title: 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 non-immunization. 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.
authors.affiliation: Department of Pediatrics, University College of Medical Science and Guru Teg Bahadur Hospital, Delhi 110 095, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Kumar
authors.forename: Anju
authors.initials: A
authors.lastname: Aggarwal
authors.forename: Sunil
authors.initials: S
authors.lastname: Gomber
mesh_terms: D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006785:Hospitals, University; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D007194:India; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*