Coverage, missed opportunities and reasons for not vaccinating children under 5 years of age in Paraguay
DOI:
https://doi.org/10.52379/mcs.v10.578Keywords:
vaccination, vaccination coverage, delay in vaccination, children, parents, ParaguayAbstract
Introduction: Vaccine-preventable diseases remain one of the main causes of infant mortality, despite advances in immunization. Globally and in the Region of the Americas, vaccination coverage has decreased, falling below the recommended 95%. In Paraguay, low vaccination rates reflect barriers that compromise public health. Objective: To determine the coverage, vaccination opportunity, and the main reasons for non-vaccination in children under 5 years of age in Fernando de la Mora, Paraguay, in 2023. Methodology: Descriptive cross-sectional study carried out in 318 children selected by two-stage probability sampling. Vaccination coverage for BCG, pentavalent, and MMR were analyzed. Data were collected using questionnaires designed in Epi.Info 7.2, recording sociodemographic variables, vaccination status, coverage, opportunity, source of information on vaccines, reasons for non-vaccination, knowledge, attitudes, practices, and sources of information, analyzed with descriptive statistics such as frequency and percentages. Results: 53% of children had complete vaccination schedules. Vaccination coverage was high for BCG (98.43%) and low for MMR-2 (37.02%). Vaccination opportunity was complete for BCG, but decreased for MMR-1 (42.01%). The main reasons for not vaccinating were lack of knowledge about the schedule (38.9%), erroneous beliefs (21.48%) and lack of time on the part of parents (21.48%). 77% of that responsible received information about vaccination, with television, radio and print media being the most frequent sources (42.5%). Conclusion: Although the initial BCG and pentavalent coverage are high, there is still a marked decline in the continuity of the schedules and the opportunity to vaccinate. Lack of knowledge and erroneous beliefs are the main barriers identified, which highlights the need to strengthen educational and awareness-raising strategies to improve coverage.
Downloads
References
Evans B, Keiser O, Kaiser L, Jombart T. Analysis of global routine immunisation coverage shows disruption and stagnation during the first two-years of the COVID-19 pandemic with tentative recovery in 2022. Vaccine X. 2023;15. https://doi.org/10.1016/j.jvacx.2023.100383
Bai S, Kumar R, ur Rehman E, Hanif S, Ashfaq M, Bader-U-Nisa. Complete immunization and reason for non-compliance among children under five years of age. Journal of the Dow University of Health Sciences. 2021;15(2):89-96. https://doi.org/10.36570/jduhs.2021.2.1180
Ketema DB, Assemie MA, Alamneh AA, Alene M, Chane KY, Alamneh YM, et al. Full vaccination coverage among children aged 12-23 months in Ethiopia: A systematic review and meta-analysis. BMC Public Health. 2020;20(1). https://doi.org/10.1186/s12889-020-08940-x
Biblioteca Virtual de Salud-Paraguay. Inmunización en Paraguay. 2023. https://paraguay.bvsalud.org/post_vitrines/inmunizacion/
Caceda LTK, Roldán-Arbieto L, Vela-Ruiz JM, Loo-Valverde M, Ponce RG, Luna-Muñoz C, et al. No cumplimiento del esquema nacional de vacunación en niños de la selva peruana, año 2019. Revista de la Facultad de Medicina Humana. 2022;22(4):689-696. https://doi.org/10.25176/rfmh.v22i4.4614
