Delays in primary vaccination of infants living in Western Saudi Arabia

OBJECTIVE: Vaccination is one of the most cost-effective means of preventing serious infectious diseases. Several studies from developing and developed countries documented considerable delays in the administration of primary vaccinations. Our objectives were to study the circumstances and contributing factors to such delays in order to design preventative measures.

METHODS: Parents of consecutive infants seen during a routine vaccination visit at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia were included prospectively between September 2000 and February 2001. Structured interviews were performed using a 20-item questionnaire. Vaccinations were considered delayed if they took place 4 or more weeks after the designated time.

RESULTS: During the study period, 227 structured interviews were conducted. All approached parents agreed to participate. The mother was interviewed in 97% of cases. Infant's ages ranged between 2-52 months (mean 3.4, standard deviation (SD) 5.1). The majority of the parents were married (98%), and 83% of the mothers were housewives. Most families (79%) had other older children. In most infants (91%), the primary vaccinations were given on time. In the remaining 9%, vaccinations were 1-38 months late (mean 3.8, SD 8.1). The most common reasons for such delays were difficulties with the appointment (30%) and non-febrile upper respiratory tract illness (20%). In only 3 (15%) infants, was the delay based on physician's advice, and only 2 (10%) had a real contraindication. Most of these parents (65%) were not concerned at all regarding the vaccination delay, and only 2 (12%) were highly concerned.

CONCLUSION: Delays of primary vaccination of infants, although uncommon, continue to occur in our region. Improved parental education and timely scheduling of follow-up appointments can easily prevent such delays.