Comments on ‘‘Monitoring vaccination coverage: Defining the role of surveys”


Response to an article - Dear Editors, Felicity Cutts and co-authors [Vaccine 34 (2016) 4103–4109] provide a good overview of the role of household surveys in monitoring of immunization coverage. More should be said, however, about the optimal monitoring strategy for lower coverage countries. The most recent WHO/UNICEF estimates of national immunization coverage (WUENIC) suggest that for 26 (57%) of 46 countries with 2015 DTP3 coverage below 85%, the administrative data over-estimate coverage by from 10 percentage points to as much as 40 percentage points.1 Of course, as the article points out, coverage surveys provide an imperfect ‘‘gold standard” with which to assess even national (let alone sub-national) immunization coverage. However, when national coverage is low it is essential to periodically attempt to validate the administrative coverage estimate with an estimate from a high quality nationwide household survey.