Peer-reviewed article
Determinants of Second-Dose Measles Vaccination Uptake Among Children Aged 15-23 Months in Benin City, Nigeria: A Mixed-Methods Study
Efemena Daniel Onowugbeda, Pius Agbalugo Odunze, Oghenerukevwe Trinitas Omonigho, Oreoluwa Joshua Orifunmishe, Vincent Yakubu Adam et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study examined how many children in Benin City, Nigeria received the second dose of measles vaccine and why some did not. Researchers surveyed 620 caregiver-child pairs and held focus group discussions with mothers. They found that most children received the first dose, but fewer completed the second dose. Mothers who attended antenatal care during pregnancy were more likely to have their children fully vaccinated. Caregivers explained that poor awareness, forgetfulness, weak reminder systems, and distance to health facilities were common barriers.
Key points
- MCV1 uptake was 90.0% and MCV2 uptake was 82.2% among children aged 15-23 months.
- Dropout between the first and second measles dose was 9.7%.
- Antenatal care attendance was independently linked to higher odds of MCV2 uptake (adjusted odds ratio 3.71, 95% CI 1.72-8.01).
- Caregivers cited poor awareness, forgetfulness, weak reminder systems, competing responsibilities, service unavailability, and distance as barriers.
- Second-dose uptake remained below the 95% target needed for measles elimination.
Limitations
The study is cross-sectional, so it cannot prove that antenatal care attendance causes higher vaccination uptake, only that they are associated; findings are also specific to one city and may not apply elsewhere.
Abstract
Background: Nigeria introduced a second dose of measles-containing vaccine (MCV2) to improve population immunity, but second-year uptake remains insufficiently described in urban settings. Objective: To determine MCV2 uptake, MCV1-MCV2 dropout, associated factors, and caregiver-reported barriers among age-eligible children in Benin City. Methods: This mixed-methods cross-sectional study analysed 460 children aged 15-23 months from a survey of 620 caregiver-child pairs. Six focus group discussions involved 54 mothers. Pearson's chi-square test and multivariable logistic regression assessed factors associated with MCV2 receipt; qualitative data were analysed thematically. Results: MCV1 and MCV2 uptake were 90.0% and 82.2%, respectively. Among MCV1 recipients, dropout was 9.7%. Antenatal-care attendance and health-facility delivery were associated with uptake at bivariate analysis. After adjustment, antenatal-care attendance remained independently associated with MCV2 receipt (adjusted odds ratio 3.71; 95% confidence interval 1.72-8.01). Caregivers described poor awareness, forgetfulness, weak reminders, competing responsibilities, occasional service unavailability, and distance. Conclusion: MCV2 uptake remained below the 95% elimination target. Antenatal and immunisation counselling, reliable sessions, reminder-recall systems, and active defaulter tracking should be strengthened.