Vaccination coverage and reasons for non-vaccination in a district of Istanbul

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Abstract

Background

In order to control and eliminate the vaccine preventable diseases it is important to know the vaccination coverage and reasons for non-vaccination. The primary objective of this study was to determine the complete vaccination rate; the reasons for non-vaccination and the predictors that influence vaccination of children. The other objective was to determine coverage of measles vaccination of the Measles Immunization Days (MID) 2005 for children aged 9 month to 6 years in a region of Umraniye, Istanbul, Turkey.

Methods

A '30 × 7' cluster sampling design was used as the sampling method. Thirty streets were selected at random from study area. Survey data were collected by a questionnaire which was applied face to face to parents of 221 children. A Chi-square test and logistic regression was used for the statistical analyses. Content analysis method was used to evaluate the open-ended questions.

Results

The complete vaccination rate for study population was 84.5% and 3.2% of all children were totally non-vaccinated. The siblings of non-vaccinated children were also non-vaccinated. Reasons for non-vaccination were as follows: being in the village and couldn't reach to health care services; having no knowledge about vaccination; the father of child didn't allow vaccination; intercurrent illness of child during vaccination time; missed opportunities like not to shave off a vial for only one child. In logistic regression analysis, paternal and maternal levels of education and immigration time of both parents to Istanbul were found to influence whether children were completely vaccinated or non-vaccinated. Measles vaccination coverage during MID was 79.3%.

Conclusion

Efforts to increase vaccination coverage should take reasons for non-vaccination into account.

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Most cited references 27

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Migration, community context, and child immunization in Ethiopia.

Gebre-Egzbiabher Kiros, Michael J V White (2004)

This paper examines the relationship between parental migration status and child immunization in Southern Ethiopia, a region characterized by high mortality and morbidity. Using the 1997 Community and Family Survey and a multilevel modeling approach, we find that children born to rural-rural migrant mothers have significantly less chance of receiving full immunization coverage than children born to non-migrant mothers. The social mechanism that explains this huge disparity is that rural-rural migrant women have limited social networks in the host community. In addition, significant variation in receiving complete immunization is found by age of child (a likely period effect), mother's education, and distance to nearest health center. Marked child immunization differentials are also observed by ethnicity. The results from the multilevel analysis confirm the persistence of substantial community effects, even after controlling for a standard array of personal and household characteristics. Given the low levels of vaccination among children born to migrant women, health policy interventions and information campaigns might be effectively augmented to reach such migrant women and their children. Community and ethnic group effects suggest that further targeting of health activities could be efficient and effective.

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Maternal recall error of child vaccination status in a developing nation.

L. Weld, Joseph J. Valadez (1991)

In the absence of vaccination card data, Expanded Program on Immunization (EPI) managers sometimes ask mothers for their children's vaccination histories. The magnitude of maternal recall error and its potential impact on public health policy has not been investigated. In this study of 1171 Costa Rican mothers, we compare mothers' recall with vaccination card data for their children younger than 3 years. Analyses of vaccination coverage distributions constructed with recall and vaccination-card data show that recall can be used to estimate population coverage. Although the two data sources are correlated (r = .71), the magnitude of their difference can affect the identification of the vaccination status of an individual child. Maternal recall error was greater than two doses 14% of the time. This error is negatively correlated with the number of doses recorded on the vaccination card (r = -.61) and is weakly correlated with the child's age (r = -.35). Mothers tended to remember accurately the vaccination status of children younger than 6 months, but with older children, the larger the number of doses actually received, the more the mother underestimated the number of doses. No other variables explained recall error. Therefore, reliance on maternal recall could lead to revaccinating children who are already protected, leaving a risk those most vulnerable to vaccine-preventable diseases.

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Mothers as active partners in the prevention of childhood diseases: maternal factors related to immunization status of preschool children in Italy.

C Bosetti, M Bonati, S Schiavio … (2000)

We examined how maternal socio-demographic factors, together with mother's education, knowledge, and perception of immunizations, can affect the uptake of optional vaccinations of preschool children in Italy. Interviews of Italian mothers were performed using a structured questionnaire administered by trained interviewers with no specific medical competence. A convenience sample of 1,035 mothers were interviewed. Fifty-nine percent of the respondents reported to have had their child immunized with the MMR vaccine and 54% reported to have had their child immunized against pertussis. In logistic regression analysis, three variables were significantly associated with both the immunization outcomes: mother's positive attitude toward immunization (OR = 1.69; IC 1.13-2.52 for pertussis; OR = 1.86, IC 1. 17-2.96 for MMR); mothers' residency in the North of the country (OR = 1.74; IC 1.32-2.30 for pertussis; OR = 1.63, IC 1.18-2.24 for MMR); and mother's receipt of satisfactory information on immunization (OR = 1.67; IC 1.15-2.21 for pertussis; OR = 2.25, IC 1. 47-3.43 for MMR). An immunization performed in recent years (after 1994), probably following the widespread use of acellular vaccine, was the most significant predictor for pertussis immunization (OR = 3.21; IC 2.43-4.24). The findings suggest that mothers' attitudes, educational level, and socio-demographic characteristics, as well as socio-economic factors and local health policies, can influence children's immunization uptake. Health promotion, based on a partnership between parents and health professionals, should become a priority in Italian vaccination policies. Copyright 2000 American Health Foundation and Academic Press.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date Collection: 2006

Publication date (Electronic): 5 May 2006

Volume: 6

Page: 125

Affiliations

[1 ]Marmara University Medical Faculty Department of Public Health, Istanbul, Turkey

[2 ]Assistant Professor of Public Health, Marmara University Medical Faculty Department of Public Health, Istanbul, Turkey

Article

Publisher ID: 1471-2458-6-125

DOI: 10.1186/1471-2458-6-125

PMC ID: 1464125

PubMed ID: 16677375

SO-VID: 3bb855b1-7c41-46b5-aae9-efad0724308a

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Vaccination coverage and reasons for non-vaccination in a district of Istanbul

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Abstract

Background

Methods

Results

Conclusion

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Chinese Journal of School Health

Most cited references 27

Migration, community context, and child immunization in Ethiopia.

Maternal recall error of child vaccination status in a developing nation.

Mothers as active partners in the prevention of childhood diseases: maternal factors related to immunization status of preschool children in Italy.

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