How did the introduction of the measles-containing vaccine second dose (MCV2) affect measles vaccine uptake? – evidence from Nigeria

Figures & data

Figure 1. Flowcharts of analysis sample.

Table 1. Summary statistics.

	Among children before MCV2 introduction (Cohort 1)	Among children after MCV2 introduction (Cohort 2)	Difference (p-value)
	(1)	(2)
N	2,520	4,005
Child age	2.91 [2.37, 3.46]	1.88 [0.54, 3.21]	<.001
Mother’s education
None	1431 (56.8%)	1,549 (38.7%)	<.001
Primary	376 (15.0%)	734 (18.3%)
Junior secondary	147 (5.8%)	322 (8.0%)
Senior secondary	422 (16.8%)	1,121 (28.0%)
Higher/Tertiary	144 (5.7%)	279 (7.0%)
Household wealth
Poorest	841 (33.4%)	1049 (26.2%)	<.001
Second	698 (27.7%)	992 (24.8%)
Middle	507 (20.1%)	877 (21.9%)
Fourth	315 (12.5%)	636 (15.9%)
Richest	159 (6.3%)	451 (11.3%)

p-value for child age is based on t-test, and p-values for education and wealth are based on chi-squared test.

Table 2. Measles vaccine uptake and dropout by cohort [CI95%].

	Received measles vaccine	Received 2nd dose of measles vaccine	Received 1st but not 2nd dose of measles (dropout)
	(1)	(2)	(3)
Panel 1: Among children before MCV2 introduction (Cohort 1)
National	70.8% [69.0, 72.6]	43.4% [41.5, 45.3]	24.3% [22.6, 26.0]
zone
North Central	78.9% [75.9, 81.9]	45.8% [42.2, 49.5]	28.1% [24.8, 31.3]
North East	67.7% [64.2, 71.2]	38.6% [34.9, 42.2]	26.2% [22.9, 29.5]
North West	64.2% [64.2, 67.3]	41.1% [38.0, 44.3]	20.9% [18.3, 23.5]
South East	95.1% [88.2, 102.0]	82.9% [70.9, 95.0]	12.2% [1.7, 22.7]
South South	88.9% [80.2, 97.5]	66.7% [53.7, 79.7]	22.2% [10.8, 33.7]
South West	79.1% [69.1, 89.1]	56.7% [44.5, 68.9]	20.9% [10.9, 30.9]
Panel 2: Among children after MCV2 introduction (Cohort 2)
National	71.0% [69.6, 72.4]	42.9% [41.4, 44.4]	24.7% [23.3, 26.1]
zone
North Central	74.7% [71.4, 78.1]	36.7% [33.0, 40.5]	32.7% [29.1, 36.3]
North East	62.2% [58.6, 65.7]	31.9% [28.5, 35.3]	27.2% [24.0, 30.5]
North West	55.5% [52.3, 58.7]	31.5% [28.5, 34.5]	22.3% [19.6, 25.0]
South East	92.2% [89.7, 94.8]	67.7% [63.2, 72.2]	22.6% [18.6, 26.6]
South South	78.2% [74.9, 81.4]	53.7% [49.8, 57.7]	21.2% [18.0, 24.4]
South West	78.4% [75.2, 81.5]	50.9% [47.1, 54.7]	22.2% [19.1, 25.4]

Figure 2. Measles vaccine uptake and dropout among cohort 1.

Figure 3. Measles vaccine uptake and dropout among cohort 2.

Table 3. Association between measles vaccination uptake and dropout and demographic characteristics, before and after MCV2 introduction.

	Ever received measles vaccine		Received 2nd dose		Dropout (measles1 = yes, measles2 = no)
	Pre RI intro	Post RI intro	Pre RI intro	Post RI intro	Pre RI intro	Post RI intro
	(1)	(2)	(3)	(4)	(5)	(6)
Mother’s education
None	ref	ref	ref	ref	ref	ref
Primary	1.227	1.381	0.987	1.309	1.308	1.284
	[0.925,1.628]	[1.097,1.738]	[0.756,1.289]	[1.049,1.634]	[0.992,1.725]	[1.016,1.624]
Junior secondary	1.801	1.686	1.314	1.33	1.323	1.500
	[1.132,2.865]	[1.223,2.325]	[0.893,1.933]	[1.004,1.787]	[0.882,1.986]	[1.106,2.034]
Senior secondary	2.86	2.306	2.047	1.770	1.076	1.262
	[1.950,4.220]	[1.787,2.976]	[1.535,2.730]	[1.417,2.209]	[0.789,1.469]	[0.991,1.606]
Higher/Tertiary	2.978	3.74	2.825	2.122	0.726	1.266
	[1.498,5.921]	[2.257,6.195]	[1.775,4.496]	[1.519,2.966]	[0.433,1.216]	[0.878,1.824]
Household wealth level
Poorest	ref	ref	ref	ref	ref	ref
Second	1.328	1.149	1.147	1.289	1.23	0.947
	[1.052,1.678]	[0.939,1.406]	[0.915,1.438]	[1.054,1.577]	[0.961,1.576]	[0.766,1.170]
Middle	1.404	1.388	1.191	1.517	1.296	0.974
	[1.056,1.868]	[1.093,1.763]	[0.910,1.559]	[1.210,1.903]	[0.968,1.736]	[0.766,1.239]
Fourth	2.060	1.580	1.448	1.743	1.342	0.818
	[1.360,3.120]	[1.173,2.130]	[1.020,2.055]	[1.334,2.277]	[0.915,1.968]	[0.607,1.102]
Richest	4.280	2.86	1.712	2.042	1.721	0.98
	[2.003,9.145]	[1.854,4.414]	[1.039,2.821]	[1.475,2.827]	[1.008,2.939]	[0.685,1.401]
Urban (vs. Rural)	1.102	1.014	1.226	1.008	0.794	0.909
	[0.831,1.462]	[0.808,1.272]	[0.952,1.579]	[0.825,1.232]	[0.603,1.047]	[0.728,1.135]
N	2464	4005	2513	4005	2503	4005
r2

The result is based on the logistic regression and it includes the state fixed effect.