Cooper S, Bicaba F, Tiendrebeogo CO, Bila A, Bicaba A, Druetz T. Vaccination coverage in rural Burkina Faso under the effects of COVID-19: evidence from a panel study in eight districts. BMC Health Serv Res. 2023;23(1):1016. https://doi.org/10.1186/s12913-023-10029-1
World Health Organization. 2018 Assessment report of the Global Vaccine Action Plan. Strategic Advisory Group of Experts on Immunization. Geneva: World Healt. https://iris.who.int/bitstream/handle/10665/276967/WHO-IVB-18.11-eng.pdf?ua=1
Organización Panamericana de la Salud / Organización Mundial de la Salud. Datos y estadísticas de cobertura de vacunación. 2009. https://www3.paho.org/hq/index.php?option=com_content&view=article&id=2043:data-statistics-immunization&Itemid=0&lang=es
Pan American Health Organization. Riesgo de brotes de enfermedades prevenibles por vacunación en las Américas alcanza su nivel más alto. 2023. https://www.paho.org/es/noticias/20-4-2023-riesgo-brotes-enfermedades-prevenibles-por-vacunacion-americas-alcanza-su-nivel
Instituto Nacional de Estatística; 2023. https://www.ine.gov.py/publicacion/2/poblacion
Instituto Nacional de Estadística. Población nacional estimada y proyectada por sexo y edad, 2000-2025. https://www.ine.gov.py/publicacion/2/poblacion
Pérez Centurión VT, Cousirat L, Araya S, Benítez I, Villafañe M, León D, et al. Impacto del nuevo modelo de actuación para elevar coberturas de vacunación en Paraguay, 2023. Rev Panam Salud Publica. 2025;48:e96. https://doi.org/10.26633/RPSP.2024.96
Araya S, Perez T, Troche A, Nissen J, Cousirat L, Nuñez L, et al. COVID-19 y coberturas de vacunación del calendario regular del Paraguay, efecto de la pandemia. Pediatría. 2021;48(3):162-8. https://doi.org/10.31698/ped.48032021003
Castrejon MM, Leal I, de Jesus Pereira Pinto T, Guzmán-Holst A. The impact of COVID-19 and catch-up strategies on routine childhood vaccine coverage trends in Latin America: A systematic literature review and database analysis. Human Vaccines & Immunotherapeutics. 2022;18(6):2102353. https://doi.org/10.1080/21645515.2022.2102353
Llau AF, Williams ML, Tejada CE. National vaccine coverage trends and funding in Latin America and the Caribbean. Vaccine. 2021;39(2):317-23. https://doi.org/10.1016/j.vaccine.2020.11.059
Rios-Blancas MJ, Lamadrid-Figueroa H, Betancourt-Cravioto M, Lozano R. Vaccination coverage estimation in Mexico in children under five years old: Trends and associated factors. Seale H, editor. PLoS ONE. 2021;16(4):e0250172. https://doi.org/10.1371/journal.pone.0250172
Sarker AR, Akram R, Ali N, Sultana M. Coverage and factors associated with full immunisation among children aged 12–59 months in Bangladesh: insights from the nationwide cross-sectional demographic and health survey. BMJ Open. 2019;9(7):e028020. https://doi.org/10.1136/bmjopen-2018-028020
Topuzoglu A, Ozaydin GA, Cali S, Cebeci D, Kalaca S, Harmanci H. Assessment of sociodemographic factors and socio-economic status affecting the coverage of compulsory and private immunization services in Istanbul, Turkey. Public Health. 2005;119(10):862–9. https://doi.org/10.1016/j.puhe.2005.01.015
Díaz-Ortega JL, Cruz-Hervert LP, Ferreira-Guerrero E, Ferreyra-Reyes LD, Delgado-Sánchez G, García-García M de L. Cobertura de vacunación y proporción de esquema incompleto en niños menores de siete años en México. Salud Pública de México. 2018;60(3):338–46. https://doi.org/10.21149/8812
Phoummalaysith B, Yamamoto E, Xeuatvongsa A, Louangpradith V, Keohavong B, Saw YM, et al. Factors associated with routine immunization coverage of children under one year old in Lao People’s Democratic Republic. Vaccine. 2018;36(19):2666–72. https://doi.org/10.1016/j.vaccine.2018.03.051
