Peer-reviewed article
Association Between Basic Immunization Status and Stunting in Toddlers Aged 12-59 Months in Indonesia.
Eka Desi Purwanti, Siti Masitoh, Sudarto Ronoatmodjo ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether children's immunization status is linked to stunting (shortness caused by malnutrition) in Indonesian toddlers aged 12-59 months. Among over 70,000 children, 23.1% were stunted and 74.9% had completed their basic immunizations. Children with incomplete immunization were 18% more likely to be stunted, and those with no immunization were 27% more likely to be stunted, even after accounting for family wealth and maternal education. The findings suggest that ensuring children complete their immunization schedule may help reduce stunting.
Key points
- 23.1% of toddlers aged 12-59 months in Indonesia were stunted
- 74.9% of children under 5 years old had complete basic immunization status
- Children with incomplete immunization had 1.18 times higher risk of stunting compared to fully immunized children
- Children with no immunization had 1.27 times higher risk of stunting
- The association remained significant after adjusting for maternal education, economic status, and birth weight
Limitations
This is a cross-sectional study, so it cannot prove that incomplete immunization causes stunting—only that they are associated. The study cannot explain the mechanisms linking immunization to stunting or identify other important factors that might explain both outcomes.
Abstract
OBJECTIVES: Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia. METHODS: We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia's Nutritional Status. A total of 70 267 toddlers, aged 12 months to 59 months, were examined. Cox regression was employed to calculate adjusted prevalence ratios (aPRs) with their 95% confidence intervals (CIs). RESULTS: The prevalence of stunting among children aged 12 months to 59 months in Indonesia was 23.1%, while 74.9% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (aPR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (aPR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child's birth weight. CONCLUSIONS: Basic immunization status influences the incidence of stunting in toddlers aged 12 months to 59 months. Thus, parents must ensure that their children's immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.