Analysis of Age Appropriate Measles Immunisation among the Eligible Children in India: A Cross-Sectional Analysis of National Family Health Survey–5

Abstract

Background: Measles continues to pose a significant health threat to children in India, contributing significantly to the global burden of measles-related fatalities. Moreover, a considerable number of children did not even receive their first dose of the measles vaccine, and those who did generally did not receive it at the recommended age. Additionally, there is limited information available in India about age-appropriate measles immunization coverage. Hence, a modest attempt was made to evaluate the extent of timeliness of measles immunization and identify factors associated with the administration of the same among children aged 12 to 23 months in India. Materials and Methods: Data from the most recent National Family Health Survey (NFHS 5, 2019–2021) were used in the present study. The sample comprised 48,928 children aged 12 to 23 months. Cox Proportional Hazard regression analysis was used to determine the significant influencing factors on age-appropriate measles immunization in India. Results: Despite fairly up-to-date measles immunization coverage in India, more than 55% of immunized children received their immunization after the recommended age. Significant percentages of untimely immunization were observed for a substantial number of States and Union Territories across India. From the regression analysis, maternal age and education, religious affiliation, access to media, and healthcare-seeking behaviors such as institutional delivery and utilization of antenatal checkup were identified as the prominent factors related to age-appropriate immunization in India. Conclusion: Untimely immunization is a crucial issue in India. Addressing the timeliness of measles immunization requires a comprehensive strategy that includes healthcare delivery, family planning, immunization perception, and general education. Efforts should be prioritized to improve awareness and accessibility for ensuring timely immunization, thereby safeguarding the health of children across India.