Non-uptake of dual protective polio vaccine and its determinants among children in Ethiopia using Ethiopian Demographic Health Survey 2019: a mixed-effect model

Abstract

INTRODUCTION: The polio vaccine is the live-attenuated antigen that prevents poliomyelitis. According to a report by the WHO, about 1 million less than 5-year-old children missed the polio vaccination from 2018 to 2021. Even though Ethiopia is the most prioritised country for polio eradication, there is not enough evidence about the combined oral and inactivated vaccine in Ethiopia. OBJECTIVE: To assess the non-uptake of the dual protective polio vaccine and its determinants among children in Ethiopia using the Ethiopian Demographic Health Survey (EDHS) 2019. METHODS: The secondary data analysis of a community-based cross-sectional study was conducted using EDHS 2019 data among 3094 participants. Mixed-effects binary logistic regression was used for descriptive analysis and identifying the predictors using a p value of <0.05. Intraclass correlation was used to assess the clustering effect. RESULTS: The prevalence of non-uptake of the dual protective polio vaccine in Ethiopia was 44% (95% CI 42.2% to 45.8%). Predictors like women with low proportions of community media exposure (adjusted OR (AOR)=2.3, 95% CI 1.8 to 2.8) and no history of antenatal care visits (AOR=2.3, 95% CI 3.89 to 6.35) were significantly associated with non-uptake of the dual protective polio vaccine. CONCLUSION: The burden of non-uptake of the dual protective polio vaccine in Ethiopia was still high. Low community media exposure and no antenatal care utilisation were the predictors of non-uptake of the dual protective polio vaccine. We recommend improving media access and antenatal care services to expand polio vaccination.