DOI: 10.4103/jfmpc.jfmpc_749_26 ISSN: 2249-4863

A cross-sectional study to estimate the magnitude and predictors of zero-dose children aged 0–23 months in rural Patna

Tajwar Yasmeen, Setu Sinha, Tulika Singh, Anshuman Sinha, Sanjay Kumar, Muhsin Moidu
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BSTRACT

Background:

Zero-dose children, those lacking their first diphtheria, pertussis, and tetanus (DPT) vaccine, are a critical target under Immunization Agenda 2030. Yet, empirical data from rural Bihar remain scarce. This study evaluates zero-dose prevalence and its sociodemographic determinants among children aged 0–23 months in rural Patna.

Methods:

We conducted a community-based cross-sectional study (January–June 2024) using probability-proportional-to-size cluster sampling to enroll 300 children. We triangulated caregiver interview data with vaccination cards, facility registers, and the Universal Immunization – Win portal. Bivariate associations were assessed using Chi-square and Fisher’s exact tests. Multivariable logistic regression was used to adjust for confounders.

Results:

Zero-dose prevalence was 4.0% (12/300). Vulnerability clustered strongly. The status was significantly associated with Muslim religion ( P = 0.0003) and low maternal education ( P = 0.0017), independent of child sex or family type. Most vaccinated children accessed local Anganwadi centers/subcenters (80.6%) on foot (71.9%). Conversely, all zero-dose children lacked immunization cards. Systemic mistrust was the primary barrier. Two-thirds (66.7%) of their caregivers reported distrusting vaccines or health authorities, and 33.3% feared adverse events. Strikingly, a quarter (25.0%) of these zero-dose children received a birth bacillus Calmette–Guérin vaccine before dropping out.

Conclusion:

Overall zero-dose prevalence in this setting is remarkably low, but the remaining burden is highly localized. Bridging this final gap requires a targeted approach. Health systems must actively track dropouts who establish initial contact at birth, paired with outreach programs.

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