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©
2005
Last
Updated
21 Mar 2006
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YELLOW FEVER
Huhn GD, Brown J, Perea W, Berthe A, Otero H, LiBeau G,
Maksha N, Sankoh M, Montgomery S, Marfin A, Admassu M. Vaccination coverage
survey versus administrative data in the assessment of mass yellow fever
immunization in internally displaced persons--Liberia, 2004. Vaccine
24(6), 730-7, 2006.
Yellow fever (YF) is a mosquito-borne vaccine-preventable
disease with high mortality. In West Africa, low population immunity increases
the risk of epidemic transmission. A cluster survey was conducted to determine
the effectiveness of a mass immunization campaign using 17D YF vaccine in
internally displaced person (IDP) camps following a reported outbreak of YF in
Liberia in February 2004. Administrative data of vaccination coverage were
reviewed. A cluster sample size was determined among 17,384 shelters using an
80% vaccination coverage threshold. A questionnaire eliciting demographic
information, household size, and vaccination status was distributed to randomly
selected IDPs. Data were analyzed to compare vaccination coverage rates of
administrative versus survey data. Among 87,000 persons estimated living in IDP
camps, administrative data recorded 49,395 (57%) YF vaccinated persons. A total
of 237 IDPs were surveyed. Of survey respondents, 215 (91.9%, 95% CI 88.4-95.4)
reported being vaccinated during the campaign and 196 (83.5%, 95% CI 78.6-88.5)
possessed a valid campaign vaccination card. The median number of IDPs living in
a shelter was 4 (range, 1-8) and 69,536 persons overall were estimated to be
living in IDP camps. Coverage rates from a rapid survey exceeded 90% by
self-report and 80% by evidence of a vaccination card, indicating that the YF
immunization campaign was effective. Survey results suggested that
administrative data overestimated the camp population by at least 20%. An
emergency, mop-up vaccination campaign was avoided. Coverage surveys can be
vital in the evaluation of emergency vaccination campaigns by influencing both
imminent and future immunization strategies.
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