2023-07-16-世界卫生组织-Immunization_Costa_Rica_2023_country_profile_18页_370kb

Costa Rica Immunization Coverage Summary (WHO/UNICEF, 2023)

This report summarizes the estimated immunization coverage levels for Costa Rica, provided by WHO and UNICEF, covering various vaccine antigens from 2011 to 2022. These estimates are based on reported administrative data, survey data, and demographic information, though with varying degrees of confidence.

Key Immunization Antigens

For each antigen, the report summarizes past performance, highlighting significant changes, stability, and areas of uncertainty.

1. BCG: High estimated coverage (ranging from 90% to 99%) from 2011 to 2019. 2020-2022 estimates were recalibrated or interpolated using previously reported data due to a lack of recent surveys.
2. DTP1: Moderate to high coverage (~85-99%) from 2011 to 2022. 2022 coverage decreased compared to previous years, and estimates lacked supporting surveys. 2015-2016 estimates were higher and supported by survey data.
3. DTP3: Generally high coverage (~85-97%) throughout the reporting period. 2022 was lower than 2021. High confidence levels were common where surveys (e.g., 2018) supported the estimates.
4. Pol3 (3rd Dose of Polio Vaccine): High coverage (~82-99%) from 2011 to 2022. Minor fluctuations occurred before and after 2019, but generally remained stable. Confidence was often based on reporting alone (GoC = R+ D+).
5. IPV1 (At least one dose of Inactivated Polio Vaccine): Initially introduced in 2015. Coverage increased from undetermined values before 2015 to reach 93-99% by 2015-2017. Estimates lacked supporting surveys from 2020 onwards.
6. MCV1 (1st Dose of Measles-Containing Vaccine): High coverage (~83-96%) from 2011 to 2022. 2022 coverage was slightly lower than previous years. Estimates were well-supported by data and surveys in earlier years.
7. MCV2 (2nd Dose of Measles-Containing Vaccine): High coverage (~80-97%) from 2012-2020, with a notable drop in coverage recorded in 2021. Confidence levels varied, often based solely on reporting.
8. RCV1 (1st Dose of Rubella-Containing Vaccine): Coverage generally followed MCV1 estimates, starting in 2011 at ~90-96%. Estimates lacked supporting surveys from 2021 onwards.
9. HepBB (Hepatitis B Birth Dose): High coverage (~71-90%) from 2011 to 2022, fluctuating notably from 2020 to 2021. 2022 estimates were interpolated due to data gaps.
10. HepB3 (3rd Dose of Hepatitis B Vaccine): High coverage (~84-99%) from 2011 to 2022, except the 2020 and 2021 estimates which were lower, and a single estimate in 2013. 2022 coverage dropped.
11. DTP3 Context: Coverage estimates for DTP3 were updated to reflect consistency with the age-appropriate schedule recommendation.
12. Hib3 (Hemophilus influenzae type b): Coverage estimates range around 88-96% across different years.
13. PcV3 (Pneumococcal Conjugate Vaccine 3rd Dose): Moderate to high coverage (~68-95%) recorded from 2011 onwards.
14. RotaC (Rotavirus Vaccine): Coverage estimates started in 2019, showing moderate levels below 98% in the years from 2020-2022.

Data Quality and Methodology

• Estimates are not country-specific averages but are based on a review of submitted data, surveys, and administrative reports, often recalibrating denominators.
• The Grade of Confidence (GoC) reflects the empirical support (reported data, surveys, demographic data) but does not judge data quality.
• Recurrent calls for high-quality national surveys (lack thereof in the recent past for most antigens) carry a risk that reported levels might not be reliable.
• Factors affecting data accuracy include reported stockouts (vaccines like HepB, HepBB, DTP1, RCV1) and potential biases in numerator/denominator data.
• The methodology relies on interpolating or recalibrating reported data when direct survey evidence is missing, limiting the presentation of traditional uncertainty measures (like confidence intervals).

Key Observations and Recommendations

• Immunization coverage for Costa Rica remains generally high, particularly for foundational vaccines like BCG, DTP, Polio, and Measles/Hepatitis B birth doses, though calculations are inconsistent or lacking for some antigens or years.
• Significant fluctuations were observed in recent years (particularly 2020-2022) for multiple antigens, often linked to lower reported data quality, lack of survey validation, or noted stockouts. High confidence levels are detrimental to vaccine coverage estimates.
• A constant call for national surveys is emphasized repeatedly to improve data reliability.

(Disclaimer: These summaries represent key points extracted from the detailed WHO/UNICEF country profile for Costa Rica regarding immunization coverage estimates.)