Abstract:

Background: Childhood immunization remains one of the most cost-effective preventive strategies against mortality and morbidity among children. The study sought to identify determinants of full vaccination status among children aged 12 to 23 months in Calabar South LGA, Cross River State. The study was a community-based cross-sectional study among 460 children in the 12 to 23 months age bracket, and information about them was obtained from their caregivers. The sample size of 460 was calculated using the Cochran formula. The study is a quantitative component of a bigger mixed-method study conducted from October to December 2023 among 5 wards selected from the 12 wards in Calabar South through a 2-stage cluster sampling. SPSS was used for data entry and analysis, and ethical approval was obtained from the CRS ethical committee (CRSMOH/RP/HREC/2023/401). The prevalence of full vaccination was presented as a pie chart. Bivariate analysis was carried out using Chi-square test statistics while significant variables at 5% were subjected to multivariable regression to identify independent determinants of full vaccination at a 95% confidence interval. The proportion with full vaccination status was 67%, factors associated with full vaccination included the child's sex/age, caregiver's age, education, occupation, relationship to the child, knowledge, and attitude towards vaccination. Independent determinants of full vaccination included caregivers' age, education, occupation, knowledge, attitude, and the occurrence of missed opportunities. Understanding these variations is crucial for policymakers and healthcare professionals to tailor interventions effectively, addressing region-specific challenges and enhancing overall vaccination coverage.

References:

[1]    World Health Organization. United Nations Children's Fund (UNICEF). Global Immunization data. Geneva:WHO;2014.Availablefrom:http://www.who.int/immunization/monitoring_surveillance/global_immunization_data.pdf. 

[2]    Tefera, Y.A., Wagner, A.L., Mekonen, E.B., Carlson, B.F. & Boulton, M.L. (2018). Predictors and Barriers to Full Vaccination among Children in Ethiopia. Vaccines (Basel);6(2):22. doi: 10.3390/vaccines6020022. PMID: 29642596; PMCID: PMC6027055.

[3]    World Health Organization. Immunization Coverage. Available online: http://www.who.int/mediacentre/factsheets/fs378/en/ (accessed on 30 January 2024).

[4]    World Health Organization. (2013). Global status report on road safety 2013: Supporting a decade of action. World Health Organization. https://www.who.int/publications/i/item/9789241564564

[5]    World Health Organization. (2020). World health statistics 2020: Monitoring health for the SDGs, sustainable development goals. World Health Organization. https://www.who.int/gho/publications/world_health_statistics/2020/en/

[6]    World Health Organization. (2021). COVID-19 weekly epidemiological update. World Health Organization. https://www.who.int/emergencies/disease-outbreak-news/item/2021-DON365

[7]    Mbengue, M. A. S., Sarr, M., Faye, A., Badiane, O., Camara, F. B. N., Mboup, S., Dieye, T. N., Determinants of complete immunization among senegalese children aged 12-23 months: evidence from the demographic and health survey. BMC Public Health. 2017 Jul 6;17(1):630. doi: 10.1186/s12889-017-4493-3. PMID: 28683781; PMCID: PMC5501441.

[8]    Tauil, M.C., Sato, A.P. & Waldman, E.A. (2016). Factors associated with incomplete or delayed vaccination across countries: A systematic review. Vaccine, 34(24):2635-43. doi: 10.1016/j.vaccine.2016.04.016. Epub 2016 Apr 22. PMID: 27109562.

[9]    Eze, P., Agu, U. J., Aniebo, C. L., Agu, S. A., Lawani, L. O. & Acharya, Y. (2021). Factors associated with incomplete immunisation in children aged 12-23 months at subnational level, Nigeria: A cross-sectional study. British Medical Journal, 11(6), e047445.

[10]   Adedire, E. B., Ajayi, I., Fawole, O. I., Ajumobi, O., Kasasa, S., Wasswa, P. & Nguku, P. (2016). Immunisation coverage and its determinants among children aged 12-23 months in Atakumosa-west district, Osun State Nigeria: A cross-sectional study. British Medical Centre of Public Health, 16(1), 905.

[11]   Muluye, M., Oljira, L., Eyeberu, A., Getachew, T., Debella, A., Deressa, A. & Dheresa M. (2022). Partial vaccination and associated factors among children aged 12-23 months in eastern Ethiopia. BMC Pediatr. 22(1), 268.

[12]   Oyo-Ita, A., Oduwole, O., Arikpo, D., Effa, E. E., Esu, E. B., Balakrishna, Y., Chibuzor M. T., Oringanje, C. M., Nwachukwu, C. E., Wiysonge, C. S. & Meremikwu, M. M. (2023). Interventions for improving coverage of childhood immunisation in low- and middle-income countries. Cochrane Database System Review, 12(12), CD008145.

[13]   National Bureau of Statistics (NBS) and the United Nations Children’s Fund (UNICEF). (2017). Multiple Indicator Cluster Survey 2016-17, Survey Findings Report. Abuja, Nigeria: National Bureau of Statistics and United Nations Children’s Fund.

[14]   Oladokun, R.E., Lawoyin, T.O., Adedokun, B.O. (2009). Immunization status and its determinants among children of female traders in Ibadan, South-Western Nigeria. Afr J Med Med Sci. 38(1):9-15. PMID: 19722422.

