Factors associated with uptake of second year of life vaccines among children 24-35 months in Western Region One, The Gambia.

• DPT4 vaccine coverage was 59.5% and MCV2 coverage was 54.4% among children aged 24-35 months
• Children whose fathers did not participate in routine immunization services were nearly twice as likely to have incomplete vaccination
• Caregivers lacking knowledge of MCV vaccination schedules had 2.18 times higher odds of incomplete vaccination
• Mothers with primary or secondary education had significantly lower odds of incomplete vaccination compared to those with no formal education
• Only 25% of health workers correctly identified the denominator for calculating MCV2 coverage

Limitations

The study is cross-sectional and cannot establish causation or track individual children over time. The findings are specific to Western Region One and may not apply to other regions of The Gambia or other countries.

Abstract

INTRODUCTION: A booster dose of Diphtheria-Pertussis-Tetanus (DPT4) and the second dose of Measles Containing Vaccine (MCV2) are recommended in all countries, and these vaccines are scheduled during the Second Year of Life (2YL). There are gaps in coverage between the vaccines given in infancy and the 2YL. This study assesses the caregivers’ factors associated with the uptake of 2YL vaccines and health workers’ knowledge and perception of 2YL vaccination. METHODS: A cross-sectional study design was used. The study participants include 355 caregivers with children aged 24-35 months and 24 health workers who offer immunization services. A multi-stage cluster sampling strategy, based on the WHO 30-cluster sampling method, was adapted to select households. Bivariate and multivariable logistic regression analyses were conducted. RESULTS: The DPT and MCV2 vaccines recorded 59.5% and 54.4% coverage, respectively. About half (49.9%) of the study participants received the OPV Booster. Children of fathers who did not participate in routine immunization services were nearly twice as likely to have incomplete 2YL vaccination compared with those whose fathers participated (aOR = 1.96; 95% CI: 1.00–2.64). The analysis revealed that caregivers who lacked knowledge of the recommended MCV vaccination schedules had higher odds of incomplete 2YL vaccination (AOR = 2.18; 95% CI: 1.01–4.72). Mothers whose education ended at the primary level [aOR = 0.41; CI = 0.19–0.87] and secondary level [aOR = 0.35; CI = 0.18–0.67] had lower odds of incomplete vaccination compared to those with no formal education. Among the 24 health workers interviewed, only 6 (25.0%) correctly identified the denominator used to calculate MCV2 coverage. CONCLUSION: The 2YL vaccine coverage is relatively low in Western Region One. Mothers' educational level, ethnicity, fathers’ participation, and caregivers' awareness of MCV schedules were significantly associated with the uptake of 2YL vaccines among children 24-35 months in WR1. The Ministry of Health should regularly support the continuous professional development of immunization staff.