odds ratio (AOR) with a 95% confidence interval and a significance level p < 0.05. Results: The proportions of children who received timely vaccinations were 24% for BCG, 46% for pentavalent 3, and 53% for measles, whereas 76%, 51%, and 36% children failed to receive the BCG, pentavalent 3, and measles vaccines, respectively, in a timely manner. The proportion of early vaccination was 3% for pentavalent 3 and 12% for measles. Several significant influencing factors including age, maternal education and working status, awareness of community clinics, socioeconomic status, and geographic variation significantly contributed to untimely and incomplete vaccination of children in Bangladesh. Conclusions: The study identified some key determinants of untimely and incomplete childhood vaccinations in the context of Bangladesh. The findings will contribute to the improvement of age-specific vaccination and support policy makers in taking the necessary control strategies with respect to delayed and early vaccination in Bangladesh. View Full-Text
Keywords: Bangladesh; childhood disease; immunization; timeliness; low vaccination coverage Bangladesh; childhood disease; immunization; timeliness; low vaccination coverage
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Sheikh, N.; Sultana, M.; Ali, N.; Akram, R.; Mahumud, R.A.; Asaduzzaman, M.; Sarker, A.R. Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh. Trop. Med. Infect. Dis. 2018, 3, 72.

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