Peer-reviewed article
Immunization Coverage and Determinants of Immunization Failure Among Children Aged 0-5 Years Admitted to a Tertiary Care Hospital in Ahmedabad, Western India: A Cross-Sectional Study
Mehariya Gayatri, Bhargaviben J Patel ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This cross-sectional study looked at the immunization status of 500 children aged 0-5 years admitted to a tertiary care paediatric department in Ahmedabad, India, between December 2016 and November 2018. About two thirds (66.6%) were fully immunized, 27.2% were partially immunized and 6.2% were not immunized, which is below the 85% programme target. Full immunization was linked to joint family structure, institutional delivery, delivery attended by a doctor, higher parental education and higher family income. The most common reasons parents gave for missed vaccines were not knowing that later doses were needed, the child being sick at the scheduled time, and lack of faith in immunization.
Key points
- Of 500 children, 66.6% were completely immunized, 27.2% partially immunized and 6.2% non-immunized.
- Coverage was highest for the birth dose (85.8%) and lowest for measles-2/booster-1 (57.7%).
- Dropout was 16.2% from BCG to measles-1 and 11.4% from Pentavalent-1 to 3.
- Complete immunization was significantly associated with joint family, institutional delivery, delivery attended by a doctor, higher parental education and higher family income; gender, birth order and possession of an immunization card were not significantly associated.
- Among 167 partially or non-immunized children, parents most often cited unawareness of the need for later doses (26.3%), child sickness (14.4%) and lack of faith in immunization (11.9%).
Limitations
The sample was purposively drawn from children admitted to one hospital, so results may not represent all children in Ahmedabad or India. Reasons for missed vaccines were parent-reported, and the analysis shows associations only, not causes.
Abstract
Background: Universal childhood immunization is among the most cost-effective public health interventions, yet full-immunization coverage in India continues to fall short of the 85% target envisaged under the Universal Immunization Programme (UIP), with substantial dropout and missed opportunities contributing to preventable morbidity and mortality. Objectives: To assess the immunization status of children aged 0–5 years admitted to the paediatric department of a tertiary care hospital in Ahmedabad and its association with socio-demographic determinants, and to identify the reasons for failure of immunization. Methods: A hospital-based, cross-sectional, purposive-sampling study was conducted in the Department of Paediatrics of a tertiary care hospital, Ahmedabad, over 24 months (December 2016–November 2018). Five hundred children aged 0–60 months were enrolled. Immunization status was ascertained by structured maternal/paternal interview, cross-verified against immunization (Mamta) cards, and classified as completely, partially, or non-immunized as per the National Immunization Schedule. Data were analysed on Microsoft Excel using Pearson's chi-square test; p<0.05 was considered significant. Results: Of 500 children (266 male, 234 female), 66.6% were completely immunized, 27.2% partially immunized, and 6.2% non-immunized. Coverage was highest for the birth dose (BCG+OPV+HepB, 85.8%) and lowest for measles-2/booster-1 (57.7%). The BCG-to-measles-1 dropout rate was 16.2% and the Pentavalent-1-to-3 dropout was 11.4%. Complete immunization was significantly associated with joint family structure, institutional delivery, delivery attended by a doctor, higher parental education, and higher family income (all p<0.05); gender, birth order, and possession of an immunization card were not significantly associated. Among the 167 partially/non-immunized children, the leading parent-reported reasons for failure were unawareness of the need for subsequent vaccination (26.3%), child sickness at the scheduled time (14.4%), and lack of faith in immunization (11.9%). Conclusion: Immunization coverage among hospitalised children in Ahmedabad remains below the UIP target and is driven largely by modifiable knowledge, attitude and health-system barriers rather than vaccine unavailability. Structured parental counselling from the antenatal period, reminder and tracking systems, and strengthened interpersonal communication by frontline health workers could substantially narrow the coverage gap.