PMID- 37234595
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230529
IS  - 2590-1362 (Electronic)
IS  - 2590-1362 (Linking)
VI  - 14
DP  - 2023 Aug
TI  - Vaccination inequities among children 12-23 months in India: An analysis of 
      inter-state differences.
PG  - 100310
LID - 10.1016/j.jvacx.2023.100310 [doi]
LID - 100310
AB  - BACKGROUND: Previous research has shown that socioeconomic and demographic risk 
      factors in children are additive and lead to increasingly negative impacts on 
      vaccination coverage. The goal of this study is to examine if different 
      combinations of four risk factors (infant sex, birth order, maternal education 
      level, and family wealth status) vary by state among children 12-23 months in 
      India and to determine the impact of >/= 1 risk factor on differences in state 
      vaccination rates. METHODS: Using data from the National Family Health Survey 
      (NFHS) conducted in India between 2005 and 2006 (NFHS-3) and 2015-2016 (NFHS-4), 
      full vaccination of children 12-23 months was examined. Full vaccination was 
      defined as receipt of one dose of bacillus Calmette-Guerin (BCG), three doses of 
      diphtheria-pertussis-tetanus vaccine (DPT) vaccine, three doses of oral polio 
      vaccine (OPV), and one dose of measles-containing vaccine (MCV). Associations 
      between full vaccination and the four risk factors were assessed using logistic 
      regression. Data were analyzed by the state of residence. RESULTS: A total of 
      60.9% of children 12-23 months were fully vaccinated, in NFHS-4, ranging from 
      33.9% in Arunachal Pradesh to 91.3% in Punjab. In NFHS-4, the odds of full 
      vaccination across all states were 15% lower among infants with 2 risk factors 
      versus 0 or 1 risk factors (OR: 0.85, 95% CI: 0.80-0.91), and 28% lower among 
      infants with 3 or 4 risk factors versus 0 or 1 risk factor (OR: 0.72, 95% CI: 
      0.67-0.78). Overall, the absolute difference in the full vaccination coverage in 
      those with > 2 vs < 2 risk factors decreased from -13% in NFHS-3 to -5.6% in 
      NFHS-4, with substantial variation across states. CONCLUSIONS: Disparities in 
      full vaccination exist among children 12-23 months experiencing > 1 risk factor. 
      Indian states that are more populous or located in the north were more likely to 
      have greater disparities.
CI  - (c) 2023 The Author(s).
FAU - Goodman, Octavia K
AU  - Goodman OK
AD  - College of Health Sciences, Old Dominion University, 5115 Terminal Blvd, Norfolk, 
      VA 23529, USA.
FAU - Wagner, Abram L
AU  - Wagner AL
AD  - Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann 
      Arbor, MI 48109, USA.
FAU - Riopelle, Dakota
AU  - Riopelle D
AD  - Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann 
      Arbor, MI 48109, USA.
FAU - Mathew, Joseph L
AU  - Mathew JL
AD  - PGIMER, QQ7G+JC4, P.G.I, Sector 12, Chandigarh 160012, India.
FAU - Boulton, Matthew L
AU  - Boulton ML
AD  - Department of Epidemiology, School of Public Health, University of Michigan, 1415 
      Washington Heights, Ann Arbor, MI 48109, USA.
AD  - Department of Internal Medicine, Infectious Diseases Division, Michigan Medicine, 
      1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
LA  - eng
PT  - Journal Article
DEP - 20230505
PL  - England
TA  - Vaccine X
JT  - Vaccine: X
JID - 101748769
PMC - PMC10205789
OTO - NOTNLM
OT  - Disparities
OT  - India
OT  - Infants
OT  - Risk factors
OT  - Vaccination
COIS- The authors declare the following financial interests/personal relationships 
      which may be considered as potential competing interests: Matthew L. Boulton 
      reports financial support was provided by National Institute on Minority Health 
      and Health Disparities of the National Institutes of Health.
EDAT- 2023/05/26 19:14
MHDA- 2023/05/26 19:15
PMCR- 2023/05/05
CRDT- 2023/05/26 12:13
PHST- 2022/09/08 00:00 [received]
PHST- 2023/04/15 00:00 [revised]
PHST- 2023/04/30 00:00 [accepted]
PHST- 2023/05/26 19:15 [medline]
PHST- 2023/05/26 19:14 [pubmed]
PHST- 2023/05/26 12:13 [entrez]
PHST- 2023/05/05 00:00 [pmc-release]
AID - S2590-1362(23)00051-7 [pii]
AID - 100310 [pii]
AID - 10.1016/j.jvacx.2023.100310 [doi]
PST - epublish
SO  - Vaccine X. 2023 May 5;14:100310. doi: 10.1016/j.jvacx.2023.100310. eCollection 
      2023 Aug.