Assessing the Effectiveness of School-based Vaccination Checks to Identify and Reach un - and Under-vaccinated Students in Zambia.

Details

• Alternative Title:
  Vaccine, 2026, v. 79: Assessing the Effectiveness of School-based Vaccination Checks to Identify and Reach un - and Under-vaccinated Students in Zambia.
• Journal Article:
  Vaccine
• Personal Author:
  Hasan, Alvira Z. ; Dombola, Aliness M. ; Prosperi, Christine ; Mufwambi, Webster ; Sakala, Rodgers ; Kapungu, Kelvin ; Chongwe, Gershom ; Singh, Prachi ; Wang, Qiulin ; Siputuma, Kennedy ; Luulu, Maybin ; Muchengwa, Malalu Mulundika ; Sakala, Constance ; Kamiji, Elicah ; Bobo, Patricia ; Sakala, Jacob ; Matanda, Kennedy ; Mwansa, Francis D. ; Ward, Kirsten ; Winter, Amy K. ; Carcelen, Andrea C. ; Truelove, Shaun A. ; Moss, William J. ; Mutembo, Simon
• Description:
  Measles supplementary immunization activities (SIAs) help close immunity gaps but are resource-intensive and may not effectively reach school-aged children who miss routine vaccination. School-based vaccination screening may offer a complementary platform, yet evidence from low- and middle-income countries (LMICs) is limited. This study evaluated the feasibility and effectiveness of school-based vaccination screening and catch-up vaccination in Zambia.
  
  A pilot intervention was conducted in 10 public and community primary schools in two urban districts (Ndola and Lusaka). Grade 1 learners were screened for routine vaccination status using under-5 cards or caregiver recall. Learners missing doses of oral poliovirus vaccine (OPV), diphtheria-tetanus-pertussis vaccine (DTP), or measles-containing vaccine (MCV) were referred for catch-up vaccination at health facilities or through school-based outreach. Descriptive and regression analyses assessed coverage, under-vaccination, catch-up uptake, and associated factors.
  
  Of 1839 learners screened (98% participation), 38.0% were under-vaccinated and 1.8% were zero-dose. MCV2 coverage was lowest (65.6%) and declined with age. Among 699 under-vaccinated learners, 68.7% received at least one catch-up dose, mostly through school-based activities. Under-vaccination was associated with older age, accompaniment by a non-biological respondent, and low maternal education. Missed catch-up vaccination was associated with longer travel time, lack of an under-5 card, and caregiver unwillingness to accept school vaccination. Post-catch-up coverage increased to 96.6% for MCV1 and 83.5% for MCV2.
  
  School-based vaccination screening was feasible, well-accepted, and substantially improved measles vaccination coverage. Scale-up should emphasize timely catch-up delivery, improved record-keeping and coordinated school-health planning. Future operational studies must assess the use of Early Childhood Learning (ECL) classes to reach children at younger ages.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Female
  • Male
  • Child
  • Vaccination
  • Schools
  • Immunization Programs
  • Measles Vaccine
  • Vaccination Coverage
  • Students
  More +
• Source:
  Vaccine, 2026, v. 79
• DOI:
  https://doi.org/10.1016/j.vaccine.2026.128453
• ISSN:
  0264-410X ; 1873-2518
• Pubmed ID:
  41904919
• Pubmed Central ID:
  PMC13137932
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  Zambia
• Pages in Document:
  128453 (20 pdf pages)
• Volume:
  79
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:940d7e60ab651a4a2e9417a9ea02996c4a79a8d6e6f5f6e4691cc8751be22e387714ce5b4036620e7b7f7b438d34416a030f23942dbf39104445d12c6ea5bf95