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Factors responsible for delayed immunisation among children under 5 years of age
S N Ughade1, S P Zodpey, S G Deshpande
1Department of Preventive & Social Medicine, Government Medical College, Nagpur.
Insights
Delayed childhood immunisation is linked to larger family size, fewer parental education years, and greater distance from health facilities. Addressing these factors can improve timely vaccination rates for children.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Childhood immunisation is crucial for disease prevention.
- Despite improvements, a significant number of children experience delayed vaccinations.
Purpose of the Study:
- To identify risk factors associated with delayed primary immunisation in children.
- To understand the parental reasons behind delayed vaccination schedules.
Main Methods:
- A hospital-based, pair-matched case-control study was conducted.
- 139 children with >90 days delay in immunisation were compared to 139 timely vaccinated children.
- Statistical analysis included calculating Odd's Ratios (OR) and 95% Confidence Intervals (CI).
Main Results:
- Significant risk factors for delayed immunisation included larger family size (OR=7.3), more children under 5 (OR=3.17), male sex (OR=3), lower paternal (OR=3.7) and maternal education (OR=4), lower socio-economic status (OR=3.7), and greater distance from health centres (OR=4.7).
- Parental negligence (56%) and unawareness (22.7%) were primary reasons for delays.
Conclusions:
- Family size, parental education, socio-economic status, and proximity to healthcare facilities are key determinants of timely childhood immunisation.
- Targeting these identified risk factors and improving parental awareness are essential strategies to reduce delayed immunisation rates.
Abstract:
Although immunisation coverage has increased substantially in recent years, still a sizable proportion of children are not being immunised at appropriate time. The present hospital based, pair matched, case control study was carried out at immunoprophylactic centre of Government Medical College and Hospital, Nagpur, to identify risk factors associated with delayed immunisation among children. This study included 139 children with a delay of more than 90 days for scheduled primary immunisation and equal number of matched control (for dose) receiving immunisation at appropriate time. The study identified significant association of family size [Odd's ratio (OR) = 7.3, 95% confidence interval (CI) = 1.5-35.6], number of children < 5 years (OR = 3.17, 95% CI = 1.1-9.9), sex (OR = 3, 95% CI = 1.2-7.4), paternal education (OR = 3.7, 95% CI = 1.6-8.5), maternal education (OR = 4, 95% CI = 1.5-10.9), socio-economic status (OR = 3.7, 95% CI = 1.1-13.2) and distance from health centre (OR = 4.7, 95% CI = 1.2-17.6) with delayed immunisation. Negligence (56%) and unawareness (22.7%) of parents were main reasons for delayed immunisation. Hence more stress on identified risk factors in the study will indirectly help in reducing the frequency of delayed immunisation.