Assessment of timely immunization in an urbanized agglomeration of East Delhi, India

Abstract

Background: The under-5 mortality rate in India has shown a decline in the last few decades. However, there is still a lot of work to be done for our country to achieve sustainable developmental goals. One of the factors contributing to child survival is immunization coverage, but high coverage does not mean timely vaccination. ‘On time’ immunization is an important yet little researched factor shielding a child from susceptibility to vaccine preventable diseases. This study aims at assessing the extent of timely immunization and predictors of intentional delay in vaccination of children.Methods: A cross-sectional study was conducted in East Delhi among caregivers having a child in the age group of 13-24 months. Sample size was calculated at 95% confidence limit and 3.5% absolute precision. The final sample size obtained was 350.Results: The percentage of fully and timely vaccinated children is 67.1%, whereas children fully vaccinated but with a delay of 4 weeks from the recommended age of administration is 19.7%. Partial vaccination was found in 11.2% of children and 2% of children were found to be not vaccinated. The most common reason for delay in immunization was pain at the time of administration leading baby cries and fear of needles (26.1%), followed by bad experience with previous vaccination (11.6%). Fear of side effects (14.5%) and being denied vaccination without card (11.6%) were other reasons.Conclusions: The immunization program should include timely completion of vaccination as a quality indicator. Delayed immunization can lead to epidemics in the community and threaten the goal of elimination of vaccine preventable diseases. Improving timeliness can be successfully achieved if the reasons for delay are taken into account.

An Analysis of the Services Provided by Municipal Ward Based Primary Health Care Outreach Teams in an Urban District in South Africa: A Key Contribution Towards Universal Access to Care.

“…4 illustrated that WBPHCOTs in the district referred across a range of conditions; initially more children were referred for immunization services, over time this dropped, possibly due to better support from the CHWs in their households. Findings from urban India also showed better immunization rates in households covered by their CHWs; [32] supporting the ndings of this paper. Greater coverage of CHW supported households therefore has the potential to improve child immunization coverage in vulnerable populations.…”

An analysis of the services provided by community health workers within an urban district in South Africa: a key contribution towards universal access to care

“…CHWs can make appropriate neonatal or pregnancy referrals [ 30 , 31 ]. Through better education about immunizations and identification of defaulters, over time there were less children to refer, improving child immunization in CHW supported households [ 32 ].…”

Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia

“…Further, the timeliness of vaccine administration (age-appropriate vaccination) was determined based on the routine schedule of Ethiopia’s national immunization program–recommended age of vaccination. Accordingly, on-time vaccination for specific vaccines was defined as a specific vaccine dose administered within 4 days before the due date [ 86 - 89 ] and within 4 weeks (inclusive of the due date) after the recommended age specified in the national immunization schedule [ 9 , 10 , 41 , 87 - 91 ]. The denominator for the timeliness of specific vaccines was considered from those infants vaccinated for that specific vaccine [ 9 , 10 , 41 , 87 - 91 ].…”