Immunization status of children in North India sal immunization of children against all vaccine- preventable diseases of the childhood by 2010 (3). The coverage of vaccination in India is far from complete despite the commitment for universal coverage. According to the National Family Health Survey (NFHS) 3, only 43.5% of children, aged 12- 23 months, were fully vaccinated—57.5% in urban areas and 38.6% in rural areas (4). Reasons for lack of coverage vary from logistic ones to those depen- dent on human behaviour. A number of previous studies have explored the reasons for non-immuni- zation (5-9) but none has been carried out on chil- dren admitted to a tertiary-care hospital. Hence, the present study was undertaken to assess the status of immunization and to analyze the various factors responsible for the suboptimal coverage of immunization among admitted patients. MATERIALS AND METHODS Study setting and sample This four-month study was conducted from April to July 2007 at a tertiary-care hospital (University College of Medical Sciences and Guru Tegh Baha- dur Hospital, New Delhi, India). Of 1,266 child patients admitted to the paediatrics ward for vari- ous ailments, 325 consecutive patients, aged 12-60 months, were selected for the study. Demographic and socioeconomic data were recorded using a questionnaire. The immunization status of the enrolled patients was assessed as per the national immunization programme (2). Mother was the pri- mary respondent; if the mother was not available, father was interviewed informally by the author (DK) after the acute phase of illness in the child was over. Mothers were asked about the immuniza- tions received by their children by one year of age, and where possible, this information was verified by cross-checking against the vaccination cards of the children. Children who had received BCG and three doses of DPT/oral polio vaccine (OPV) and measles vaccine as scheduled in the first year of life were classified as fully immunized. Those who had missed any dose of six primary vaccines were labelled as partially immunized, and those who had not received any vaccine, except OPV in pulse polio immunization, up to 12 months of age, were defined as non-immunized (8). If the child was par- tially immunized or non-immunized, the reasons for the same were recorded using open-ended ques- tions. Analysis of data For a power of 80% and alpha of 0.05, sample size was calculated as 288 using a previous study (9) in Volume 28 | Number 3 | June 2010 Kumar D et al. which the proportion of completely-immunized children was 25%. Statistical analysis was carried out using the SPSS software (version 13). The p val- ue of <0.05 was considered significant. Chi-square test and logistic regression analysis were done to determine the statistical significance of the associa- tion between the immunization status and the re- corded demographic details. Ethics The study was approved by the ethical committee of the Guru Tegh Bahadur Hospital, New Delhi. Written informed consent was taken from the par- ents of the study subjects. RESULTS Of the 325 consecutively-admitted children, aged 12-60 months, 148 (45.54%) were male and 177 (54.46%) were female. The mean±standard devia- tion of age was 34.14±12.96 months. Mothers were the primary respondents in 273 (84%) cases and fa- thers in 52 (16%) cases. Only 104 (32%) cases were from Delhi, and the remaining ones were from the nearby states. Of the 325 children, only 58 (17.85%) were fully immunized, 156 (48%) were partially im- munized, and 111 (34.15%) were non-immunized. Fifty-two (89.66%) of the fully-immunized children had immunization cards with them compared to 50 (18.73%) children who were either partially or non-immunized. All the partially-immunized pa- tients and 83.78% of the non-immunized patients received OPV during the pulse polio immunization campaign. The coverage of pulse polio immuniza- tion was 96%. Table 1 shows the demographic profiles of the study children in relation to the immunization sta- tus. Of the 58 completely-immunized patients, 51 (87.93%) were male while 58 (37.2%) of the 156 partially-immunized patients were male (p<0.001). Of the 104 patients from Delhi, 39 (37.5%) were completely immunized, and 19 (8.6%) of the 221 patients from outside Delhi were completely im- munized. This difference was significant (p<0.001). Of Hindus (n=35), 37% received complete immuni- zation, and 3.37% of Muslims (n=6) received com- plete immunization. Fathers of the non-immunized or partially-immunized cases were educated only up to primary level or less (82.77%, n=221) while 89.66% of fathers of the completely-immunized children were educated up to more than primary level. This was statistically significant (p=0.021). The effect of maternal education was also statisti- cally significant (p=0.016). There was, however, no effect of birth-order or family type (p>0.05). 301