PMID: 40322413 https://pubmed.ncbi.nlm.nih.gov/40322413/

Abstract

BACKGROUND: Vaccination remains a cornerstone of child survival, yet coverage in low-resource settings often falls below global targets. Socio-demographic disparities, such as parental education, income, and healthcare access, persistently influence vaccine uptake in developing countries. This study focuses on Bhubaneswar, India, where rapid urbanization intersects with inequities in immunization access, to identify actionable predictors of compliance among children under the age of two.

OBJECTIVES: This cross-sectional study aimed to assess the association between socio-demographic factors, including parental education, and vaccination compliance among children under the age of two in Bhubaneswar, a developing country setting.

METHODS:  A cross-sectional study was done in the pediatric outpatient department (OPD) at a teaching institute. This study was conducted in a teaching hospital in Eastern India from November 2019 to April 2020. The children aged 10 to 24 months attending immunization clinics/pediatrics OPD were selected for the study. The immunization records of enrolled children were collected at the hospital by visiting their homes or using WhatsApp (Meta Platforms, Inc., Menlo Park, California, United States). Demographic and clinical details (age, sex, living area, and maternal/paternal education) were recorded in a predesigned proforma. The data were collected by a trained researcher and entered into a Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States) datasheet.

RESULTS:  We enrolled 851 children in this study, which revealed a Bacillus Calmette-Guérin (BCG) vaccine coverage rate of 787 (92.48%), declining with age. Oral polio vaccine (OPV) coverage ranged from 680 (79.91%) at birth to 783 (92.01%) by 14 weeks, while diphtheria, pertussis, and tetanus (DPT) and fractional inactivated polio vaccine (IPV) rates were quite low, ranging from 220 (25.9%) at six weeks to 271 (31.84%) at 14 weeks. Pentavalent vaccine coverage was higher, between 439 (51.6%) at six weeks and 496 (58.3%) at 14 weeks. Only 357 (41.95%) of children under the age of two were fully immunized. Maternal and paternal education significantly influenced vaccine compliance (p < 0.05), with higher education correlating with better coverage. Vaccines outside the state program, such as pneumococcal conjugate vaccine (PCV) and rotavirus, had low uptake. Additionally, there were socio-demographic disparities in vaccine coverage.

CONCLUSION:  This study highlights low vaccination compliance, with only 357 (41.95%) children under two years fully immunized in Bhubaneswar, India. Parental education predicts higher coverage, especially for BCG, DPT, and non-state-sponsored vaccines (hepatitis A and chickenpox). Socio-demographic disparities emphasize the need for targeted interventions integrating education and equitable access to improve immunization outcomes in a developing setup.