Missed opportunities for immunization for children under five years attending primary health care centers and the reasons for their occurrence in Baghdad /Al-Karkh

Abstract

Immunizations are recognized as one of the most impactful public health interventions in the 20th century. They are regarded as a safe, cost-effective, and powerful means of preventing deaths and improving lives. The objective of this study was to assess the extent and reasons behind missed opportunities for immunization among children under five years old attending primary health care centers in Baghdad/AlKarkh. A cross-sectional study involving caregivers of children attending primary health care centers, carried out from October 1, 2022, to January 5, 2023. A sample of 400 children under five years old was randomly enrolled, with 299 of them eligible for at least one vaccine dose during their visit to the health facility. The mean age of the children was 17.24±15.13 months. The female-to-male ratio was approximately 1:1.4, while the 14.5% of the caregivers were males and 85.5% were females. The vast majority of the sampled population had a low socio-economic status. The study found that 32.7% of the eligible children had missed opportunities for immunization, accounting for 24.5% of the total sample, and the highest rate was for the first dose of the measles/mumps/rubella vaccine, accounting for 9.0% of cases. The main reason for missing immunization was attributed to healthcare workers (19.4%). The study highlights the relatively high prevalence of missed opportunities for immunization among children under five years old attending primary health care centers in Baghdad/AlKarkh, indicating gaps in vaccination efforts. The highest specific missed opportunity was observed for the MMR first dose vaccine. The study recommends training healthcare workers on routine immunization services, particularly emphasizing accurate contraindications for immunization.