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Vaccines 2019, 7(1), 24; https://doi.org/10.3390/vaccines7010024

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

1
Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
2
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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Abstract

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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