Immunization status of children in North India in Delhi. We observed a low coverage of complete immunization among Muslim patients as has been found by other authors (8,13). Deliveries in the hospital, including those born by caesarean section, were more likely to be com- pletely immunized (p<0.001). This may be because vaccination was started at birth, and parents were educated regarding subsequent vaccinations. There- fore, institutional deliveries should be promoted to increase the coverage of immunization. Education of fathers and mothers was also related to the low coverage of immunization in our study. Such find- ings were also observed by others (10,11,13). On lo- gistic regression, three most common demographic factors affecting the immunization status were ma- ternal education, religion, and place of delivery; hence, there is a need for maternal education. The common reasons for partial immunization and non-immunization were: lack of knowledge about vaccination (30.3%); vaccination has side-effects (28.8%); lack of knowledge about subsequent doses (22.1%); lack of faith in the effectiveness of immu- nization (21.7%); OPV was thought to be the only vaccination (20.9%); vaccine should not be given if the child is suffering from minor illnesses, such as mild diarrhoea with no dehydration or acute res- piratory infections (12.7%); child was sick on the scheduled date (12.7%); and minor reactions dur- ing previous vaccination (11.9%). Similar reasons have been reported in a study among urban slums of Lucknow district (8). The single most common reason for partial vaccina- tion was lack of knowledge about subsequent doses (22.09%); this highlights the need for training of medical officers and health workers about effective communication after vaccination regarding pos- sible side-effects, their treatment, and the schedule for the next visit. The fact that minor illnesses, such as cough and diarrhoea, are not a contra-indication to vaccination needs to be told to the parents. Re- cently, it has been emphasized that satisfaction of clients, in terms of behaviour of health workers and information given by them, and easy accessibility are factors significantly different in completely- immunized and partially-immunized group (14). For non-immunization, the commonest reason was the lack of knowledge about vaccination. The present study highlights that the immuniza- tion status of children admitted to atertiary-care hospital is low—reasons being low educational sta- tus of parents, lack of awareness, ineffective com- munication by healthcare providers, and miscon- ceptions associated with immunization. These issues need to be addressed at the tertiary level to improve the coverage of immunization. 304 Kumar D et al. REFERENCES 1. Frenkel LD, Nielsen K. Immunization issues for the 21st century. 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