Assessment of Immunization Status and Reasons for Incomplete Immunization among Children Aged 1–5 Years Admitted to Al-Khidmat Raazi Children Hospital, Rawalpindi

Abstract

Background: Immunizations are considered among the most effective and cost-effective preventive measures for childhood morbidity, mortality, and vaccine-preventable illnesses. Although free vaccination of children under the auspices of Pakistan's Expanded Program of Immunization (EPI) is available, incomplete immunization continues to pose a problem for public health practice. Children admitted to the hospital constitute a critical segment where such gaps can be detected and filled. Objective: To assess the immunization status of children aged 1–5 years admitted to Al-Khidmat Raazi Children Hospital, Rawalpindi, and to identify patterns and factors associated with incomplete immunization. Methodology: The descriptive cross-sectional study was done in Al-Khidmat Raazi Children Hospital, Rawalpindi for six months. In total, 160 child-caregiver pairs were taken by using non-probability consecutive sampling. Data was collected using a structured interview schedule. Immunization status was determined based on the EPI schedule in Pakistan using immunization cards or the recall of caregivers if immunization cards were not available. The data was analyzed using SPSS. Methods like descriptive statistics, Pearson chi-square test, independent samples t-test, and binary logistic regression analysis were done. Results: In the total sample of 160 children, 123 (76.9%) were fully vaccinated, 34 (21.3%) were incompletely vaccinated, and 3 (1.9%) did not receive any vaccine. A total of 37 children (23.1%) were regarded as incompletely immunized among the incompletely vaccinated and unimmunized children. The immunization cards were reported to be available for 128 caretakers (80.0%), but only 116 (72.5%) were able to show their card during the interview, and only 86 (53.8%) had updated card till their latest visit. In the case of incompletely immunized and unimmunized children, the multiple doses of missed vaccine (27.0%) were common, followed by measles/mumps and rubella (MR) (21.6%) and pneumococcal conjugate vaccine (PCV) (18.9%). Card possession was significantly correlated with immunization status (χ²=6.90, p=0.032), as well as card update status (χ²=5.99, p=0.050). However, none of the predictor variables achieved significance in adjusted logistic regression analysis. Conclusion: Even though more than three-quarters of hospitalized children were vaccinated completely, close to one quarter were partially vaccinated. Card ownership and update in documentation were linked to better immunization status at the bivariate level. Assessing the immunization status of children on admission and giving them the opportunity to get their vaccines could improve vaccination coverage rates.