Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family health survey–4

Choudhary, Tarun Shankar; Reddy, N. Samarasimha; Apte, Aditi; Sinha, Bireshwar; Roy, Sudipto; Nair, Nayana P.; Sindhu, Kulandaipalayam Natarajan; Patil, Rutuja; Upadhyay, Ravi Prakash; Chowdhury, Ranadip

doi:10.1016/j.vaccine.2019.03.039

Cited by 49 publications

(42 citation statements)

References 31 publications

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“…15 Vaccine delay refers to administration of scheduled dose of the vaccine being delayed by 28 days or more. 16 The data were interpreted using proportions and Chisquare tests and statistical software SPSS 16 was used for analysis.…”

Section: Methodsmentioning

confidence: 99%

Determinants of delayed vaccination among children under 2 years attending an immunisation clinic of a tertiary care hospital, Kolkata

Chakraborty

Joardar

2020

Int J Res Med Sci

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Background: Immunization is one of the most effective public health measures for disease prevention and when administered timely leads to substantial reduction in child mortality and morbidity. However, timely administration of vaccines remains neglected putting the children at risk of acquiring the infections. Methods: The study is a cross-sectional, observational study, conducted in the immunization clinic of KPC Medical College and Hospital from January to March 2019 among children below the age of 2 years. The sample size was 332. The mothers were interviewed with a pre-designed and pre-tested schedule regarding socio-demographic details and records were reviewed for scheduled date of immunization and to find any delay.Results: Total 33.7% children had some delay in receiving vaccines. The delay was found to be more in mothers <20 years of age, female children, children belonging to Hindu religion, children from joint family, children belonging to class 4 SES, children where maternal education is up to primary level and children with birth order≥3. Significant association was found between vaccine delay birth and order. (p<005). Sickness of the child accounted for 41% of the delays followed by both parents working, which accounted for 25.9% of delays.Conclusions: Delay in vaccination was found in approximately one-third of children. Thus more awareness generation is required among mothers regarding the timeliness of vaccinations and risk it poses on the children making them more susceptible to diseases in the period of delay.

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Section: Methodsmentioning

confidence: 99%

Determinants of delayed vaccination among children under 2 years attending an immunisation clinic of a tertiary care hospital, Kolkata

Chakraborty

Joardar

2020

Int J Res Med Sci

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“…Subgroup analysis found that children in less educated, poorer, and lower caste households had lower pre-COVID levels of immunization, consistent with prior evidence on the socioeconomic predictors of delayed and incomplete vaccination in India. [42,43] Worryingly, these subgroups also experienced somewhat larger declines during the lockdown that catch-up efforts had not addressed by the time of this study. These disparities may reflect lower trust or awareness of the importance of immunization among households, but also the inadequate reach of the health system among these populations.…”

Section: Discussionmentioning

confidence: 76%

Covid-19 Related Immunization Disruptions in Rajasthan, India: A Retrospective Observational Study

Jain

Chopra

Falézan

et al. 2020

Preprint

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IntroductionGovernments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations to reach children with missed vaccinations. This paper evaluated immunization disruptions during India’s March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India.MethodsIn this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one year old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown.ResultsRelative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9 months (OR 0.550; 95%CI 0.367-0.824; p=0.004), but more likely to be immunized at 10-12 months (OR 1.761; 95%CI 1.196-2.591; p=0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95%CI 0.478-0.816; p=0.001) by the time of survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, and their immunization coverage was 6.9pp above heavily exposed children despite their younger age. Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant.ConclusionDisruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due their immunizations during the lockdown remained less likely to be fully immunized 4-5 months after it lifted, even as younger cohorts due immunizations in June or later returned to pre-lockdown schedules.

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“…17,28 The reasons behind the low age-appropriate vaccines coverage rate might include a lack of awareness about the immunization schedule, low socio-economic status, hard to access health care facilities, reluctancy in administering vaccines, hesitancy of parents regarding vaccination, insu cient infrastructure to transport and store the vaccine in hard to reach areas, and occurrence of unusual events such as natural disaster, disease outbreak (pandemic situation). 20,26,27,[29][30][31][32][33] The huge earthquake of 2015 in Nepal signi cantly affected the healthcare services in different provinces throughout the country. 34 Our study was conducted after the earthquake.…”

Section: Discussionmentioning

confidence: 99%

Age-appropriate vaccination coverage and its determinants in children aged 12-36 months in Nepal: a national and subnational assessment

Rauniyar

Iwaki

Yoneoka

et al. 2021

Preprint

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Background Vaccination is one of the effective ways to develop immunity against potential life-threatening diseases in children in early age. This study is focused on analysing the age-appropriate vaccination coverage at national and subnational levels and identify the factors associated with age-appropriate coverage in Nepal.Methods 460 children aged 12-36 months were included in the study. The data was obtained from Nepal Demographic and Health Survey (NDHS) 2016-17. Age-appropriate coverage of Bacillus Calmette-Guerin vaccine (BCG), oral polio vaccine (OPV) doses 1-3, pentavalent vaccine (PE) doses 1-3, and first dose of measles, mumps, and rubella vaccine (MMR) were estimated using Kaplan Meier method. Multilevel logistic regression with random intercept was used to identify the factors associated with age-appropriate vaccination. Results The crude coverage of the vaccines included in the study ranged from 91.5% (95% CI, 88.5-93.7) for PE3 to 97.8% (95.8-98.7) for BCG. Although the crude coverage of all the vaccines was above 90%, the age-appropriate coverage was significantly low, ranging from 41.5% (36.5-46.6) for PE3 to 73.9 % (69.2-78.1) for PE1. Furthermore, high disparity in timely vaccination coverage was observed at regional level. Compared to the age-appropriate vaccination coverage in other provinces, Province 2 had the lowest coverage of all, followed by that in Province 6. The timeliness of vaccination was significantly associated with subnational regions i.e., provinces and the season of childbirth.Conclusion Although the immunization program in Nepal has achieved the target of 90% crude coverage of all the childhood vaccines, the age-appropriate coverage is significantly low which undermines the effectiveness of the vaccines administered. Thus, along with crude coverage, timeliness of the vaccines administered should be taken into consideration and thoroughly monitored at national and subnational levels. Provincial government should formulate tailored strategies to ensure the timely administration of the childhood vaccines.

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Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family health survey–4

Cited by 49 publications

References 31 publications

Determinants of delayed vaccination among children under 2 years attending an immunisation clinic of a tertiary care hospital, Kolkata

Determinants of delayed vaccination among children under 2 years attending an immunisation clinic of a tertiary care hospital, Kolkata

Covid-19 Related Immunization Disruptions in Rajasthan, India: A Retrospective Observational Study

Age-appropriate vaccination coverage and its determinants in children aged 12-36 months in Nepal: a national and subnational assessment

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Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family health survey–4

Cited by 49 publications

References 31 publications

Determinants of delayed vaccination among children under 2 years attending an immunisation clinic of a tertiary care hospital, Kolkata

Determinants of delayed vaccination among children under 2 years attending an immunisation clinic of a tertiary care hospital, Kolkata

Covid-19 Related Immunization Disruptions in Rajasthan, India: A Retrospective Observational Study

Age-appropriate vaccination coverage and its determinants in children aged 12-36 months in Nepal: a national and subnational assessment

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Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family health survey–4