title: Reasons for non-vaccination during national immunization days: a case study in Istanbul, Turkey.
abstract: OBJECTIVE
  The member states of the 41st World Health Assembly agreed to aim for the global eradication of polio by the year 2000. Turkey adopted this goal and made substantial progress. In this report, we present the results of a coverage and risk factor survey conducted to evaluate vaccine delivery during the 1999 national immunization days (NIDs) in a large district of Istanbul, Turkey. This study provides important information regarding risk factors and reasons for non-vaccination during the NIDs, defines rumours about the NIDs, and provides estimates of vaccination coverage.
  
  
  METHODS
  A survey was conducted 3-10 days after the second round of 1999 NIDs using the standard expanded programme on immunization cluster survey method, for each of 10 health centre areas in Umraniye. In total, 2102 children were included in the analysis.
  
  
  RESULTS
  The vaccination coverage rate was 82.2%. Logistic regression analysis showed increased risk of non-vaccination in people who did not know the purpose of the NIDs, who had not had contact with a mobile vaccination team, who were unvaccinated in the first round of 1999 NIDs and who lived in the area of the Central Health Centre. Use of primary-level state healthcare facilities for routine childhood immunizations, and living in the area of the Adem Yavuz Health Centre had significant positive effects on vaccination.
  
  
  CONCLUSIONS
  To achieve better results, better publicity of national campaigns using mass media, and improved use of mobile teams, are necessary.
authors.affiliation: Department of Public Health, Marmara University Medical Faculty, Haydarpaşa, Istanbul 34617, Turkey. hharmanci@marmara.edu.tr
authors.forename: H
authors.initials: H
authors.lastname: Harmanci
authors.forename: Y
authors.initials: Y
authors.lastname: Gürbüz
authors.forename: S D
authors.initials: SD
authors.lastname: Torun
authors.forename: N
authors.initials: N
authors.lastname: Tümerdem
authors.forename: T
authors.initials: T
authors.lastname: Ertürk
mesh_terms: D016009:Chi-Square Distribution; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009313:National Health Programs; D010349:Patient Compliance; D011051:Poliomyelitis / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology