Predictors of timely administration of measles immunization among children aged 12–23 months in Aw-Bare Woreda, Ethiopia

Abstract

Measles remains a leading cause of vaccine-preventable childhood morbidity and mortality, particularly in low-resource settings. Timely vaccination is critical to ensure effective immunity. This study aimed to assess the timely measles immunization status and identify factors associated with timely vaccination among children aged 12–23 months in Aw-Bare Woreda, Ethiopia. A community-based cross-sectional study was conducted among 357 children aged 12–23 months and their mothers/caregivers. Data were collected through structured interviews and vaccination card reviews. Multivariate logistic regression was used to identify factors associated with timely measles vaccination. About 45% of children were vaccinated against measles at the recommended age of 9 months. The remaining 55% were either vaccinated early (4.3%), vaccinated late (21.4%), and not vaccinated at all (29.3%). Factors positively associated with timely vaccination included maternal age 21–30 years (AOR = 2.9, 95% CI 1.10–7.90) and 31–40 years (AOR = 1.92, 95% CI 1.14–3.25), maternal education at primary school level (AOR = 3.75, 95% CI 2.26–9.54), being a housewife (AOR = 2.21, 95% CI 1.1–4.35), married marital status (AOR = 2.53, 95% CI 1.46–4.36), planned pregnancy (AOR = 0.54, 95% CI 0.25–0.87), vaccination at health facility (AOR = 1.44, 95% CI 1.01–2.05), antenatal care attendance (≥ 3 visits AOR = 3.13, 95% CI 1.50–5.03), Children born at home (AOR = 0.62, 95% CI 0.44–0.88), postnatal care (AOR = 2.21, 95% CI 1.55–3.16), and maternal knowledge about vaccination programs (AOR = 2.53, 95% CI 1.46–4.36). Children cared for by caregivers other than their biological mothers were less likely to be vaccinated on time (AOR = 0.19, 95% CI 0.05–0.66). Timely measles immunization coverage among children aged 12–23 months in Aw-Bare Woreda remains suboptimal. Key factors positively associated with timely immunization include maternal age, education, marital status, planned pregnancy, paternal education, place of vaccination, and utilization of antenatal, place of delivery, and postnatal care services. Enhancing maternal knowledge and strengthening maternal health service access are critical to improving timely measles vaccination coverage in this community.