Effect of vaccine reminder and tracker bracelets on routine childhood immunization coverage and timeliness in urban Pakistan (2017-18)

A randomized controlled trial

Bibliographic Data

ID15366706
AuthorsDanya Arif Siddiqi (0000-0001-9457-9110, corresponding author), Rozina Feroz Ali (0000-0002-1338-9620, Interactive Research and Development), Mehr Ahmed Mujtaba Munir (0000-0003-2824-1263, Interactive Research and Development), Mehr Munir, Mubarak Taighoon Shah (0000-0001-9979-619X, Interactive Research and Development), Aamir Khan (0000-0001-8431-2498, Harvard Global Health Institute), Aamir Javed Khan, Subhash Chandir (0000-0002-6523-8875, Interactive Research and Development)
Year2020
Volume20
Issue1
Publication date2020-07-11
Open AccessYes
TypeARTICLE
VenueBMC Public Health (JOURNAL)
Journal identifiersISSN: 1471-2458 • E-ISSN: 1471-2458
PublisherBioMed Central (PUBLISHER • GB)
DOI10.1186/s12889-020-09088-4
OpenAlexW4255809562
LanguageEN
Citations received5
References cited26

Background Inability to track children’s vaccination history coupled with parents’ lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. We evaluated the impact of two types of silicone immunization reminder bracelets for children in improving immunization coverage and timeliness of Pentavalent-3 and the Measles-1 vaccines. Methods Children < 3 months were enrolled in either of the 2 intervention groups (Alma Sana Bracelet Group and Star Bracelet Group) or the Control group. Children in the intervention groups were provided the two different bracelets at the time of recruitment. Each time the child visited the immunization center, a hole was perforated in the silicone bracelet to denote vaccine administration. Each child was followed up till administration of Measles-1 vaccine or till 12 months of age (if they did not come to the center for vaccination). Data was analyzed using the intention-to-treat population between groups. The unadjusted and adjusted Risk Ratios (RR) and 95% confidence interval (CI) for Pentavalent-3 and Measles-1 coverage at 12 months of age were estimated through bivariate and multivariate analysis. Time-to-Pentavalent-3 and Measles-1 immunization curves were calculated using the Kaplan–Meier method. Results A total of 1,445 children were enrolled in the study between July 19, 2017 and October 10, 2017. Baseline characteristics among the three groups were similar. Up-to-date coverage for the Pentavalent-3 /Measles-1 vaccine at 12 months of age was 84.6%/72.0%, 85.4%/70.5% and 83.0%/68.5% in Alma Sana Bracelet group, Star Bracelet group and Control group respectively but the differences were not statistically significant. In the multivariate analysis, neither the Alma Sana bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06), (adjusted RR: 1.05; 95% CI: 0.97-1.13) nor the Star bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06) (adjusted RR: 1.03; 95% CI: 0.95-1.11) was significantly associated with Pentavalent-3 vaccination or Measles-1 vaccination. Conclusion Although we did not observe any significant impact of the bracelets on improved immunization coverage and timeliness, our findings add to the existing literature on innovative, low cost reminders for health and make several suggestions for enhancing practical implementation of these tools. Trial registration ClinicalTrials.gov NCT03310762 . Retrospectively Registered on October 16, 2017

Biostatistics · Confidence interval · Environmental health · Immunization · Measles · Measles vaccine · Population · Vaccination · Medicine · SARS-CoV-2 and COVID-19 Research · Vaccine Coverage and Hesitancy · Virology and Viral Diseases · Epidemiology · Immunology · Internal Medicine · Pediatrics

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