2022-07-05-世界卫生组织-Immunization_Guatemala_2022_country_profile_17页_387kb

Immunization Coverage Estimates for Guatemala (WHO and UNICEF, 2021 Revision)

Report Overview

This report outlines WHO and UNICEF estimates of national immunization coverage for Guatemala, based on data received as of July 7, 2022. The estimates cover years from 2010 to 2021 and are country-specific, derived from national reports, surveys, and adjusted for potential biases. No data is borrowed from other countries, and the goal is to reflect routine immunization performance.

Methodology

• Estimates are based on empirical data, with confidence grades (GoC) indicating the level of empirical support:
  • GoC ••• (high confidence): Supported by reported data, surveys, or population projections.
  • GoC •• (medium confidence): Supported by at least one data source, but not challenged.
  • GoC • (low confidence): No directly supporting data or data challenging the estimate.
• Data sources include administrative records, survey-based estimates (e.g., household surveys), and extrapolations from demographic data. Surveys may adjust for recall bias or interpolation.
• No underlying probability model is used; thus, uncertainty measures like confidence intervals are not provided.

Key Vaccines and Coverage Trends

The following categories summarize coverage for nine vaccines. Values represent percentages of surviving infants covered and are subject to the GoC.

BCG Vaccine

• Years: 2010–2021, average around 91–93%. Recent declines due to COVID-19 impacts and stock-outs (e.g., mandatory syringe shortages in 2015–2020). Recommended use continues, with notes on human resource constraints.

DTP1, DTP3, and Related Doses

• DTP1/DTP3: Coverage stability with periods of decline during 2014 and 2020–2021. DTP3 estimate improved in 2017–2018 from 82–86% but fell in 2021 due to COVID-19 diversion. Surveys from 2013 and 2014 sometimes challenge data (e.g., GoC challenged by R- in 2021).

Polio (Pol3/IPV1)

• Pol3: Coverage peaked at ~85% in 2017 but declined to ~70% in 2021 due to recalibration from 2013 and COVID-19 impacts. Estimates challenged by low confidence grades (e.g., GoC ••• indicates high support in some years).
• IPV1: Introduced in 2015, coverage stabilized around 90–98%, but 2021 data questioned due to COVID-19 diversion. No high-confidence surveys in recent years.

Measles-Containing Vaccines (MCV1/MCV2)

• MCV1/RCV1: Estimates 60–94% over the period, with fluctuations; RCV1 mirrored MCV1 without direct data. 2021 coverage under 90% due to COVID-19. Surveys like 2013–2015 showed strong support but recent years lack representative data.
• MCV2: Coverage around 67–94%, with 2021 strong confidence from national reports, but challenges existed earlier.

Hepatitis B (HepB1/HepB3)

• HepB1: Coverage doubled from ~30% in 2014 to ~50% in 2017–2021, with low estimates in 2010s but improving trends. 2021 estimate revised down due to COVID-19.
• HepB3: Similar to HepB1, coverage increased but remained low in some years; 2021 data reflected COVID-19 impacts with no survey verification.

Hib3 and Other Vaccines (Hib3, RotaC, PcV3)

• Hib3/RotaC/PcV3: Coverage varied widely (30–99%), influenced by vaccine introduction timing (e.g., rotavirus in 2010). 2021 data saw declines due to COVID-19, with RotaC coverage around 80% but low confidence in some cases.

Challenges and Concerns

• External Factors: COVID-19 led to staff diversion, dose delivery declines, and stock-outs (e.g., vaccines reported stock-outs nationally from 2014 to 2021).
• Data Issues: Routine estimates relied heavily on administrative data, which can be inaccurate; disruptions in 2014 affected reporting. No nationally representative surveys in 2015–2021, limiting confidence without additional proof.
• Confidence Grades: Many recent estimates (post-2020) have lower GoC due to COVID-19, reflecting uncertainty. Surveys from 2012–2015 provided high confidence but were not repeated recently.

Recommendations

WHO and UNICEF advise high-quality, nationally representative household surveys to confirm coverage levels, as their data alone may not capture true immunization performance. Estimates should be used cautiously, considering potential biases and operational challenges. Further details available at: WHO or UNICEF.