Prevalence and predictors of immunization in a health insurance plan in a developing country.

Background: The aim of the present study was to describe rates and predictors of compliance with immunization schedule among children enrolled in the Health Insurance Plan of the American University of Beirut.

Methods: Charts were reviewed for 774 children, and 154 parents underwent a randomly selected sample survey of demographic characteristics, parental behavior and attitudes, and health-care system variables.

Results: The overall compliance rate was 49.9%. By age 4 years, 54.6% of children had taken the required vaccines on time. A total of 86% of parents whose children were non-compliant had recall bias. Age of the child (older), incorrect parental perception of immunization status, mother's low education, and use of other health-care facility, were associated with non-compliance.

Conclusions: Health education about vaccines should be promoted, with an emphasis on high-risk groups. Recall systems and other tools to increase immunization coverage may have an effective role, but in developing countries, aspects such as wide availability of computers and addresses need to be secured before such implementation.