Association between childhood vaccination status and hospitalization due to vaccine-preventable diseases in children

Abstract

Background: Vaccine-preventable diseases remain a significant cause of morbidity and hospitalization for children in LMICs, such as Pakistan. Low immunisation status and nutritional vulnerability can predispose to increased risk of serious illness leading to admission to hospital. In this study, the relationship between childhood immunization status and hospitalization for vaccine-preventable diseases was assessed. Methods: In this prospective study 300 children admitted to a tertiary care hospital in Pakistan were included. Demographic, socioeconomic, nutritional, diagnostic and clinical outcome data was recorded. Vaccination status was grouped as full, partial, or none (for age). Vaccine-preventable disease-related hospitalization was the primary outcome. The data was analyzed by using IBM SPSS Statistics version 27. Univariable and multivariable binary logistic regression analysis were conducted. Results: 112 (37.3%) admissions were due to vaccine preventable diseases. The percentage of children who were fully vaccinated for children hospitalized for VPD was 25.0%, compared to 69.1% of children admitted for reasons other than VPD. However, total adjustment, partial vaccination had 4-fold higher odds (aOR 4.12, 95% CI 2.18–7.79) of VPD hospitalization, and children who were not vaccinated had more than 8-fold higher odds (aOR 8.34, 95% CI 3.78–18.41). Undernutrition also was independently related to VPD hospitalization. Admission to VPD was linked to increased length of hospital stay, complications, increased use of the intensive care unit and mortality. Conclusion: Incomplete vaccination was strongly associated with VPD-related hospitalization and adverse clinical outcomes. Strengthening routine immunization and nutritional support may substantially reduce preventable pediatric hospital burden in Pakistan.