Full Immunisation Coverage

Outcome

full immunisation coverage (% of children aged 12-23 / 24-35 months who are vaccinated)

This indicator measures the proportion of children aged 12-23 months / 24-35 months who have received all vaccines recommended in the national immunisation schedule by the time of measurement. It is an outcome indicator reflecting access to and continuity of routine immunisation services and, more broadly, the functionality of the primary health care (PHC) system. In ECHO-funded actions (where direct vaccination is typically not supported), this indicator can still be used to track whether improvements to logistics, cold chain, referral / defaulter tracing, or service delivery capacity are associated with better immunisation completion.

Determine the indicator value using the following steps:

 

1) Define “fully immunised” for the country and age group:

  - First, obtain the current national immunisation schedule (and any relevant updates used in the project area).

  - Define which antigens / doses count as “full immunisation” for this indicator (this differs by country).

  - Decide whether you will report for:

        - 12-23 months (standard for “fully immunised by age 1”), and/or

        - 24-35 months (useful where the vaccination status of children is more often confirmed using cards / records, or where catch-up vaccination is common).

Document the exact definition used (list the doses/antigens included).

 

 

2) Choose the data source and verification method

Use one primary method and document it clearly. Prefer methods aligned with WHO/UNICEF routine immunisation monitoring.

 

Method A: Household survey (recommended when feasible)

  - use a probability-based cluster survey approach where possible to ensure results are representative of the target population (common practice in immunisation coverage measurement)

  - determine vaccination status by:

        - home-based record (vaccination card), and if not available

        - caregiver recall (note: recall tends to over/under-estimate depending on context; document limitations)

 

Method B: Routine Health Information System (HIS) / facility reporting (use with caution)

  - use this when the estimated number of children in the area is reliable, and routine reporting is timely, complete, and reasonably accurate

  - coverage estimates may be biased where there is displacement, incomplete reporting, stock-outs, or poor target population estimates

 

 

3) To calculate the indicator value (i.e. the “full immunisation coverage”):

  - divide the number of fully immunised children in the selected age group (numerator) by the total number of children in the same age group (denominator)

  - multiply the result by 100 to convert it to a percentage

Calculate the indicator separately for each age group reported (12–23 months and/or 24–35 months).

 

 

4) Interpret results appropriately for ECHO-funded actions: Because DG ECHO typically supports system enablers (e.g., cold chain, logistics, supply management, supportive supervision, defaulter tracing) rather than vaccine delivery itself, present this indicator as reflecting system functionality and access, not as direct attribution to ECHO funding. Where possible, explain the plausible contribution pathway (e.g., reduced stock-outs, improved cold chain uptime, improved outreach session regularity, improved follow-up of defaulters).

The data can be disaggregated by:

  - sex of child (female/male)

  - age band (12–23 vs 24–35 months)

  - location (settlement/camp vs host community; district; facility catchment)

  - population group (IDPs/refugees/host community) where relevant and safe

  - card availability (card/documented vs recall) to improve transparency of data quality

1) “Fully immunised” must be defined country-by-country (national schedule), and the definition should be reported alongside results.

 

2) A common reference point used in child health monitoring is very high coverage (e.g., >90%), but targets should be set realistically based on baseline, context, and access constraints.

 

3) Routine coverage estimates should be interpreted with caution and triangulated where possible, especially in settings with displacement or uncertain population estimates.

 

4) Ensure data collection follows ethical practice (informed consent, confidentiality) and does not create pressure on caregivers to report vaccinations inaccurately.

 

5) The indicator is one of DG ECHO’s Key Outcome Indicators.