Spatiotemporal distribution of timely measles-containing vaccine coverage among children born in Hebei Province during 2019–2023: a secondary analysis of provincial routine immunisation registry data
- 1College of Public Health, Hebei University, Baoding, Hebei, China
- 2Immunisation Planning and Management Division, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
- 3Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
Abstract
Objectives: To analyse the spatiotemporal distribution characteristics of timely vaccination coverage for the first dose of measles-containing vaccine (MCV1) among children born in Hebei Province, China, from 2019 to 2023.
Design: Population-based cross-sectional secondary data analysis of routine provincial immunisation registry data.
Setting: All county-level districts in Hebei Province, China.
Participants: All children with immunisation records established at birth in the Hebei Provincial Immunisation Information Management System who were born between 1 January 2019 and 31 December 2023 and remained in the province until 8 months of age (total birth cohort, n=2 831 956).
Primary and secondary outcome measures: The primary outcome was timely MCV1 vaccination coverage. Secondary outcomes included global spatial autocorrelation, local spatial clustering and spatiotemporal distribution characteristics.
Results: A total of 167 districts and counties were included. The overall timely coverage of MCV1 among children born in Hebei Province from 2019 to 2023 was 43.49%, demonstrating an increasing trend from 2019 to 2023, rising from 40.57% in 2019 to 53.35% in 2023 (Cochran-Armitage trend test χ2=16 059.55, p<0.05). Pronounced seasonal variations were observed across birth cohorts, with lower coverage among children born in the second quarter, followed by a gradual increase in the third quarter. Significant positive global spatial autocorrelation was detected at the county level, global Moran’s I ranged from 0.55 in 2019 to 0.45 in 2023 and local spatial autocorrelation analysis identified high-high clusters primarily in central-southern and northeastern Hebei Province, while low-low clusters were mainly concentrated in the northwestern region.
Conclusions: Timely MCV1 vaccination coverage among children born in Hebei Province from 2019 to 2023 remained suboptimal, characterised by notable seasonal fluctuations and distinct spatial clustering. Targeted, season-specific interventions in identified low-coverage clusters may improve timeliness. Further research is needed to explore individual-level barriers to vaccination delay.
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BibTeX
@article{wang2026spatiotemporal,
title = {{Spatiotemporal distribution of timely measles-containing vaccine coverage among children born in Hebei Province during 2019–2023: a secondary analysis of provincial routine immunisation registry data}},
author = {Yichang Wang and Yanli Cong and Shiheng Cui and Yu Guo and Yaping Li and Qi Li},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-122115},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122115},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Spatiotemporal distribution of timely measles-containing vaccine coverage among children born in Hebei Province during 2019–2023: a secondary analysis of provincial routine immunisation registry data
AU - Yichang Wang
AU - Yanli Cong
AU - Shiheng Cui
AU - Yu Guo
AU - Yaping Li
AU - Qi Li
PY - 2026
DA - 2026/10/27
JO - BMJ Open
DO - 10.1136/bmjopen-2026-122115
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122115
AB - Objectives: To analyse the spatiotemporal distribution characteristics of timely vaccination coverage for the first dose of measles-containing vaccine (MCV1) among children born in Hebei Province, China, from 2019 to 2023. Design: Population-based cross-sectional secondary data analysis of routine provincial immunisation registry data. Setting: All county-level districts in Hebei Province, China. Participants: All children with immunisation records established at birth in the Hebei Provincial Immunisation Information Management System who were born between 1 January 2019 and 31 December 2023 and remained in the province until 8 months of age (total birth cohort, n=2 831 956). Primary and secondary outcome measures: The primary outcome was timely MCV1 vaccination coverage. Secondary outcomes included global spatial autocorrelation, local spatial clustering and spatiotemporal distribution characteristics. Results: A total of 167 districts and counties were included. The overall timely coverage of MCV1 among children born in Hebei Province from 2019 to 2023 was 43.49%, demonstrating an increasing trend from 2019 to 2023, rising from 40.57% in 2019 to 53.35% in 2023 (Cochran-Armitage trend test χ2=16 059.55, p<0.05). Pronounced seasonal variations were observed across birth cohorts, with lower coverage among children born in the second quarter, followed by a gradual increase in the third quarter. Significant positive global spatial autocorrelation was detected at the county level, global Moran’s I ranged from 0.55 in 2019 to 0.45 in 2023 and local spatial autocorrelation analysis identified high-high clusters primarily in central-southern and northeastern Hebei Province, while low-low clusters were mainly concentrated in the northwestern region. Conclusions: Timely MCV1 vaccination coverage among children born in Hebei Province from 2019 to 2023 remained suboptimal, characterised by notable seasonal fluctuations and distinct spatial clustering. Targeted, season-specific interventions in identified low-coverage clusters may improve timeliness. Further research is needed to explore individual-level barriers to vaccination delay.
SN - 2044-6055
SN - 2044-6055
ER -