Assessment of risk factors associated with oral polio vaccine refusal in Rahim Yar Khan District,Pakistan(2017)

Objective:This study aimed to determine the risk factors associated with oral polio vaccine(OPV)refusal.Methodology:A case-control study was conducted in Rahim Yar Khan(RYK)District,Pakistan.A case was defined as‘‘any child aged<5 years who was enrolled in the microplans of RYK District as part of the National Immunization Days program in January 2017 and whose parents or guardians refused to receive OPV for these eligible children.”The age-and sex-matched controls(1:1)were obtained from the same locality.Ratios were calculated,and odds ratios(ORs)were determined at 95%confidence interval(CI)and p<0.05.Results:Among the 110 children,64(58%)were male(male to female ratio,1.4:1).The mean age was 29.5 months(range,0.26–60 months).Seventy-four(67.2%)children were living in urban areas and 29(26.3%)children were living in peri-urban and rural areas,while seven(6.3%)were considered nomads.A total of 72(65.2%)children were Punjabi speaking,33(30%)were Saraiki speaking,2(3.7%)were Urdu speaking,and 2(1.82%)were Balochi speaking.Repeated campaigns(n=91,82.7%)was the major reason for OPV refusal.Living at a distance>1 km from a healthcare facility was significantly associated(OR,2.5;95%CI,1.4–4.4;p<0.05)with OPV refusal,while prior visits by healthcare workers(OR,0.11;95%CI,0.06–0.22;p<0.05)and mother’education above primary level(OR,0.42;95%CI,0.24–0.73;p<0.05)were inversely associated with OPV refusal.Conclusion:On the basis of our recommendations,door-to-door social mobilization visits by healthcare workers to alleviate fear,misconception,and fatigue of repeated campaigns and strict accountability mechanism were developed by district government at pre-and intra-campaign levels.