Adverse events following immunization: orchestrated outcome of mothers' knowledge and behavior on vaccination practices

Neel M. Mishra, Sandeep Dhingra, K. M. Adhikari


Background: Adverse events following immunization (AEFI) are a common occurrence in children after vaccination and can lead to loss of trust in the immunization program. Fear of AEFIs is a major factor implicated in ‘Vaccine Hesitancy’ as seen in countries with high vaccination coverage and low burden of vaccine preventable diseases. The study aimed at assessing the knowledge, attitudes and practices of mothers regarding AEFI and its impact on vaccination of their children

Methods: A descriptive, cross sectional survey was conducted at the immunization clinic of a tertiary care hospital of western India. Mothers attending the immunization clinic were interviewed using a validated questionnaire. A sample size of 221 was derived based on the incidence of common AEFIs.

Results: Awareness of AEFI was present in 86.4% participants while only 28% mothers confirmed that information regarding AEFIs was given to them at the time of immunization. Though awareness of minor side effects like fever (98%) and local reaction (85%) was good, less than 15% of the mothers were aware of serious AEFIs such as seizures and anaphylaxis. Only 66% mothers indicated that they would first consult their doctor in case of an adverse effect. Knowledge regarding true contraindications to vaccination was poor.

Conclusions: Awareness of the possibility of AEFI was good and trust in immunization as a vital health intervention was intact. Awareness about serious AEFIs which necessitate prompt management was inadequate while that for minor side effects was satisfactory. Healthcare seeking behavior of mothers to serious AEFIs was appropriate.


Adverse events, Attitudes and practices, Immunization, Mothers knowledge

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