Evaluation of factors, associated with defaulting routine immunization in children

Gayathri Devi Chinnappa, Chikkanarasa P. S. Reddy, Sarala Sabapathy, Deepthy Alice Varghese


Background: India was one of the first countries to adopt the World Health Organization’s Expanded Programme of Immunization (EPI). The program started globally in 1974 and was initiated in India in 1978. Immunization is considered to be one of the most important cost-effective and a powerful public health intervention. Achieving maximum coverage, however, has been a challenge due to many reasons, including high rates of defaulters from the program. The term ªdefaulterº is used to refer a child who misses the scheduled vaccinations for any reason. The objective of this study was to explore the reasons behind defaulting from the routine immunization program.

Methods: A study was conducted in Bowring and Lady Curzon Hospital, Bangalore between January 2012 and December 2012. A total of sixty six children’s’ details were gathered from mothers of defaulted children. Children below 5 years attending OPD were included in the study. Children above 5 years and inpatients were excluded. Observations and review of relevant documents was done.

Results: Of the 66 children, in our study, males were more than females. Children in the age group of 2 years to 5 years were 17(25%) as compared to those between 1 to 2 years. Mothers were more literate than fathers. Muslim children had the best immunization coverage. The main determinant of defaulting was lack of knowledge and awareness regarding immunization by the mothers (21/31%) followed by sickness in children (11/16%), causing them to default immunization schedules

Conclusions: The main reason for defaulting from the immunization program was lack of awareness, regarding immunization by mothers in the community.


Defaulters, Immunization coverage, National immunization programme, Partial immunization, Routine Immunization, Vaccine preventable diseases

Full Text:



Lahariya C. A brief history of vaccines & vaccination in India. Indian J Med Res. 2014 Apr;139(4):491-511.

International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3), 2005-06: India: Volume I. Mumbai: IIPS. Available at: or

Singh P, Yadav RJ. Immunization status of children of India. Ind Pediatr. 2000;37(11):1194-9.

Zewdie A, Letebo M, Mekonnen T. Reasons for defaulting from childhood immunization program: a qualitative study from Hadiya zone, Southern Ethiopia. BMC Public Health. 2016;16(1):1240.

Aregawi HG, Gebrehiwot TG, Abebe YG, Meles KG, Wuneh AD. Determinants of defaulting from completion of child immunization in Laelay Adiabo District, Tigray Region, Northern Ethiopia: A case-control study. PloS one. 2017;12(9):0185533.

Ibnouf AH, Van den Borne HW, Maarse JA. Factors influencing immunisation coverage among children under five years of age in Khartoum State, Sudan. South African Family Practice. 2007;49(8):14-14f.

Mathew JL. Inequity in childhood immunization in India: a systematic review. Ind Pediatr. 2012;49(3):203-23.

Sharma R, Desai VK, Kavishvar A. Assessment of immunization status in the slums of Surat by 15 clusters multi indicators cluster survey technique. Indian J Commun Med. Official publication of Indian Association of Preventive Social Medicine. 2009 Apr;34(2):152.

Chavan VP, Maralihalli MB. Immunization status of children less than 5 years attending to tertiary care hospital out-patient department in an urban area, prospective-descriptive study. Intern J Contemporary Pediatr. 2016;3(2)639-44.

Nirupam S, Chandra R, Srivastava VK. Universal Immunization Programme: In Sarojini nagar block of Lucknow district. Ind J Community Med. 1991;16(2):82.

Kar M, Reddaiah VP, Shashi Kant. Primary Immunization Status of Children in Slum Areas of South Delhi - The Challenge of Reaching the Urban Poor, Indian J Comm Med. 2001;26(3):151.

Yadav J, Singh P. Immunization Status of Children and Mothers in the State of Madhya Pradesh. Ind J Comm Med. 2004;29(3):147-8.