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. 2025 Aug 6;15(8):e099678.
doi: 10.1136/bmjopen-2025-099678.

Bridging the gap in full immunisation coverage with parental awareness and attitudes: a community-based cross-sectional analysis on routine childhood vaccinations in Perambalur district of Tamil Nadu, South India

Neeraj Vinod Mohandas  1 , Vinod Mohandas  2 , Avani Dinesh  3   4 , Krishnapillai Vijayakumar  5 , Vijay Anand  6 , Sanidhya S Karve  7
Affiliations

Bridging the gap in full immunisation coverage with parental awareness and attitudes: a community-based cross-sectional analysis on routine childhood vaccinations in Perambalur district of Tamil Nadu, South India

Neeraj Vinod Mohandas et al. BMJ Open. .

Abstract

Objectives: To determine the independent predictors of full immunisation coverage (FIC) among children aged 12-23 months along with the parental awareness and attitudes (of children aged ≤23 months) regarding routine childhood vaccinations in Perambalur district of Tamil Nadu, South India.

Design: A community-based cross-sectional analysis.

Setting: Perambalur district situated in the central region of Tamil Nadu state, South India.

Participants: Parents of children aged ≤23 months.

Outcome measures: The primary outcome measured was the FIC and FIC plus in the district along with the parental awareness and attitudes regarding routine childhood vaccinations. The independent predictors of FIC and FIC plus were determined using multivariable logistic regression models.

Results: The study included 652 children, with a mean (±SD) age of 16.47 (±6.37) months and a male-to-female ratio of 60:40. The FIC and FIC plus of children aged 12-23 months were 91.3% (95% CI 88.64 to 93.33) and 79.7% (95% CI 76.15 to 82.80), respectively. The immunisation card retention was 97.9% among the parents of children aged 12-23 months. The independent predictors of FIC included below poverty line families (adjusted OR (AOR) 0.11; 95% CI 0.02 to 0.64), illiteracy among mothers (AOR 0.67; 95% CI 0.32 to 0.87), lack of immunisation card (AOR 0.14; 95% CI 0.03 to 0.55), lack of frequent home visits by healthcare worker (AOR 0.38; 95% CI 0.18 to 0.79) and hesitancy of parents towards vaccination (AOR 0.26; 95% CI 0.12 to 0.87).

Conclusion: This study revealed a high FIC in this specific district. However, achieving full coverage is influenced by factors like socioeconomic status, maternal education and parental attitudes. Understanding these factors is essential for improving immunisation rates and ensuring all children are protected.

Keywords: Awareness; Child; Community child health; Immunization Programs; Parents; Vaccination.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. STROBE flowchart. NFHS-5, National Family Health Survey-5; STROBE, Strengthening the Reporting of Observational Studies in Epidemiology.
Figure 2
Figure 2. Distribution and coverage of vaccinations according to UIP among children aged 12–23 months (n=561). DPT, diphtheria, pertussis and tetanus; fIPV, fractional dose of inactivated polio vaccine; JE, Japanese encephalitis; MR, measles and rubella; OPV, oral polio vaccine; PCV, pneumococcal conjugate vaccine; UIP, Universal Immunization Programme.
Figure 3
Figure 3. Parental awareness and attitude towards routine childhood immunisation (n=652).
Figure 4
Figure 4. Regression model I showing the independent predictors of full immunisation coverage (FIC) among children aged 12–23 months (n=561). *p value <0.05 is statistically significant. ##Above poverty line. #Below poverty line.
Figure 5
Figure 5. Regression model II showing the independent predictors of full immunisation coverage plus (FIC plus) among children aged 12–23 months (n=561) *p value <0.05 is statistically significant. ##Above poverty line. #Below poverty line.
See this image and copyright information in PMC

References

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