2022-07-05-世界卫生组织-Immunization_Côte_d_Ivoire_2022_country_profile_27页_422kb

• Immunization Coverage Trends in Cote d'Ivoire (2010-2021): Estimated coverage varied significantly across vaccines and years due to data limitations, reporting issues, and vaccine stock-outs, with fluctuations around 50-93%. Key vaccines include BCG (e.g., 79% in 2015), DTP (e.g., DTP1 dropped to 84% in 2020), and polio (e.g., Pol3 averaged ~80% but challenged by stock-outs). Coverage often fell due to shortages, pulling estimates down from reported levels.
• Methodology: WHO and UNICEF estimates rely on reported national data, surveys, and calibration, with a "Grade of Confidence" (GoC) indicating empirical support. No statistical uncertainty bounds were provided. Data quality varied, leading to adjustments and discrepancies, such as calibration to prior years or survey evidence.
• Challenges: Frequent vaccine stock-outs (e.g., 4-12 month national shortages) consistently undermined coverage. Disagreements with government estimates were noted, and trends were sometimes adjusted or challenged based on external evaluations.
• Key Findings: Despite efforts to improve coverage through campaigns and increased vaccination sessions, overall immunization performance showed high variability, with some antigens like BCG reaching over 90% in certain years, while others like HepB3 and Rotavirus fluctuated notably. Vaccine introduction and shortage recovery periods influenced coverage rates, highlighting the impact of supply chain issues.

**Summary of Immunization Coverage for Cote d'Ivoire (2010-2021):**
- **Coverage Range:** Estimates vary by year and vaccine, generally between 50-95%, peaking around certain periods due to surveys or campaigns.
- **Methodology Overview:** Estimates are based on national reports, surveys (e.g., Yaounde City's systematic coverage survey), and calibration to maintain consistency across antigens. GoC reflects empirical support.
- **Specific Trends and Challenges:**
  - **Stock- Outs:** Common for years 2015-2021, leading to reductions in estimates (e.g., DTP3 dropped from 87% in 2016 to 76% in 2021).
  - **Data Issues:** Official data often calibrated; survey evidence (e.g., household surveys) showed discrepancies, with confirmation methods affecting coverage (e.g., card vs. history). For instance, MCV1 was low in the second age cohort due to surveys challenging reported levels.
  - **Vaccine-Specific Notes:** BCG and DTP coverage saw fluctuations in 2010-2015 due to shortages. Polio coverage relied heavily on surveys and faced challenges, while newer vaccines like IPV and HepB introduced in later years showed gradual uptake.
  - **Discrepancies:** Government often disputed WHO/UNICEF estimates, highlighting differences in reporting versus assessments (e.g., in Pol3, estimates clashed with national reports).
  - **Overall Impact:** Coverage stability affected by external events (e.g., supplementary immunization campaigns distracting from routine services in 2014). Trends show peaks recoverable but sustained high levels difficult during shortage periods.