Volume 42 - Article 1 | Pages 1–14 Author has provided data and code for replicating results

Relationship between vaccination and nutritional status in children: Analysis of recent Demographic and Health Surveys

By Maria Teresa Solis-Soto, Deepak Paudel, Francesco Nicoli

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Date received:18 Dec 2018
Date published:03 Jan 2020
Word count:1965
Keywords:Demographic and Health Surveys (DHS), nutrition, underweight, vaccinations
Additional files:readme.42-1 (text file, 11 kB)
 demographic-research.42-1 (zip file, 2 kB)
 demographic-research.42-1_Supplemental Tables (pdf file, 152 kB)


Background: A body of evidence suggests that vaccines support the development of the immune system and also improve overall health.

Objective: To study the effect of the complete basic vaccination schedule (Bacille Calmette-Guérin, i.e., BCG; measles; polio 3; and Diphtheria, Tetanus toxoids, and Pertussis, i.e., DTP3) on nutritional status of children under 2 years of age.

Methods: Recent DHS data from 16 countries conducted after 2013 were used. After a bivariate descriptive analysis, a logistic regression analysis was conducted to predict the likelihood of underweight, stunting, and wasting by immunization status. A combined odds ratio was computed and adjusted for background variables.

Results: A significantly higher prevalence of underweight was found among children with incomplete vaccination schedules in seven countries. Similarly, wasting and stunting were frequently observed in under-vaccinated children in four countries. Moreover, logistic regression adjusted for background variables revealed a relation between incomplete vaccination and underweight in Angola, Chad, and Guatemala (95% CI lower bound > 1). Combining data of all countries, underweight (adjusted Odds Ratio, aOR 1.21, 95% CI 1.11‒1.31), wasting (aOR 1.18, 95% CI 1.05‒1.33), and stunting (aOR 1.07, 95% CI 1.00‒1.14) were associated with poor vaccination status. The overall effect was consistent with both sexes except the results for wasting for females and stunting for males, though insignificant.

Contribution: To our knowledge, this is the first paper assessing the relation between vaccination and nutritional status at a multi-country level with a huge dataset. Our analysis suggests a poor nutritional status in children with an incomplete vaccination schedule.

Author's Affiliation

Maria Teresa Solis-Soto - Universidad de O’Higgins, Rancagua, Chile [Email]
Deepak Paudel - Save the Children, Kathmandu, Nepal [Email]
Francesco Nicoli - Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Italy [Email]

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