[15]   Fatiregun, A.A., Adebowale, A.S., Ayoka, R.O., Fagbamigbe, A.F. (2013). Assessing full immunisation coverage using lot quality assurance sampling in urban and rural districts of southwest Nigeria. Trans R Soc Trop Med Hyg. 2013 Nov;107(11):731-40. Doi: 10.1093/trstmh/trt079. Epub. PMID: 24062523.

[16]   Muluye, M., Oljira, L., Eyeberu, A., Getachew, T., Debella, A., Deressa, A. & Dheresa M. (2022). Partial vaccination and associated factors among children aged 12-23 months in eastern Ethiopia. BMC Pediatr. 22(1), 268.

[17]   Matta, P., Mouallem, R. & Akel, M. (2020). Parents’ knowledge, attitude and practice towards children’s vaccination in Lebanon: role of the parent-physician communication. BMC Public Health 20, 1439

[18]   Adedire, E.B., Ajayi, I., Fawole, O.I., Ajumobi, O., Kasasa, S., Wasswa, P.& Nguku, P. (2016). Immunisation coverage and its determinants among children aged 12-23 months in Atakumosa-west district, Osun State Nigeria: a cross-sectional study. BMC Public Health;16(1):905. Doi: 10.1186/s12889-016-3531-x. PMID: 27578303; PMCID: PMC5006522.

[19]   Tefera, Y.A., Wagner, A.L., Mekonen, E.B., Carlson, B.F. & Boulton, M.L. (2018). Predictors and Barriers to Full Vaccination among Children in Ethiopia. Vaccines (Basel); 6(2):22. Doi: 10.3390/vaccines6020022. PMID: 29642596; PMCID: PMC6027055.

[20]   Tauil, M.C., Sato, A.P. & Waldman, E.A. (2016). Factors associated with incomplete or delayed vaccination across countries: A systematic review. Vaccine. 2016 May 23;34(24):2635-43. Doi: 10.1016/j.vaccine.2016.04.016. Epub. PMID: 27109562.

[21]   Barrow, A., Afape, A.O, Cham, D. & Azubuike, P.C. (2023). Uptake and determinants of childhood vaccination status among children aged 0-12 months in three West African countries. BMC Public Health.; 23(1):1093. Doi: 10.1186/s12889-023-15863-w. PMID: 37280553; PMCID: PMC10246109.

[22]   Tesema, G.A., Tessema, Z.T., Tamirat, K.S. & Teshale, A.B. (2020).  Complete basic childhood vaccination and associated factors among children aged 12-23 months in East Africa: a multilevel analysis of recent demographic and health surveys. BMC Public Health; 20(1):1837. Doi: 10.1186/s12889-020-09965-y. PMID: 33256701; PMCID: PMC7708214.

[23]   Patel, P.N., Hada, M., Carlson, B.F. & Boulton, M.L. (2021). Immunization status of children in Nepal and associated factors, 2016. Vaccine;39(40):5831-5838. doi: 10.1016/j.vaccine.2021.08.059. Epub 2021 Aug 26. PMID: 34456076.

[24]   Deressa, A.T., Desta, M.S. & Belihu, T.M. (2020). Vaccination Status and Associated Factors among Street Children 9-24 Months Old in Sidama Region, Ethiopia. Ann Glob Health;86(1):4. doi: 10.5334/aogh.2650. PMID: 31934551; PMCID: PMC6952879.

[25]   Yadita, Z.S. & Ayehubizu, L.M. (2021). Full immunization coverage and associated factors among children aged 12-23 months in Somali Region, Eastern Ethiopia. PLoS One; 16(12):e0260258. doi: 10.1371/journal.pone.0260258. PMID: 34874949; PMCID: PMC8651113.

[26]   Etana, B. & Deressa, W. (2012). Factors associated with complete immunization coverage in children aged 12-23 months in Ambo Woreda, Central Ethiopia. BMC Public Health; 12:566. doi: 10.1186/1471-2458-12-566. PMID: 22839418; PMCID: PMC3508824.

[27]   Legesse, E. & Dechasa, W. (2015). An assessment of child immunization coverage and its determinants in Sinana District, Southeast Ethiopia. BMC Pediatr; 15:31. doi: 10.1186/s12887-015-0345-4. PMID: 25886255; PMCID: PMC4438454.

[28]   Yakum, M.N., Atanga, F.D., Ajong, A.B., Eba-Ze, L.E. & Shah, Z. (2023). Factors associated with full vaccination and zero vaccine dose in children aged 12-59 months in 6 health districts of Cameroon. BMC Public Health; 23(1):1693. doi: 10.1186/s12889-023-16609-4. PMID: 37658309; PMCID: PMC10474728.

[29]   Mohamud, A.N., Feleke, A., Worku, W., Kifle, M. & Sharma, H.R. (2014). Immunization coverage of 12-23 months old children and associated factors in Jigjiga District, Somali National Regional State, Ethiopia. BMC Public Health; 14:865. doi: 10.1186/1471-2458-14-865. PMID: 25146502; PMCID: PMC4158082.

[30]   Riaz, A., Husain, S., Yousafzai, M. T., Nisar, I., Shaheen, F., Mahesar, W., Dal, S. M., Omer, S. B., Zaidi, S. & Ali, A. (2018). Reasons for non-vaccination and incomplete vaccinations among children in Pakistan. Vaccine, 36(35), 5288-5293.