%0 Journal Article
%T Whom and Where Are We Not Vaccinating? Coverage after the Introduction of a New Conjugate Vaccine against Group A Meningococcus in Niger in 2010
%A Sung Hye Kim
%A Lorenzo Pezzoli
%A Harouna Yacouba
%A Tiekoura Coulibaly
%A Mamoudou H. Djingarey
%A William A. Perea
%A Thomas F. Wierzba
%J PLOS ONE
%D 2012
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0029116
%X MenAfriVac is a new conjugate vaccine against Neisseria meningitidis serogroup A developed for the African ※meningitis belt§. In Niger, the first two phases of the MenAfriVac introduction campaign were conducted targeting 3,135,942 individuals aged 1 to 29 years in the regions of Tillab谷ri, Niamey, and Dosso, in September and December 2010. We evaluated the campaign and determined which sub-populations or areas had low levels of vaccination coverage in the regions of Tillab谷ri and Niamey. After Phase I, conducted in the Filingu谷 district, we estimated coverage using a 30℅15 cluster-sampling survey and nested lot quality assurance (LQA) analysis in the clustered samples to identify which subpopulations (defined by age 1每14/15每29 and sex) had unacceptable vaccination coverage (<70%). After Phase II, we used Clustered Lot Quality Assurance Sampling (CLQAS) to assess if any of eight districts in Niamey and Tillab谷ri had unacceptable vaccination coverage (<75%) and estimated overall coverage. Estimated vaccination coverage was 77.4% (95%CI: 84.6每70.2) as documented by vaccination cards and 85.5% (95% CI: 79.7每91.2) considering verbal history of vaccination for Phase I; 81.5% (95%CI: 86.1每77.0) by card and 93.4% (95% CI: 91.0每95.9) by verbal history for Phase II. Based on vaccination cards, in Filingu谷, we identified both the male and female adult (age 15每29) subpopulations as not reaching 70% coverage; and we identified three (one in Tillab谷ri and two in Niamey) out of eight districts as not reaching 75% coverage confirmed by card. Combined use of LQA and cluster sampling was useful to estimate vaccination coverage and to identify pockets with unacceptable levels of coverage (adult population and three districts). Although overall vaccination coverage was satisfactory, we recommend continuing vaccination in the areas or sub-populations with low coverage and reinforcing the social mobilization of the adult population.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0029116