ArticleVaccines2022
Correlates of Zero-Dose Vaccination Status among Children Aged 12-59 Months in Sub-Saharan Africa: A Multilevel Analysis of Individual and Contextual Factors.
Article in Vaccines, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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The trial behind it
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Who cites it
30 citing papers in PubMed, 40 citations in OpenAlex.
- Predicting zero-dose vaccination status in 27 sub-Saharan African countries: a machine learning approach.BMJ health & care informatics · 2026Article
- Progress in reaching zero-dose children: analysis of population-modifiable risk factors and inequity trends in low- and lower-middle-income countries.International journal for equity in health · 2026Article
- Factors contributing to incomplete vaccination among children aged 12 to 59 months in Mbale city, Eastern Uganda: a caregivers and health workers' perspective.BMC pediatrics · 2026Article
- Spatial distribution and multilevel determinants of unvaccinated children in Somaliland: analysis of the 2020 Somaliland Health and Demographic Survey (SLHDS).BMC public health · 2026Article
- Determinants of childhood vaccination differ between conflict-affected and non-conflict regions in Cameroon.Frontiers in public health · 2026Article
- Understanding barriers to immunization among women with zero-dose or under-immunized children in an urban area in Cameroon.Frontiers in public health · 2026Article
- Risk factors associated with Shigella diarrhea in 6-35-month-olds: A cross-sectional study, Malawi, 2022-2024.PLOS global public health · 2026Article
- Article
- Behavioural and social drivers of immunisation among zero dose children in pastoralist communities of Ethiopia: a qualitative study.BMJ open · 2025Article
- Multiple deprivations as drivers of suboptimal basic child vaccination in Latin America and the Caribbean: cross-sectional analysis of household survey data for 18,136 children across 211 regions in 15 countries.International journal for equity in health · 2025Article
- Predictors of incomplete childhood vaccination in four West African countries: a population based cross-sectional study.Scientific reports · 2025Article
- Risk factors associated with zero-dose and under-immunized children, and the number of vaccination doses received by children in Ethiopia: a negative binomial regression analysis.BMC public health · 2025Article
- Article
- Individual and community level maternal factors for zero-dose children in Ethiopia using mini-EDHS 2019: a mixed effects model.BMJ open · 2025Article
- Prevalence and determinants of full vaccination coverage according to the national schedule among children aged 12-35 months in Ghana.Scientific reports · 2025Article
- Article
- Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India.BMJ public health · 2025Article
- Mapping zero-dose children in Kenya - A spatial analysis and examination of the socio-demographic and media exposure determinants.PloS one · 2025Article
- Determinants of vaccination coverage during the COVID-19 pandemic among children aged 12-23 months in southern Ethiopia: a cross-sectional study.Frontiers in pediatrics · 2025Article
- Prevalence and Trends of Not Receiving a Dose of DPT-Containing Vaccine Among Children 12-35 Months: An Analysis of 81 Low- And Middle-Income Countries.Journal of epidemiology and global health · 2024Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
Despite ongoing efforts to improve childhood vaccination coverage, including in hard-to-reach and hard-to-vaccinate communities, many children in sub-Saharan Africa (SSA) remain unvaccinated. Considering recent goals set by the Immunization Agenda 2030 (IA2030), including reducing the number of zero-dose children by half, research that goes beyond coverage to identify populations and groups at greater risk of being unvaccinated is urgently needed. This is a pooled cross-sectional study of individual- and country-level data obtained from Demographic and Health Surveys Program and two open data repositories. The sample includes 43,131 children aged 12-59 months sampled between 2010 and 2020 in 33 SSA countries. Associations of zero-dose status with individual and contextual factors were assessed using multilevel logistic regression. 16.5% of children had not received any vaccines. Individual level factors associated lower odds of zero-dose status included mother's primary school or high school education, employment, use of antenatal care services and household wealth. Compared to children in countries with lower GDP, children in countries with relatively high GDP had nearly four times greater odds of being unvaccinated. Both individual and contextual factors are correlated with zero-dose status in SSA. Our results can inform efforts to identify and reach children who have not received any vaccines.
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