Vaccination Status and Its Determinants Among Children Aged 12 to 23 Months in Mettu and Sinana Districts, Oromia Region, Ethiopia: A Comparative Cross Sectional Study

Abstract

Background

Globally, more than 19 million children have not received all of their vaccination benefits, resulting in an estimated one million deaths worldwide each year. Vaccine-preventable diseases are becoming more common in Ethiopia, despite the fact that official vaccination coverage is sufficient to develop herd immunity locally for some diseases such as measles. This mistrust of the official report prompted us to conduct a community survey and compare it to other areas where there have been no reports of vaccine-preventable disease.

Methods

A community-based comparative cross-sectional study was conducted from 20/01–20/02/2021 in Sinana and Mettu districts. Probability proportional to estimate size was used to select 23 clusters. We recruited 228 from Mettu and 436 from Sinana by systematic random sampling. We used a structured questionnaire to collected data from mother–child pair using card and history. We conducted independent t-tests to test coverage differences between districts. We identified determinants of full vaccination status by multivariate logistic regression analysis after bivariate candidate selection.

Results

Fully vaccinated children accounted for 62.7% in Sinana and 91.6% in Mettu, demonstrating a significant coverage difference (p<0.001). Being a resident of Mettu (AOR: 3.5, 95% CI [1.5, 6.9]), intended pregnancy (AOR 5.9, 95% CI [2.4, 11.3]), 4 or more antenatal care visits (AOR: 2.09, 95% CI [1.4, 3]), having postnatal care (AOR: 3.5, 95% CI [1.6, 7.9]), younger child age (AOR: 0.87, 95% CI [0.8, 0.9]), having up to three children (AOR 3, 95% CI [1.13, 8]) and good knowledge of vaccine schedule (AOR: 2.4, 95% CI [1.4, 4]) were associated positively with full vaccination status.

Conclusion

Full vaccination status was 91.6% in Mettu and 62.7% in Sinana district. Place of residence, ANC, PNC, pregnancy intention, child number, age of child and knowledge of vaccination schedule were significantly associated with vaccination status of the children.

Keywords:

• vaccination status
• determinants
• 12–23 months children
• Mettu district
• Sinana district

Abbreviations

ANC, Antinatal Care; AOR, Adjusted Odds Ratio; BR, Birth Rate; CDC, Communicable Disease Control; CI, Confidence Interval; CMYP, Comprehensive Multiyear Plan; CVDPV, Circulating Vaccine Derived Poliovirus; DEFF, Design Effect; DPT, Diphtheria, Pertussis and Tetanus Vaccine; EDHS, Ethiopian Demographic Health Survey; EPI, Expanded Program of Immunization; GAVI, Global Alliance for Vaccine and Immunizations; GIVS, Global Immunization Vision and Strategy; GVAP, Global Vaccine Action Plan; Hep B, Hepatitis B Virus; Hib, Hemophilus Influenza B Virus; HMIS, Health Information Management System; ICC, Intra-Cluster Correlation Coefficient; IM, Infant Mortality; MCV, Measles Vaccine; MDG, Millennium Development Goal; MNT, Maternal and Neonatal Tetanus; MR, Mortality Ratio; NWPV1, New Wild Poliovirus; PCV, Pneumococcal Conjugated Vaccine; PNC, Postnatal Care; PPS, Probability Proportion to Size; RED, Reaching Every District; SOS, Sustainable Outreach Services; UNICEF, United Nation Children’s Fund; VPD, Vaccine Preventable Disease; WHO, World Health Organization; YC, Number of Years of eligible children in the cohort.

Data Sharing Statement

Data will be available upon request to the corresponding author.

Ethics Approval and Consent to Participate

This study was conducted according to the principles of the Declaration of Helsinki.⁴⁴ Ethical clearance was obtained from Jimma University, Institute of Health, Institutional Review Board (IRB) research committee offering to review the ethics of research design and objectives. Official letter was written to Bale and Ilu Aba Bora zonal health office and then to Sinana and Matu districts and to selected kebele administrators. After explaining the study objectives, each study participant provided written informed consent. Respondents participated on a voluntary basis. Participants were informed that the information to be collected was anonymous; those who were unhappy during the interview were asked to leave, and only those who were willing were interviewed. Throughout the research process, response confidentiality was maintained. Respondents’ privacy and cultural norms were respected.

Acknowledgments

We would like to extend our thanks to Jimma University for providing a conducive environment that helped us to conduct this study. We are also very glad to forward our special thanks for the unlimited assistance of hospital and health center managers. Our sincere thanks also go to data collectors, supervisors and the study participants for their contribution to this work.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in relation to this work.

Additional information

Funding

No funding was received for this particular study.