Public Knowledge and Opinion on Childhood Routine Immunizations in Two Major Cities of Anambra State, Nigeria

BACKGROUND: Immunization programs suffer recurrent setbacks in developing countries. PURPOSE: We evaluated the knowledge and opinion of parents towards childhood immunization. MATERIALS AND METHODS: A cross-sectional study was conducted among 2400 parents/guardians in two major Anambra cities. RESULTS: The male:female ratio was 1:1 and about two-third (64.3%) of respondents were aged 21–40 years. The majority were married (85.0%), Christians (88.3%), and had heard about childhood immunization (92.3%) mainly from formal settings (56.5%). A little above half (56.2%) of them correctly cited “disease prevention” as reason for childhood immunization. A larger proportion of those that gave this correct response worked in tertiary institutions and had post-secondary school education (p<0.001). The majority of the respondents appropriately agreed or disagreed with opinions that can influence immunization uptake. However, some of them did not agree that immunization was important during the first year of life (16.7%) or afterwards (23.1%); to ensure full immunization (22.8%) or maintain proper immunization records (25.6%) of their children; and to actively support childhood immunization (33.9%). Likewise, some respondents would withhold immunization for perceived fear of adverse reactions (30.7%) or if naturally acquired infection was perceived to confer better protection (28.2%). Respondents who worked in tertiary institutions, and had higher education or family income were more likely to agree or disagree appropriately to opinions. Males had comparable opinions with females although females seemed to do better in opinions that reflect actual vaccination practice. CONCLUSION: Awareness of the term “immunization” was high although knowledge of its indication did not measure up with this awareness, especially among the less educated. Most parents, especially those who worked in tertiary institutions,r had higher income, or education, were favorably disposed towards opinions that could positively influence immunization uptake. Efforts should be intensified at improving awareness on the indication, benefits and safety of immunization, and improving public opinions in order to optimize childhood immunization.