Significant Vaccination Delay can Occur Even in a Community with Very High Vaccination Coverage: Evidence from Ballabgarh, India

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Background: The current study was undertaken to estimate the delay in vaccination for National Immunization Schedule vaccines in under-five children and explore causes for this delay.Methods: The study was carried out in Ballabgarh Health and Demographic Surveillance Site in Northern India. It is a secondary data set-based study of children born between 1991 and 2004. Causes for delay in vaccination were explored by informal discussions.Results: Total of 25 517 children were included in the analysis. Vaccination coverage at 1 year of age was high for all National immunization schedule vaccines (78.7% for measles to 97.4% for OPV-1). Children for delayed vaccination ranged from 15.9% (95% CI 15.4–16.3) for OPV booster to 83.5% (95% CI 83.1–83.9) for OPV-3. Non-availability of children was identified as important determinants of the delay.Conclusions: We conclude that focus on ‘quantity’ in vaccination (high vaccination coverage) needs to be supplemented with quality of vaccination (in-time vaccination).

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