Factors associated with adherence towards different vaccines of childhood immunization of under five children among mothers attending Klinik Kesihatan Seremban

Introduction: Immunization schedule varies among each country based on situations and diseases. Adherence namely completeness and timeliness towards the schedule is the basis of children protection as seroconversion is age-dependent. Hence, even if immunization coverage is persistently high, as of late, vaccine preventable diseases are on the rise. Objective: To determine the factors associated with adherence (completeness and timeliness) towards different vaccines of childhood immunization of under five children among mothers attending Klinik Kesihatan Seremban. Methodology: A cross-sectional study was conducted among mothers with under five children attending Klinik Kesihatan Seremban. 320 respondents were selected based on systematic random sampling method. Dependent variable was adherence (completeness and timeliness) and independent variables include socio-demographic characteristics, child factors, healthcare services and logistics. Data was collected using self-administered questionnaires and proforma. All the data that had been collected was analyzed using SPSS version 22 involving descriptive and inferential statistics. Result: A total of 314 respondents consented, giving a 98.1% response rate. The study revealed that 98.09 % of respondents adhering towards completeness of immunization schedule while a range of 56.5 % to 97.1 % of respondents adhered in term of vaccine timeliness. There was significant association between types of transportation and adherence (completeness) towards immunization schedule (p=0.041). Employment status was also significantly associated with adherence (timeliness) towards BCG vaccine (p=0.008), Hepatitis B Dose 1 vaccine (p=0.018) and Hepatitis B Dose 2 vaccine (p=0.040). There was also a significant association between education level and adherence (timeliness) towards DTaP/IPV/HiB Dose 4 (p=0.019). Maternal age group and usage of government clinic was also significantly associated with adherence (timeliness), p=0.030 and p=0.017 towards MMR dose 1 vaccine. Household income was the predictor for adherence (completeness) towards immunization schedule. The predictors for adherence (timeliness) towards BCG, Hepatitis B Dose 1, Hepatitis B Dose 2 and MMR Dose 1 were employment status, birth order, maternal age and household income respectively. Conclusion: The findings of this study denote the high level of adherence (completeness) towards childhood immunization schedule but of varying level of adherence (timeliness) towards different vaccine scheduled. Household income was the predictor for both adherence (completeness) and adherence (timeliness) of MMR dose one but of different category. Other predictors include employment status, birth order and maternal age for BCG, Hepatitis dose one and dose two respectively.

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