Ozcirpici B, Sahinoz S, Ozgur S, Bozkurt AI, Sahinoz T, Ceylan A, et al. Vaccination coverage in the South-East Anatolian Project (SEAP) region and factors influencing low coverage. Public Health. febrero 2006;120(2):145–54. https://doi.org/10.1016/j.puhe.2005.04.008
Alcalá PA, Faria LB, Elias VP, de Paula BN, Donalisio MR. Tendencia temporal de la cobertura vacunal de DTPA, Pentavalente y embarazada y casos de Tos Ferina en el primer año de vida, 2013 A 2023, Campinas, SP. The Brazilian Journal of Infectious Diseases. 2024;28:104029. https://doi.org/10.1016/j.bjid.2024.104029
Moura LDL, Neto M, Souza-Santos R. Temporal trend of the dropout rate and vaccination coverage of the triple viral vaccine in Brazil, 2014–2021. Epidemiol Serv Saúde. 2023;32(3):e2023117. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-96222023000300301&tlng=en
Banjari MA, Alamri AA, Algarni AY, Abualjadayel MH, Alshardi YS, Alahmadi TS. How often do children receive their vaccinations late, and why? SMJ. 2018;39(4):347–53. https://doi.org/10.1590/S2237-96222023000300004.EN
Véliz L, Campos C, Vega P. Conocimiento y actitudes de los padres en relación a la vacunación de sus hijos. Revista chilena de infectología. febrero 2016;33(1):30–7. http://www.scielo.cl/scielo.php?script=sci_abstract&pid=S0716-10182016000100005
Boscan M, Salinas B, Trestini ML, Tomat M. Actitud de las madres en el cumplimiento del calendario de vacunación de niños menores de 6 años. Salus. 2012;16(1):33–41. http://ve.scielo.org/scielo.php?script=sci_abstract&pid=S1316-71382012000100006
Domínguez A, Astray J, Castilla J, Godoy P, Tuells J, Barrabeig I. False beliefs about vaccines. Aten Primaria. 2019;51(1):40–6. https://doi.org/10.1016/j.aprim.2018.05.004
Machado-Alba JE, Machado-Duque ME, Vargas-Zambrano JC. High coverage and timeliness of vaccination of children under 6 years of age in Risaralda, Colombia. Human Vaccines & Immunotherapeutics. 2023;19(2):2257424. https://doi.org/10.1080/21645515.2023.2257424
Al-Regaiey KA, Alshamry WS, Alqarni RA, Albarrak MK, Alghoraiby RM, Alkadi DY, et al. Influence of social media on parents’ attitudes towards vaccine administration. Human Vaccines & Immunotherapeutics. 2022;18(1):1872340. https://doi.org/10.1080/21645515.2021.1872340
Du F, Chantler T, Francis MR, Sun FY, Zhang X, Han K, et al. Access to Vaccination Information and Confidence/Hesitancy towards Childhood Vaccination: A Cross-Sectional Survey in China. Vaccines. 2021;9(3):201. https://doi.org/10.3390/vaccines9030201
Bolaños-Herrera MC, Chandi-Yandun SL, León-Revelo EM. Importancia del esquema de vacunación a madres de niños menores 5 años. Revista Arbitrada Interdisciplinaria de Ciencias de la Salud Salud y Vida. 2024;8(2):600–8. https://doi.org/10.35381/s.v.v8i2.4247
Zurita GMC, Jiménez JAS, Caicedo MCB, Armas MTD. Nivel de conocimiento sobre inmunización en madres, padres y cuidadores que asisten al Centro de Salud Tipo C Lasso, Cotopaxi-Ecuador. La Ciencia al Servicio de la Salud y la Nutrición. 2023;13(2):52–61. https://doi.org/10.47187/cssn.Vol13.Iss2.197
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ivonne Montiel, Andrea Ferloni, Silvia Gómez, Mónica Arellano, Miryam Soliz, Rossanna Prado, Claudia Barrios, Lorena Romero, Adriana Benítez, Lina Molina, Margarita Samudio, Águeda Cabello
This work is licensed under a Creative Commons Attribution 4.0 International License.
