Immunization Status of Children Admitted to a Tertiary-care Hospital of North India: Reasons for Partial Immunization or Non-immunization

Abstract

Reasons for the low coverage of immunization vary from logistic ones to those dependent on human
behaviour. The study was planned to find out: (a) the immunization status of children admitted to a
paediatric ward of tertiary-care hospital in Delhi, India and (b) reasons for partial immunization and nonimmunization.
Parents of 325 consecutively-admitted children aged 12-60 months were interviewed using
a semi-structured questionnaire. A child who had missed any of the vaccines given under the national
immunization programme till one year of age was classified as partially-immunized while those who had
not received any vaccine up to 12 months of age or received only pulse polio vaccine were classified as
non-immunized. Reasons for partial/non-immunization were recorded using open-ended questions. Of
the 325 children (148 males, 177 females), 58 (17.84%) were completely immunized, 156 (48%) were
partially immunized, and 111 (34.15%) were non-immunized. Mothers were the primary respondents in
84% of the cases. The immunization card was available with 31.3% of the patients. All 214 partially- or
completely-immunized children received BCG, 207 received OPV/DPT1, 182 received OPV/DPT2, 180
received OPV/DPT3, and 115 received measles vaccines. Most (96%) received pulse polio immunization,
including 98 of the 111 non-immunized children. The immunization status varied significantly (p<0.05)
with sex, education of parents, urban/rural background, route and place of delivery. On logistic regression,
place of delivery [odds ratio (OR): 2.3, 95% confidence interval (CI) 1.3-4.1], maternal education (OR=6.94,
95% CI 3.1-15.1), and religion (OR=1.75, 95% CI 1.2-3.1) were significant (p<0.05). The most common
reasons for partial or non-immunization were: inadequate knowledge about immunization or subsequent
dose (n=140, 52.4%); belief that vaccine has side-effects (n=77, 28.8%); lack of faith in immunization (n=58,
21.7%); or oral polio vaccine is the only vaccine required (n=56, 20.9%. Most (82.5%) children admitted
to a tertiary-care hospital were partially immunized or non-immunized. The immunization status needs
to be improved by education, increasing awareness, and counselling of parents and caregivers regarding
immunizations and associated misconceptions as observed in the study.

Key words: Child; Immunization; Vaccination; India

DOI: 10.3329/jhpn.v28i3.5560

J HEALTH POPUL NUTR 2010 Jun;28(3):300-304