Predictors of Vaccination in India for Children Aged 12–36 Months

Introduction India has one of the lowest immunization rates worldwide despite a longstanding Universal Immunization Program (UIP) that provides free childhood vaccines. This study characterizes the predictors for under- and non-vaccination among Indian children aged 12–36 months. Methods This study...

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Bibliographic Details
Published in:American journal of preventive medicine 2015-12, Vol.49 (6), p.S435-S444
Main Authors: Shrivastwa, Nijika, PhD, MHSA, MPH, Gillespie, Brenda W., PhD, Kolenic, Giselle E., MA, Lepkowski, James M., PhD, Boulton, Matthew L., MD, MPH
Format: Article
Language:English
Subjects:
Child, Preschool
Culture
Female
Humans
Immunization Programs - statistics & numerical data
India
Infant
Internal Medicine
Logistic Models
Male
Residence Characteristics
Socioeconomic Factors
Vaccination - statistics & numerical data
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Summary:Introduction India has one of the lowest immunization rates worldwide despite a longstanding Universal Immunization Program (UIP) that provides free childhood vaccines. This study characterizes the predictors for under- and non-vaccination among Indian children aged 12–36 months. Methods This study utilized District Level Household and Facility Survey Data, 2008 (DLHS3), from India. DLHS3 is a nationally representative sample collected from December 2007 through December 2008; this analysis was conducted during 2014. Children’s vaccination status was categorized as fully, under-, and non-vaccinated based on whether children received all, some, or none of the UIP-recommended vaccines (one dose each of bacillus Calmette–Guérin and measles, and three doses of diphtheria–pertussis–tetanus). A multinomial logistic regression model estimated the odds of under-vaccination compared with full vaccination, and odds of non-vaccination compared with full vaccination. Analytic predictors included socioeconomic, cultural, household, maternal, and childhood characteristics. Results The analysis included 108,057 children; the estimated proportions of fully, under-, and non-vaccinated children were 57%, 31%, and 12%, respectively. After adjusting for state of residence, age, gender, household wealth, and maternal education, additional significant predictors of children’s vaccination status were religion, caste, place of delivery, number of antenatal care visits, and maternal tetanus vaccination, all of which demonstrated large effect sizes. Conclusions India’s immunization coverage remained low in 2008, with just slightly more than half of all children aged 12–36 months fully vaccinated with UIP-recommended vaccines. A better understanding of the predictors for vaccination can help shape interventions to reduce disparities in full vaccination among children of differing demographic/cultural groups.
ISSN:0749-3797
1873-2607
DOI:10.1016/j.amepre.2015.05.008