2023-07-16-世界卫生组织-Immunization_Republic_of_North_Macedonia_2023_country_profile_19页_369kb

North Macedonia Immunization Coverage Summary (WHO-UNICEF 2022 Revision)

Overview

This report details the immunization coverage estimates for North Macedonia by the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) for the years 2011-2022. These estimates are based on national data, surveys, and expert inputs to assess the percentage of infants and children receiving key vaccines and doses. Coverage reflects routine immunization performance, with grades of confidence indicating reliability. All data considers potential biases and limitations, and estimates should be used cautiously.

Methodology

• Coverage estimates are country-specific, not borrowed from other nations, and based on empirical data, surveys, or administrative reports.
• Key indicators include vaccines like BCG, DTP1/DTP3, Pol3, IPV1, MCV1/MCV2, RCV1, HepBB, HepB3, Hib3, RotaC, and PcV3.
• The Grade of Confidence (GoC) measures the strength of data support, yet no classical uncertainty measures (e.g., confidence intervals) are provided.
• Surveys, such as the North Macedonia Multiple Indicator Cluster Surveys, informed estimates when available, adjusted for recall bias.
• COVID-19 pandemic disruptions in 2020-2021 caused significant declines in coverage, unexplained by countries.
• Vaccines are assessed for completion rates, e.g., at least one dose for some, or three doses for polio and hepatitis B.

Key Findings

• Overall coverage has remained between 70-98% for many vaccines, with fluctuations.
• Pre-pandemic peaks occurred in 2017-2018, with high coverage (e.g., 99% for DTP1). A dip due to COVID-19 led to lower coverage in 2020-2021.
• For HepBB, stockouts and data issues reduced coverage reliability.
• Vaccine-specific coverage shows:
  • BCG: Early 2010s coverage stable around 97%. Declined in post-pandemic years.
  • DTP1/DTP3: Coverage held at 98% in 2017-2018. Pandemic affected DTP3 coverage in 2020 before recovery.
  • Pol3: Coverage ranged 91-98%, with post-2020 dip.
  • IPV1: Introduction in 2015 boosted coverage to ~98%, declining during COVID-19.
  • MCV1/MCV2: Coverage declined in early 2010s but stabilized, with COVID-19 impacts visible.
  • Other vaccines showed variations based on disease epidemiology and reporting.
• Surveys highlight data gaps; for instance, some estimates rely on extrapolation or interpolated data, challenging confidence for certain years.
• Trends indicate resilience in immunization efforts, but COVID-19 highlighted systemic vulnerabilities.

COVID-19 Impact

• The pandemic caused service disruptions leading to coverage declines in 2020, particularly for vaccines recorded through administrative data.
• Unexplained declines were noted, but aligning with global trends. Estimates for 2021-2022 often lacked accepted empirical data.

Summary of Trends

• Pre-2015: Gradual improvements in coverage, with some vaccines falling post-2020.
• Post-2015: Introduction of new vaccines like HPV and adjustments for polio risks.
• Coverages generally clustered around 90%, but underpinned by varying data reliability.

Use of Estimates

• These estimates guide public health decisions but are subject to biases. Users should consider the GoC and context-specific inaccuracies.
• Further details and older data available at provided links.