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Immunization remains the most important and cost effective public health strategy for disease prevention. However, routine immunization coverage in Nigeria has continued to fall below average. Missed opportunities are one of the obstacles to raising immunization coverage among children, leading to resurgence of vaccine preventable diseases. This study was to determine the prevalence of missed opportunities for immunization against the eight diseases listed in the national programme on immunization (NPI) schedule and the associated factors in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. This was a cross sectional study involving 307 mother-neonate pairs attending the immunization clinic of Nnamdi Azikiwe Teaching Hospital, Nnewi between April and June 2010. The participants were recruited consecutively and interviewed with a semi-structured self-administered questionnaire. Most mothers (70.0%) had good knowledge of immunization and their main sources of information were the antenatal clinic (57.3%) and the media (27.0%). Their perception of immunization services in the teaching hospital was generally good (93.2%). The prevalence of missed opportunities for immunization was about 17%. Lack of vaccine(s), visit of client on a wrong day and vaccine not opened because of few clients were the major reasons for non-immunization, accounting for 44.2%, 36.6% and 15.4% respectively. The commonest vaccines missed were those given at birth and six weeks of age (BCG, OPV0, OPV1, HBV1 and DPT1). Mothers Age , education and knowledge of immunization were not significantly associated with missed opportunities. The identified reasons for missed opportunities in this study seem to be associated with the health facility. These should be addressed through adequate communication between mothers and health workers, training of health workers and policy flexibility. Keywords: missed opportunity, immunization, teaching hospital, Nnewi, Nigeria.
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