Vaccination coverage estimates by EPI cluster sampling survey of children (18-24 months) in Flanders, Belgium

A random cluster sample according to the EPI cluster sampling technique was conducted in 1999 in Flanders (North Belgium) to ascertain the vaccination coverage of 18 to 24-mo-old children. Polio is the only mandatory vaccine. Diphtheria-tetanus-pertussis (DTP), Haemophilus influenzae type b (Hib), hepatitis B (HB) and measles-mumps-rubella (MMR) are included in the recommended schedule of vaccinations. For Hib and HB, a minimal cost was charged. Professional interviewers conducted interviews with the parents of 1110 children randomly selected in 89 municipalities. Analysis was conducted on the results of 1005 children. The coverage level (95% confidence interval) for the full schedule was 96% (95-97) for polio, 89% (87-91) for DTP, 78% (74-82) for Hib, 68% (64-72) for HB and 83% (81-87) for MMR. The vaccinations were administered by the regional children's health organization (70%), paediatricians (17%) and GPs (11%). No sociodemographic factors could be associated with vaccination coverage. One province showed significantly (p<0.01) lower vaccination coverage levels compared with those of the other four provinces for DTP (91% vs 82%), Hib (78% vs 53%), HB (73% vs 46%) and MMR (87% vs 66%). Conclusion: There is a need for more and better information about vaccination for parents as well as for the healthcare providers.