Immunization status of children under 7 years in the Vikas Nagar area, North India

Immunization has played a major part in reducing childhood morbidity and mortality worldwide. Knowledge of vaccine coverage and reasons for poor uptake are essential for the achievement of herd immunity.

An observational study was carried out in September 2003, in 10 villages in the Vikas Nagar area around Herbertpur Christian Hospital in Uttaranchal, North India. We aimed to assess vaccination rates and potential socio-cultural, economic and religious influences on vaccine uptake. A total of 470 families were visited and details of immunization status of the oldest child under 7 years in each household were taken. Age range of children included was 9 months to 6 years.

The overall primary immunization rate was 77.2%, children receiving the first booster was 73.1% and children receiving the second booster was 58.4%. The most common vaccinations to be missed were the diphtheria, pertussis, tetanus at 18 months and diphtheria, tetanus at 5 years. Measles was the most frequently omitted vaccination in the primary course (19.4%). Poor education was the most frequent reason given by parents for failure to vaccinate. Immunization rates did not differ according to gender of the child. A lower immunization rate was found in Muslim families (65.4% primary) compared with Hindu (85.2%). Parental literacy had a beneficial effect such that up to 20% more children were immunized.

These results highlight the potential importance of literacy, and religious or cultural influences on the success of the Expanded Programme of Immunization, and will have important implications for areas with similar cultural demographics.