Table 4. Association between dropout and sociodemographic characteristics, by zone.

	Among Cohort 1						Among Cohort 2
	north central	north east	north west	south east	south south	south west	north central	north east	north west	south east	south south	south west
	Dropout (measles1 = yes, measles2 = no)						Dropout (measles1 = yes, measles2 = no)
	(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)	(11)	(12)
Mother’s education
None	ref	ref	ref	ref	ref	ref	ref	ref	ref	ref	ref	ref
Primary	1.122	1.594	1.882	1	0.909	1.388	1.027	1.176	1.63	0.835	1.321	1.671
	[0.712,1.766]	[0.980,2.593]	[1.213,2.919]	[1.000,1.000]	[0.084,9.785]	[0.087,22.209]	[0.656,1.608]	[0.706,1.958]	[1.024,2.607]	[0.281,2.479]	[0.540,3.236]	[0.745,3.749]
Junior secondary	1.82	1.284	0.842	2.278	2.025	3.724	1.001	2.933	2.327	0.655	1.188	2.823
	[0.968,3.421]	[0.615,2.680]	[0.356,1.992]	[0.239,21.667]	[0.126,32.434]	[0.098,141.262]	[0.526,1.903]	[1.482,5.807]	[1.086,4.987]	[0.205,2.092]	[0.440,3.206]	[1.158,6.881]
Senior secondary	1.005	1.881	0.911	1	0.213	1.525	0.831	1.46	1.957	0.542	1.5	2.316
	[0.637,1.586]	[1.112,3.183]	[0.439,1.892]	[1.000,1.000]	[0.020,2.314]	[0.132,17.685]	[0.519,1.330]	[0.910,2.344]	[1.043,3.671]	[0.186,1.580]	[0.630,3.572]	[1.080,4.967]
Higher/Tertiary	1.101	0.249	1.507	1	1	0.966	1.178	0.467	1.978	0.491	2.012	2.570
	[0.536,2.259]	[0.055,1.131]	[0.514,4.420]	[1.000,1.000]	[1.000,1.000]	[0.049,19.199]	[0.545,2.549]	[0.155,1.407]	[0.586,6.671]	[0.123,1.952]	[0.718,5.643]	[1.044,6.329]
Household wealth level
Poorest	ref	ref	ref	ref	ref	ref	ref	ref	ref	ref	ref	ref
Second	1.41	1.027	1.462	0.601	1	0.288	1.204	1.259	0.664	0.449	1.562	0.936
	[0.914,2.176]	[0.665,1.586]	[0.985,2.169]	[0.039,9.239]	[1.000,1.000]	[0.016,5.280]	[0.785,1.846]	[0.834,1.901]	[0.442,0.997]	[0.214,0.943]	[0.733,3.328]	[0.440,1.988]
Middle	0.973	1.229	1.670	1.23	0.219	0.253	1.059	1.219	1.189	0.297	1.194	1.117
	[0.584,1.623]	[0.729,2.072]	[1.057,2.640]	[0.119,12.703]	[0.015,3.227]	[0.011,6.070]	[0.640,1.753]	[0.718,2.071]	[0.761,1.857]	[0.145,0.612]	[0.565,2.524]	[0.522,2.391]
Fourth	0.798	0.999	1.709	1	0.28	0.96	0.677	0.748	0.99	0.250	1.353	0.825
	[0.407,1.564]	[0.488,2.044]	[0.874,3.339]	[1.000,1.000]	[0.018,4.322]	[0.060,15.408]	[0.334,1.372]	[0.370,1.514]	[0.523,1.875]	[0.110,0.568]	[0.607,3.017]	[0.360,1.894]
Richest	1.056	1.892	1.045	1	1	1.165	0.701	2.002	1.908	0.196	1.002	1.336
	[0.466,2.397]	[0.674,5.310]	[0.325,3.359]	[1.000,1.000]	[1.000,1.000]	[0.046,29.403]	[0.282,1.745]	[0.715,5.603]	[0.695,5.240]	[0.071,0.542]	[0.404,2.484]	[0.579,3.079]
Urban (vs. Rural)	1.157	0.839	0.713	1	1.219	0.777	1.61	0.921	0.457	0.822	1.172	0.988
	[0.697,1.920]	[0.533,1.322]	[0.448,1.135]	[1.000,1.000]	[0.197,7.538]	[0.125,4.825]	[0.952,2.721]	[0.575,1.473]	[0.277,0.754]	[0.361,1.873]	[0.674,2.039]	[0.586,1.667]
N	720	690	948	24	39	67	645	724	928	424	618	666
r2

The result is based on the logistic regression.