Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination

OBJECTIVES: We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1-9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA). METHODS: Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince North Centre South and West) 40 clusters were randomly selected in each region and 35 households were selected per cluster. RESULTS: Among the 7000 visited households 75.8% had at least one child aged 1-9 years; of these 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1-4 years had significantly lower MR SIA coverage than those aged 5-9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8-9.1%). Awareness educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001). CONCLUSIONS: The 2012 SIA successfully increased MR coverage; however to maintain measles and rubella elimination coverage needs to be further increased among children aged 1-4 years and in regions with lower coverage. (c) 2014 John Wiley & Sons Ltd.