Knowledge, Attitude, Compliance Towards Immunization Among Parents Of Children Between 12–24 Months Who Are Vaccine Defaulters – A Questionnaire-Based Study

Abstract

Background: Immunization remains a critical and cost-effective public health strategy to reduce childhood morbidity and mortality. However, vaccine defaulting, particularly among children aged 12–24 months, continues to hinder complete immunization coverage in India. Identifying parental knowledge, attitude, and behavioural factors is vital for addressing these gaps.

Aim: To assess the knowledge, attitude, and compliance towards immunization among parents of children aged 12–24 months who are vaccine defaulters and to evaluate the vaccine-wise default rates and impact of education and socioeconomic status on compliance behaviour.

Materials and Methods: A cross-sectional study was conducted over a six-month period at Thirakhazukundram PHC under Shri Sathya Sai Medical College & Research Institute. A total of 215 parents or caregivers of children aged 12–24 months who had defaulted from one or more scheduled vaccinations were enrolled. Data was collected using a pre-tested, structured questionnaire assessing demographic details, knowledge, attitude, compliance patterns, missed vaccines, and barriers to vaccination. Data analysis was done using SPSS, and Chi-square test was applied for categorical variables, with p < 0.05 considered significant.

Results: Of the 215 participants, 47.4% demonstrated adequate knowledge and 42.3% had a favourable attitude towards immunization. Only 31.2% of parents resumed missed vaccinations, while 68.8% failed to follow up. The most commonly defaulted vaccines were Pentavalent-3 (28.8%), OPV-3 (27.0%), and PCV-3 (20.0%). Education and monthly household income showed statistically significant associations with compliance behaviour (p < 0.05). Additional barriers included lack of reminders (73.5%), long wait times, fear of side effects (38.6%), affordability concerns (28.8%), and cultural beliefs.

Conclusion: The study revealed low compliance among parents of vaccine defaulters, with significant associations between default behaviour and both educational and socioeconomic factors. Dropout rates were highest for third-dose vaccines, underscoring the need for strengthened follow-up systems, awareness drives, and targeted interventions addressing financial and logistical barriers to improve immunization uptake.