Prevalence of vaccine hesitancy and its associated factors in an urban area of West Bengal, India

Rajib Sikder, Dipankar Mukherjee, Ujjwal Pattanayak, Kunal Kanti Majumdar, Subha Sankha Kundu, Rituraj Dey, Gautam Kumar Joardar


Background: Vaccine hesitancy is delay in acceptance or refusal of vaccines despite availability of vaccine services. This study was conducted to find out the prevalence and factors associated and contributing to vaccine hesitancy for childhood vaccinations in Rajpur-Sonarpur municipalty of south 24 parganas, India.

Methods: A cross‑sectional study was done among 352 children aged 0-59 months. Hesitancy to all childhood vaccination including the birth doses were observed. By simple random sampling ward no 8 was selected among the 37 wards of Rajpur-Sonarpur municipalty. All the vaccination center of ward no 8 on various vaccination days were covered from July 2019- December 2019. Data were collected at these vaccination centers by interviewing parents /associates of the children. Validated version of vaccine hesitancy survey questionnaire by the World Health Organization was used.

Results: Vaccine hesitancy was present among 103 (29%) parents/relatives /associates of children. Delay was more common for measles and the booster doses of other vaccines. Reluctance to vaccinate was the most common reason (26.2%) for vaccine hesitancy. About 15(15.4%) parents reported to be unaware or confused of when to vaccinate their children. Improper counselling by health care givers, illness or irritability of the child were other causes.

Conclusions: To avoid delay in vaccination weekly vaccination days were recommended. Community level campaigning and home visit of those eligible children to generate awareness about vaccination and to avoid reluctance in parents/associates of children were suggested.


Vaccine hesitancy, Childhood vaccination, Vaccine delay

Full Text:



Black S, Rappuoli R. A crisis of public confidence in vaccines. Sci Transl Med. 2010;2:61.

Leask J. Target the fence‑sitters. Nature. 2011;473:443‑5.

Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007‑2012. Vaccine. 2014;32:2150‑9.

World Health Organization. Department of Immunization, Vaccines and Biologicals (IVB). SAGE October 2014. Geneva: World Health Organization; 2014. Available from: https://www. Accessed on 20 January 2020.

The SAGE Working Group. Summary WHO SAGE. Conclusions and Recommendations on Vaccine Hesitancy. Available from: immunization/programmes_systems/summary_of_sage_vaccinehesitancy_2pager.pdf?ua=1. Accessed on 22 January 2020.

Ministry of Health and Family Welfare. District Level Household and Facility Survey‑4; West Bengal Factsheet (2012‑13). Mumbai, India: International Institute for Population Science; 2012‑13. Available from: Accessed on 20 January 2020.

Madhavi Y, Puliye JM, Mathew JL, Raghuram N, Phadke A, Shiva M, et al. Evidence‑based national vaccine policy. Indian J Med Res. 2010;131:617‑28.

Thakrar DV, Kanabar BR, Patel UV, Kadri AM, Oza JR, Mitra AH. Assessment of facilities for routine immunization at urban health centres of Rajkot city, Gujarat, India, November 2014. Sch J Appl Med Sci. 2016;4:3208‑12.

Dasgupta P, Bhattacherjee S, Mukherjee A, Dasgupta S. Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri, India. Indian J Public Health. 2018;62:253-8.

Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G, et al. Communicating with parents about vaccination: A framework for health professionals. BMC Pediatr. 2012;12:154.

Ministry of Health and Family Welfare, Government of India. National Family Health Survey 2015‑16: State Fact Sheet West Bengal. Mumbai (India): International Institute for Population Science; 2016. Available from:

Barman D, Dutta A. Access and barriers to immunization in West Bengal, India: Quality matters. J Health Popul Nutr. 2013;31:510‑22.

Clark A, Sanderson C. Timing of children’s vaccinations in 45 low‑income and middle‑income countries: An analysis of survey data. Lancet 2009;373:1543‑9.

Lauridsen J, Pradhan J. Socio‑economic inequality of immunization coverage in India. Health Econ Rev. 2011;1:11.

Sharma S. Socioeconomic factors of full immunization coverage in India. World J Vaccines. 2013;3:102‑10.

Naeem M, Adil M, Abbas SH, Khan MZ, Naz SM, Khan A, et al. Coverage and causes of missed oral polio vaccine in urban and rural areas of Peshawar. J Ayub Med Coll Abbottabad. 2011;23:98‑102.

Corsi DJ, Bassani DG, Kumar R, Awasthi S, Jotkar R, Kaur N, et al. Gender inequity and age‑appropriate immunization coverage in India from 1992 to 2006. BMC Int Health Hum Rights. 2009;9(1):S3.

Mathew JL. Inequity in childhood immunization in India: A systematic review. Indian Pediatr. 2012;49:203‑23.

Patel TA, Pandit NB. Why infants miss vaccination during routine immunization sessions? Study in a rural area of Anand district, Gujarat. Indian J Public Health. 2011;55:321‑3.

Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM. Parental vaccine safety concerns in 2009. Pediatrics. 2010;125:654‑9.

Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G, et al. Immunization attitudes and beliefs among parents: Beyond a dichotomous perspective. Am J Health Behav. 2005;29:81‑92.

Mandal NK, Sinhamahapatra B, Sinha N, Mukhopadhyay DK, Das R, Biswas AB. Child immunization and vitamin A supplementation in the district of Bankura, West Bengal. Int J Med Public Health. 2011;1:22‑6.

Singh P, Yadav RJ. Immunization coverage in Bihar. Indian Pediatr. 1998;35:156‑60.

Manjunath U, Pareek RP. Maternal knowledge and perceptions about the routine immunization programme- A study in a semiurban area in Rajasthan. Indian J Med Sci. 2003;57:1.