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Vaccines 2019, 7(1), 24;

Analysis of State-Specific Differences in Childhood Vaccination Coverage in Rural India

Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
Department of Internal Medicine, Division of Infectious Disease, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
Author to whom correspondence should be addressed.
Received: 21 December 2018 / Revised: 19 February 2019 / Accepted: 21 February 2019 / Published: 24 February 2019
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There is little research on state-level differences in child health outcomes in India. The aim of this study was to identify state-level characteristics that relate to childhood immunizations. Most state-level characteristics came from the 2011 Indian Census. Individual-level data and other state-level characteristics were obtained from the 2007–2008 District Level Household and Facility Survey. Predictors of full vaccination were assessed with logistic regression models. Among 86,882 children 12–36 months, 53.2% were fully vaccinated. Children living in bigger households (≥7 members), born in non-institutional settings, and female had lower odds of complete vaccination. Individuals living in states in the mid-range of poverty had lower odds of full vaccination compared to those in lower or higher poverty states (3rd vs. 1st quintile: odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.30, 0.42). Greater average population per primary health center was associated with decreased odds of full vaccination (5th vs. 1st quintile: OR: 0.37, 95% CI: 0.30, 0.47). Vaccination coverage in India can be explained by a complex interplay of individual- and state-level factors. Solutions to increasing vaccination must be multisectoral and acknowledge the cultural and socio-economic diversity that influences an individual child’s vaccination coverage along with within-state disparities. View Full-Text
Keywords: India; vaccination coverage; religion India; vaccination coverage; religion

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Shrivastwa, N.; Wagner, A.L.; Boulton, M.L. Analysis of State-Specific Differences in Childhood Vaccination Coverage in Rural India. Vaccines 2019, 7, 24.

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