Risk factors for the incomplete immunization of children of health workers at a tertiary referral hospital in Surabaya, Indonesia

Background: Health workers as role models play a key role in increasing immunization coverage. The coverage of complete basic immunization in the city of Surabaya is 98.1%, a figure not similar to the incidences of infectious diseases that can be prevented by immunization. This study aims to determine the risk factors for incomplete immunization of the children of health workers. Methods: A case-control questionnaire study comparing incompletely immunized children (case group) and completely immunized children (control group) was done. Participants were children of health workers at a tertiary referral hospital in Surabaya. We conducted interviews and distributed and collected questionnaires from December 2021 to April 2022. Bivariate and multivariate analyses were conducted using the Pearson chi-square test and binary logistic regression. Results: Overall, 148 questionnaires were distributed, 33 of which were excluded due to incomplete data. Therefore, 115 health workers’ children were eligible participants. 62 participants (53.9%) made up the case group, while the control group consisted of 53 participants (46.1%). The average age of the children was 12.5 months, 51.3% were boys and 48.7% were girls. The parental age, parental knowledge, mother's education, and the presence of the coronavirus disease 2019 (COVID-19) pandemic has a significant association with the children’s immunization status with p-values of 0.043, 0.005, 0.002, and p < 0.001, respectively. The children of health workers with a low level of knowledge are 4.8 times more likely to be incompletely immunized (OR 4.887, 95% CI 1.346–35.152). In addition, the possibility of the incomplete immunization of a child is eight times higher for a low-income family (OR 8.679; 95% CI 1.429–52.701). Conclusions: Low levels of parental knowledge and income are associated with the occurrence of incomplete immunization among the children of health workers at a tertiary referral hospital in Surabaya.