Age at first dose of measles vaccination in Ethiopia.

BACKGROUND Although measles vaccination is recommended to be given at nine months of age in Ethiopia and in most of sub-Saharan Africa, no information is available about the age at which children actually receive their first dose of measles vaccine. This has important implications in terms of preventing infection and averting epidemics of measles. OBJECTIVE To determine the age at which Ethiopian children actually receive their first dose of measles vaccine. DESIGN Cross sectional study. SETTING All major vaccination facilities including private and non-governmental health facilities that were registered with the Addis Ababa city Administration Health Bureau. SUBJECTS A total of 17,674 records of children who received measles vaccination in health facilities were reviewed and in rural areas 615 children were surveyed over one year period September 2004 to August 2005. RESULTS In both the urban and the rural settings the median age of children at first dose of measles vaccination was nine months. In the rural areas only 19.8% of children had vaccination cards. Measles coverage by card and history in rural areas was 84.4%. Many children from the rural site received measles vaccination during supplemental immunisation activities (SIAs) rather than from routine vaccination programmes. Measles coverage significantly varies among sub-cities in Addis Ababa. CONCLUSION Vaccination practices and measles coverage levels do not support delaying the first measles vaccine dose. Strengthening the routine vaccination programmes must receive priority before changing recommended age for the first dose of measles vaccine.