AUTHOR’S REPLY

Year : 2019  |  Volume : 63  |  Issue : 2  |  Page : 161

Author's Reply for article “Vaccine Hesitancy for Childhood Vaccinations in Slum Areas of Siliguri: A Critical Commentary”

Pallabi Dasgupta¹, Sharmistha Bhattacherjee², Abhijit Mukherjee², Samir Dasgupta^3
1 Demonstrator, Department of Community Medicine, RG Kar Medical College, Kolkata, India
² Assistant Professor, Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri, West Bengal, India
³ Professor, Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri, West Bengal, India

Correspondence Address:
Sharmistha Bhattacherjee
Department of Community Medicine, North Bengal Medical College and Hospital, Post: Sushrutanagar, Siliguri - 734 012, West Bengal
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijph.IJPH_80_19

1. We agree to the point raised by readers here. However, in the backdrop of the slum area, and our study covering grossly all childhood vaccinations, responses solely based on mothers'/caregivers' responses could not be relied on. Hence, we used immunization cards for validating the responses. The World Health Organization Strategic Advisory Group of Experts on immunization has defined vaccine hesitancy as “delay in acceptance or refusal of vaccination despite the availability of vaccination services.” Vaccine hesitancy occurs along acontinuum between full acceptance and outright refusal of all vaccines, i.e., when there is acceptance of some and delay or refusal of some of the recommended vaccines^[2]
2. In the present study, birth doses are operationally defined as vaccines given within 14 days.^[1] Moreover, there needs a minimum gap of 4 weeks between the primary doses.^[3] Hence, if a child is vaccinated after 4 weeks of the scheduled period, he is already late for the next dose. In the sociocultural context of the area, she might be even out of the cascade of immunization. Hence, based on previous studies^[4] and experts' opinion, we used this operational definition
3. In a widely promoted and structured routine immunization delivery system in India, forgetfulness can be a proxy indicator for hesitancy. Further exploration in this regard was beyond the scope of our study
4. Within limitations of our study, we have explored few aspects of this emerging problem. Further researches could be done for in-depth exploration of “reluctance.”

References

1.	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.   [PUBMED]  [Full text]
2.	World Health Organization. Department of Immunization, Vaccines and Biologicals (IVB). SAGE October, 2014. Geneva: World Health Organization; 2014. Available from: http://www.who.int/immunization/sage/meetings/2014/october/Yellow-bookSAGE2014_final.pdf?ua=1. [Last accessed on 2019 Feb 17].
3.	Ministry of Health and Family Welfare, Government of India. Handbook for Vaccine and Cold Chain Handlers. 2nd ed. New Delhi: Government of India; 2016. p. 8-9.
4.	Yadav K, Srivastava R, Kumar R, Chinnakal P, Rai SK, Krishnan A. Significant vaccination delay can occur even in a community with very high vaccination coverage: Evidence from Ballabgarh, India. J Trop Pediatr 2012;58:133-8.