A cross-sectional study conducted in Brazzaville from August 12 to 18, 2024, has shed light on the factors associated with zero-dose vaccination status among children aged 12-23 months. The study, which involved 780 children selected through 30-stage cluster sampling, found that 51.9% of the children had not received any routine vaccines. This proportion is significantly higher than the 35.7% reported in the 2023 national vaccination coverage survey. The study aimed to identify the factors contributing to this trend.
The study used a mixed approach to establish vaccination status, combining maternal or caregiver reports with verification of vaccination documents. Data were collected through face-to-face interviews on tablets via Kobocollect, using a structured pre-tested questionnaire. Bivariate and multivariable logistic regression analyses were used to identify independently associated factors. The results showed that children cared for by babysitters were more likely to be zero-dose.
The study found that several factors were independently associated with zero-dose status. Children whose mothers were aged 20-24 years were more likely to be zero-dose, with an adjusted odds ratio (aOR) of 2.6. Additionally, children whose mothers had a primary education level were more likely to be zero-dose, with an aOR of 3.3. The distance to the vaccination center also played a role, with children living 16-29 minutes away being more likely to be zero-dose.
Perception of vaccination was also a significant factor. Children whose mothers had a negative perception of vaccination were more likely to be zero-dose, with an aOR of 6.3. Those whose mothers had a neutral perception of vaccination were also more likely to be zero-dose, with an aOR of 4.9. These findings highlight the need for targeted interventions to address these factors.
The study's results have important implications for immunization programs in Brazzaville. The high proportion of zero-dose children in the city is a significant challenge, given their vulnerability to vaccine-preventable diseases. The findings suggest that interventions should focus on geographic accessibility, education of young mothers, and restoration of trust in vaccination.
The study's authors emphasize the need for targeted interventions to reduce the number of zero-dose children. They suggest that improving geographic accessibility to vaccination centers, educating young mothers about the importance of vaccination, and addressing negative perceptions of vaccination could help increase vaccination coverage. Such interventions could be implemented through partnerships between healthcare providers, community leaders, and local authorities.
The study's findings are consistent with previous research on zero-dose children. According to UNICEF, zero-dose children are a major challenge for immunization programs worldwide. The organization's data show that in 2021, an estimated 25 million children worldwide had not received any routine vaccines. The study's results highlight the need for continued efforts to address this issue in Brazzaville and beyond.
Key points
- The study found that 51.9% of children aged 12-23 months in Brazzaville had not received any routine vaccines.
- Factors independently associated with zero-dose status included being cared for by a babysitter, maternal age 20-24 years, primary education level, distance to vaccination center, and negative or neutral perception of vaccination.
- Targeted interventions focusing on geographic accessibility, education of young mothers, and restoration of trust in vaccination are needed to reduce the number of zero-dose children.
